Thursday, 21 July 2005
Joining up health and social care
Nothing would make better sense and be more welcome than for health and social care to be joined up and seamlessly delivered, since that is the way users need to access services. The Government’s proposals – shortly to be consulted on in tandem with healthcare options outside of hospital - have considerable implications for “independence and risk taking” and could lead to individual care package payments to people with long-term conditions to spend as they thought best. This is a welcome idea if people want this (one size will not suit everyone), and individuals have the capacity to handle it. People living with long term conditions who could manage their own care might become their own “key worker”.
The ideas trailed in the current Green Paper on adult social care, however, say nothing about moving to a system of free personal care, as exists in Scotland. That will leave means tested social care services (which themselves vary from local authority to local authority) meshing poorly with free NHS services and so the confusion in England will continue despite the joined up rhetoric.
Another aspect that needs highlighting is that complaints and redress procedures for social care services are likely to be subsumed into the more bureaucratic NHS complaints system. Currently the local authority complaints process produces better and quicker investigation and local resolution of complaints and concerns from users and carers. Local resolution and speed are elusive objectives often times in the NHS complaints procedure. A health and social care connection whose redress system reflected the known shortcomings of the NHS side of the partnership would be a step backwards for users and should be resisted.
And where in all of this are there any coherent proposals for users and carers to have a voice? Perhaps it will all be revealed in the White Paper anticipated for September.