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Social Care and Health working together
00A – 31 Jan
Care at Home in England 4th February 2010, Edinburgh
Janet CramptonDH National Programme Manager, Ageing Strategy & Intergenerational Project
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Social Care and Health working together
00A – 31 Jan
The English story ….…Building a Society for All Ages
1. The Older People & Dementia branch of the Department of Health’s Social Care Directorate
2. The context which is informing the need for change
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Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
• National Dementia Strategy• Partnerships for Older People project• Dignity in Care (With Respect)• Green Paper on future funding of social
care• NHS reforms• NHS Operating Framework• End-of-Life and Palliative Care
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Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
1. The Older People & Dementia branch of the Department of Health’s Social Care Directorate
2. The context which is informing the need for change
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Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
2. The context in which is informing the need for change :
• demographic, economic and political challenges
• an ageing workforce
• strategic shifts from acute to prevention
• greater investment in home-based solutions
• move from buildings/service-based to individual needs
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Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
2. The context in which is informing the need for change (contd) :
• role of housing and home-based services
• Increasing using of telecare
• sharing risk and giving people more control
• partnership working to deliver better outcomes
• commissioning ‘fundamentals’ – Getting it right, because it matters!
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Social Care and Health working together
00A – 31 Jan
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Social Care and Health working together
00A – 31 Jan
% increase in older people in England
Rapid growth of over 65s in next 10 years
<10% Increase
10%-18%
18%-26%
>26% Increase
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Social Care and Health working together
00A – 31 Jan
34% of the population will be 50+ in 2009 – with concentrations in ‘retirement areas’
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Social Care and Health working together
00A – 31 Jan
By 2029 over 40% of the population will be over 50 - and virtually everywhere in the country will look like current ‘retirement areas’
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Social Care and Health working together
00A – 31 Jan
Why does England need to change?
• A reminder of the present system
– Based on matching a limited range of services to people’s assessed needs – not meeting growing expectations
– Costs are rising and services are under increasing demographic pressures
- Many services are still very ‘traditional’
– Many people assess the current situation as being ‘in crisis’
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Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
Local authorities' response
– Commissioners are still buying commodities and focusing on unit costs – time/task etc – and NOT outcomes
- Looking to make efficiency savings (including shifting largevolumes of in-house services to the private and voluntary sectors) (Different in England to Scotland)
– Changing eligibility criteria to restrict access.
The current system of social care is not sustainable
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Social Care and Health working together
00A – 31 Jan
The Cost of Healthcare
• NHS spending represents 7.3% of UK GDP
• £20bn efficiency savings needed in 2011/14
(equivalent of 6% of NHS budget)
• Parliamentary moves to reduce spending on healthcare, social care and public spending generally
• People are to take more responsibility for their own health, their own care
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Social Care and Health working together
00A – 31 Jan
The Cost of Social Care (PSS)
• Diverging patterns of social care commissioning across UK
• £20.7 bn on PSS in 2007/08
• £15.3 bn on adults and older people’s PSS
- 48% on residential care
- 43% on domiciliary care
• 40,000 new referrals every week
• 1.77m clients receiving PSS in 07/08
• Fewer and fewer people to provide services
• More and more people needing services
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Social Care and Health working together
00A – 31 Jan
Living – and dying – with LTC
We need less
inappropriate referral to unnecessary treatment
hospitalisation for the elderly with dementia
traditional response and ‘medical model’
End-of-Life care in institutionalised settings
avoidance of the sensitive but essential issues unhelpful bureaucracy and poor regulation
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Social Care and Health working together
00A – 31 Jan
Living – and dying – with LTC
We need more and better
pain management
ensuring the right to a ‘good death
(but) giving people a live, not a service
focus on real needs and people’s choices
innovation and creative solutions
staff training
more telecare and smarter use of all available resources
keeping people active, healthy and happy
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Social Care and Health working together
00A – 31 Jan
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Social Care and Health working together
00A – 31 Jan
Thank you for listening
Janet Crampton
National Programme Manager
Department of Health’s Social Care Programmes
+ 44 7789 653196