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A little faith could go a long way

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There is a worrying amount of fog swirling around adult social care at the moment obscuring the welcome clarity of vision and direction
generated by the Care Bill, now back in Parliament.

The current position is as ambiguous as I can remember.

I attribute this to three things. The most obvious is the dissonance between ambition in the bill and the day-to-day realities of managing with a lot less money. Councils have worked hard to mitigate the impact but there is growing evidence of stress in the system. The transformation needed is daunting.

The second is the confusion surrounding the status of funding from the NHS for iterations it has been subject to local determination between commissioners. The government says it can help mitigate the effects of cuts and secure new efficiencies from integration. The chief executive of the NHS has made it clear he is accountable for its use to secure health gain and he wants clear sight of it.

The third issue is the focus on means rather than ends. A lot of effort is being focused on the mechanics of integration, prevention, personalisation and entitlement, to the detriment of simpler solutions to getting better outcomes.

It was refreshing to chair a session at the national sector conference in Harrogate recently that showcased the work of Prevention Matters programme, developed with the Innovation Unit.

It builds on the common hunch that we are missing a trick by focusing just on those with high-end needs. Their leap of faith is that investment now in a preventative model could see a 25% reduction in demand by 2016.

Most striking is the wide engagement of more than 100 local organisations and the focus on motivating and enabling people to make the most of their assets, interests and support.

There is a commitment to track the impact of this on a target cohort of 20,000. We need this combination of rigour and fresh thinking to keep the plates spinning.


Andrew Cozens, chair, Carers Trust

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