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Adass: Integration must not see NHS 'swallow' care

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The development of a sustainable homecare workforce is key to the success of the latest push to integrate health and adult social care, according to the new president of the Association of Directors of Adult Social Services.



Harold Bodmer

Speaking to LGC ahead of taking up his new role at the Adass Spring Seminar this week, Harold Bodmer (pictured), director of community services at Norfolk CC, laid out his priorities for the coming year.

He said local government must ensure the development of 44 health and social care sustainability and transformation plans across the country – as ordered by the health service’s national leadership – did not result in social care being absorbed into the NHS.

Mr Bodmer also said homecare providers should play an important role in developing new models of delivery under the STP process, which would improve pay and conditions for staff, alongside outcomes for service users.

He said: “There are real issues about sustainability, availability, models of commissioning and models of delivering [homecare] – and making sure it fits in to the whole pathway of integration. We need to think how we support that workforce differently.

“It is not just about money, it is about how we do it and how people are trained and supported.”

Mr Bodmer said delivery models should focus more on outcomes, rather than the current “time and task” approach, with providers incentivised to develop people’s independence and sense of wellbeing.

“It is about a different kind of relationship that people have to the community in which they work and incentives could be based on outcomes individuals have identified themselves,” he added.

Currently three of the STP leaders are senior council figures. 

Mr Bodmer said local government was best placed to ensure a community-based approach to developing effective delivery models.

He said: “What we bring to the table is making sure that social care does not get swallowed up in the NHS and we also bring to the process democratic accountability that is responsible to local communities.

“Working with individuals, organisations and communities is very different from some of the way the NHS has traditionally worked.”

Mr Bodmer welcomed the 2% council tax precept for adult social care and said it would help raise public awareness of how society supports vulnerable people.

But he questioned whether government funding via the precept and better care fund, backloaded over the final two years of the spending review term, would be sufficient.

“If savings were ever easy to be made then they have been made. The money being taken out now will have an impact on individuals – we would be dishonest to pretend otherwise.”

He added the opportunities provided by STPs, the devolution agenda and the better care fund meant failure to improve the system was not an option.

“If we can’t do it now, we might as well pack up and stop talking about it,” he said.

“We have to do it; we can’t sustain a health system without it and can’t sustain the current social care system without joining in some way with the NHS.”

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