If you want to transform the system, you need to talk to the whole of it. And for health and social care, that includes adult social care providers.
Everyone agrees that integration between social care and health services is a good thing, despite its faltering steps. Recently the public accounts committee said that while there are places where integrated working has been successful, “it is a long way from being in place everywhere”, citing “longstanding legal, structural and cultural barriers” to change.
One big barrier is that organisations which provide adult social care services are often excluded from discussions. Residential and nursing homes care for 460,000 people in the UK, many of whom have multiple complex health needs, and over 500,000 more rely on social care at home.
For the last 18 months, the Care Provider Alliance has urged sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) to engage independent and voluntary adult social care at a strategic level.
NHS England’s June 2018 publication Breaking Down Barriers appeared to support our involvement in talks by including care homes and home care services on the list of system parts that should “come together” to form local STPs.
In practice we have found that is rarely the case. Only a few STPs include the independent and voluntary adult social care sector in membership or on senior boards.
Adult social care providers who have had contact with STPs have not always enjoyed the experience. We have been told it did not feel like a consultation, providers were involved too late, the partnership was too NHS-focused, or that it made little or no effort to engage.
Our alliance sees this as a huge missed opportunity and can flag local examples where the sector has been engaged beneficially. A recent publication by Nice as part of the Quality Matters programme features two areas where collaboration with local care associations helped work progress.
Thus our message to local authority and health leaders is that the independent and voluntary adult social care sector is ready for collaboration to ensure people receive properly joined-up care at a local level.
We urge NHS and local authority leaders in every area to look again at whether this is an opportunity they may be missing.
Michael Voges, chair of the Care Provider Alliance and chief executive of Associated Retirement Community Operators