Ploughing more money into social care is not the solution to the crisis facing our care system, writes the deputy leader of Sevenoaks DC. Instead, we must move upstream: properly prioritising prevention and looking at everything from housing to community inclusion.
If the staff at the Environment Agency were faced with a problem at the mouth of a river, they would not seek to solve it by focusing all their efforts there. Instead, they would move upstream to tackle the causes. In the same way, the route to reducing demand on social and hospital care is to move further upstream and tackle the reasons why people need more care.
The current system is broken. It needs a complete overhaul to ensure it works with the modern demands of people living longer and growing more frail as they age. But that does not necessarily mean they cannot live independently with a system that supports them. As the government plans a green paper on social care and reviews NHS funding, it must focus on promoting independence and look beyond the care system to do so.
For instance, a major cause of hospital admissions for people over 65 is trips and slips that lead to broken bones, a stay in hospital and, in many cases, a move from home to residential care. So the green paper needs to have falls prevention as a significant goal. This can be addressed by constructing more purpose-built homes that are both wheelchair accessible and designed to prevent slips and trips.
For those who don’t wish to move, home adaptations are essential. Encouraging older people to exercise and strengthen their core muscles will also help to prevent falls. Chair yoga, swimming and gentle walking groups for older people don’t only help prevent falls but they also help with loneliness.
For the 850,000 UK people currently living with dementia – and that number is set to rise to over one million by 2025 – it is vital to stay in familiar surroundings for as long as possible. Home adaptations so that kitchen cupboards are made transparent and easier to find things in, and the use of technologies that remind people to take their medication, have lunch and go for a walk, can all support this. Dementia-friendly communities that wrap around the home can provide even more support for people as they step out of their front door.
Loneliness in the modern world is absolutely toxic and is estimated to cost the NHS alone £10bn a year. That does not include the costs to social care. Local housing policies that aim to keep families and communities together is a great first step in addressing this modern epidemic. Local commissioning of smaller charities and voluntary groups is also essential as people trust the local brands they have known all their life and more likely to be willing to accept their help or volunteer for them. Large scale commissioning may be more economical, but it is killing off smaller groups and making loneliness worse.
The green paper needs to take a health-in-all-policies approach at both central and local government level to ensure that by solving problem A, they have not created health problems C, D and E. A cautionary tale is the removal of the local connection criteria for shared ownership homes. This contributed to breaking up families and to loneliness in older people. We need to at least prioritise local people in order to keep families and communities nearby.
At a local government level, meanwhile, more resources need to be put into prevention and more emphasis placed on the role that districts play in two-tier areas. In unitary areas, this role is often downplayed to focus on social care. If we carry on in this way we will always have a health and social care problem for older people. This is not only financially costly, but it is cutting people’s lives short and removing some of their quality of life.
In the same way that the Environment Agency looks upstream to solve problems, the green paper needs to step back and focus on preventing the things that leave people needing health and social care. It will mean the government needs to be brave as it is always easier to throw more money at the current problem. But that will only provide a temporary fix before yet more money is needed again – and ultimately this is not fair on the people we represent.
Michelle Lowe (Con), deputy leader, Sevenoaks DC