Reconstructing social care in England

Categories: Care.

Over the next month we will feature articles from a range of organisations and individuals involved with end of life care, on their perspectives and experiences of social care.

The series will bring together some of the national and local drivers for changing social care for dying people, and highlight how some organisations are making change a reality. Articles have been contributed by people from different organisations and in different roles, with a common goal – to improve the care of the dying. 

If you would like to write a brief article for ehospice on the importance of social care to people approaching the end of life, or a new service or approach you or your organisation has developed to improve the social care available to dying people, please contact the editor

Overhauling social care

The Queen’s Speech announced a bill to reform social care, which is expected to be introduced to Parliament within the coming weeks. The announcement follows a period of consultation and pre-legislative scrutiny of the draft care and support bill.

Once the bill is introduced to Parliament, a period of debate will take place in both Houses of Parliament, the outcome of which will shape the content of the bill and ultimately whether the bill will become legislation.

The bill, which sets out a new legislative framework and funding system for social care, could have a significant impact on the care of people approaching the end of life.

The growing crisis

The announcement comes as the latest annual survey of social care budgets carried out by the Association of Directors of Adult Social Services (ADASS) shows that the funding situation for social care is “already bleak” and “getting bleaker”. 

According to ADASS president Sandie Keene: “Gazing into the next two years, without additional investment from that already planned, an already bleak outlook becomes even bleaker.”

The survey shows substantial savings have already been made by adult social care, with more planned. However, 13% of the planned savings (£104 million) will result in direct withdrawal of services.

In the care and support white paper, which set out the vision for the new system, the Coalition Government stated that it saw much merit in providing social care for people in the last 12 months of life free at the point of delivery – recommendations of the Palliative Care Funding Review and the Dilnot Commission which also have the support of the joint committee on the draft care and support bill.

Recognition of the importance of social care at the end of life is not new.

A shift in culture

The Department of Health’s End of Life Care Strategy (2008) called for a shift in the culture of social and healthcare workforce. Cultural transformation takes a long time and progress is difficult to measure. However, we know that some organisations involved in the care of the dying already have a culture that leads to better outcomes for dying people.

A shift in practice

Such organisations can help speed up cultural change in others by developing partnerships and collaborative projects to share best practice and support improvements. Some of the articles in this series highlight how successful this approach can be to changing the experiences of dying people.

This reflects a report by the National Audit Office on End of Life Care (2008), which called for social care and health to work more closely together to improve the care of the dying. Partnerships and collaboration will help to join up care, as well as address the legacy of underfunding and undervaluing the social care system. 

The future

We cannot be certain that the care and support bill will be passed, as reform of the social care system has eluded many previous governments. However, the country’s finances and changing demography provide little room for reform to be delayed further; indeed, as our social care series will show, many are already working to address issues with the current system.

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