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Social Care and Health working together
00A – 31 Jan
Care at Home in England 4th February 2010, Edinburgh
Janet CramptonDH National Programme Manager, Ageing Strategy & Intergenerational Project
Social Care and Health working together
00A – 31 Jan
The English story ….…Building a Society for All Ages
1. The Older People & Dementia branch of the Department of Health’s Social Care Directorate
2. The context which is informing the need for change
Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
• National Dementia Strategy• Partnerships for Older People project• Dignity in Care (With Respect)• Green Paper on future funding of social
care• NHS reforms• NHS Operating Framework• End-of-Life and Palliative Care
Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
1. The Older People & Dementia branch of the Department of Health’s Social Care Directorate
2. The context which is informing the need for change
Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
2. The context in which is informing the need for change :
• demographic, economic and political challenges
• an ageing workforce
• strategic shifts from acute to prevention
• greater investment in home-based solutions
• move from buildings/service-based to individual needs
Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
2. The context in which is informing the need for change (contd) :
• role of housing and home-based services
• Increasing using of telecare
• sharing risk and giving people more control
• partnership working to deliver better outcomes
• commissioning ‘fundamentals’ – Getting it right, because it matters!
Social Care and Health working together
00A – 31 Jan
Social Care and Health working together
00A – 31 Jan
% increase in older people in England
Rapid growth of over 65s in next 10 years
<10% Increase
10%-18%
18%-26%
>26% Increase
Social Care and Health working together
00A – 31 Jan
34% of the population will be 50+ in 2009 – with concentrations in ‘retirement areas’
Social Care and Health working together
00A – 31 Jan
By 2029 over 40% of the population will be over 50 - and virtually everywhere in the country will look like current ‘retirement areas’
Social Care and Health working together
00A – 31 Jan
Why does England need to change?
• A reminder of the present system
– Based on matching a limited range of services to people’s assessed needs – not meeting growing expectations
– Costs are rising and services are under increasing demographic pressures
- Many services are still very ‘traditional’
– Many people assess the current situation as being ‘in crisis’
Social Care and Health working together
00A – 31 Jan
Building a Society for All Ages
Local authorities' response
– Commissioners are still buying commodities and focusing on unit costs – time/task etc – and NOT outcomes
- Looking to make efficiency savings (including shifting largevolumes of in-house services to the private and voluntary sectors) (Different in England to Scotland)
– Changing eligibility criteria to restrict access.
The current system of social care is not sustainable
Social Care and Health working together
00A – 31 Jan
The Cost of Healthcare
• NHS spending represents 7.3% of UK GDP
• £20bn efficiency savings needed in 2011/14
(equivalent of 6% of NHS budget)
• Parliamentary moves to reduce spending on healthcare, social care and public spending generally
• People are to take more responsibility for their own health, their own care
Social Care and Health working together
00A – 31 Jan
The Cost of Social Care (PSS)
• Diverging patterns of social care commissioning across UK
• £20.7 bn on PSS in 2007/08
• £15.3 bn on adults and older people’s PSS
- 48% on residential care
- 43% on domiciliary care
• 40,000 new referrals every week
• 1.77m clients receiving PSS in 07/08
• Fewer and fewer people to provide services
• More and more people needing services
Social Care and Health working together
00A – 31 Jan
Living – and dying – with LTC
We need less
inappropriate referral to unnecessary treatment
hospitalisation for the elderly with dementia
traditional response and ‘medical model’
End-of-Life care in institutionalised settings
avoidance of the sensitive but essential issues unhelpful bureaucracy and poor regulation
Social Care and Health working together
00A – 31 Jan
Living – and dying – with LTC
We need more and better
pain management
ensuring the right to a ‘good death
(but) giving people a live, not a service
focus on real needs and people’s choices
innovation and creative solutions
staff training
more telecare and smarter use of all available resources
keeping people active, healthy and happy
Social Care and Health working together
00A – 31 Jan
Social Care and Health working together
00A – 31 Jan
Thank you for listening
Janet Crampton
National Programme Manager
Department of Health’s Social Care Programmes
+ 44 7789 653196