Health services which were designed for a certain kind of simplicity – illnesses and accidents which could be cured or fixed - are now faced with the increasingly complex reality for people who have multiple, interrelated health conditions and wider life challenges.
Attempts to simplify services are often based on ‘single front doors’ and providing advisors or coordinators who can navigate complex systems. Wouldn’t it be better to create genuine simplicity: health and care services in which people with long term support needs deal with a small, consistent group of people, all focused on ordinary life goals: somewhere good to live, people to love, something meaningful to do.
Case study: Dave
‘Dave’ is in his fifties. He sustained head injuries inflicted by his father as a child and has experienced a lifetime of bipolar disorder, which Dave cannot recognise and manage.
Dave spent many years living in shelters, where he was very vulnerable to coercion, but has since lived with an approved Shared Lives carer for nine years. He may never live completely independently, but Dave now has a network of positive friendships which have expanded his life in the community. He watches his local football club with the son of his previous Shared Lives carer. He dresses smartly and manages his personal care and medical treatment. He saves money and has had several holidays. His Shared Lives carer can identify signs when his mental health is deteriorating and get help. Dave no longer has to exchange favours to keep friends, but likes to help neighbours on his street to put out their bins and receives many Christmas cards in return.
Dave’s array of needs make him look ‘complex’ to single-issue services, but the solution to living a good life was not technical: he needed a stable relationship and a group of friends and supporters, like any of us.
There are 10,000 Shared Lives carers, approved and trained by one of the UK’s 150 regulated schemes who match them with an adult who needs support. Together, they share family and community life. Half of the 14,000 people using Shared Lives move in with their chosen Shared Lives carer; half visit for day support or overnight breaks. People get safe, personal care and support, in a place which feels like home. They make friends and become more active.
The Care Quality Commission rates Shared Lives as better than all other forms of social care - and on average Shared Lives costs £8,000 a year less for people with mental ill health.
An independent evaluation showed how Shared Lives support improved people’s mental health through improvements in general wellbeing, increased participation in community life, crisis prevention, gaining independence, and specific examples where hospital stays were prevented. A 2013 survey said that 30% of people in Shared Lives had their first holiday; 17% started volunteering or found a job and nearly all made friends: a third made five or more friends.
Shared Lives carers have a demanding role, and they can only do that work with input from health and other professionals, but Dave’s experience, those of the people in ‘My Choice, our Life’ and hundreds of others show that simple responses are sometimes the best.