This week Jeremy Hunt tried to make it clear to the doubters that the creation of a Department of Health and Social Care is more than cosmetic. In a wide-ranging speech on social care, Jeremy Hunt acknowledged that he feels the 'weight of stalled reform programmes' to social care on his shoulders.
Seven principles will guide the reforms he leads, including driving up quality, integrating care around the person, and giving people more control. But underpinning these principles will be a commitment to back the most innovative models of social care and scale these to reach many more people. He said:
'We will therefore look at how the government can prime innovation in the market, develop the evidence for new models and services, and encourage new models of care provision to expand at scale.'
We should welcome this statement. For too long social care has been subject to short-term thinking and firefighting, commissioning models of care that neither provide good value nor better outcomes for people who receive care. The sector has been starved of investment and it is very difficult to stop one way of delivering services and start another – what can be known as ‘double running’ – when you don't have the money. But this is not the only reason the sector has become stuck: we need to find better ways to commission the innovative models of care we know exist, including helping people who purchase or manage their own care to find and in some cases, co-design them.
In a report published earlier this year with Nesta and PPL, we highlight effective approaches for scaling well-evidenced innovative models of care, avoiding endless cycles of short-term ‘pilots’. We point to examples such as North Yorkshire council’s innovation fund, Age UK’s holistic model of support to help older people stay independent, and the growth of family-based Shared Lives which thinks small and personal but has reached national scale.
Wellbeing, resilience and independence
Scaling innovation locally starts with people who make long term use of services, their families and front-line workers being involved in co-design. Strategic goals need to be aligned around more human goals: wellbeing, resilience and independence, reflected in funding and incentives that demand and pay for them.
Creativity is often locally-driven, but there is a place for Government action which recognises that many areas’ resources are committed in just keeping existing services afloat. We are calling on the Government to create an innovation scaling fund, to demonstrate new approaches to scaling across local areas, incorporating the most evidence-based and promising models of care.
Jeremy Hunt acknowledged in his speech that the task facing Government is daunting, but the models of care and support which could transform people’s experience of care and support already exist: we just need to have the courage to back them.
Alex Fox is CEO of Shared Lives Plus and the author of A new health and care system: escaping the invisible asylum published by Policy Press. Ewan King is director of business development and delivery, the Social Care Institute for Excellence.