‘Unsustainable’ social care services face overhaul

Social care services in Northern Ireland face an overhaul after the country’s health minister today declared them “unsustainable in their current form”.

Edwin Poots was announcing the terms of reference for a review of health and social care that is intended to ensure their affordability in the face of tightening budgets over the next four years.

The review will be focused on shifting services out of acute and institutional settings into the community but is also likely to consider a larger role for independent providers, as in the rest of the UK.

Currently in Northern Ireland, most adult care is delivered by the country’s five health and social care trusts.

The review, led by Health and Social Care Board chief executive John Compton, has been asked to learn from arrangements in England, Wales and Scotland.

Last week, Poots said the independent sector was “particularly well placed to deliver the flexible and responsive services we need to enable people to live as independently as possible for as long as possible”.

The review will look at the quality and accessibility of health and social care services and how they take into account the needs of users and carers. Compton will present proposals to Poots for their reconfiguration by 30 November.

“The review needs to proceed without delay given the seriousness of the situation facing our health services,” Poots said today. “However, it must be evidence-based with robust analyses and conclusions on future service delivery.”

Poots has appointed a team of five external advisers to the review: Chris Ham, chief executive of the King’s Fund, GP Dr Ian Rutter; retired health and social care civil servant Paul Simpson; healthcare academic Professor Deirdre Heenan of the University of Ulster; and Mark Ennis, executive chair of energy company SSE Ireland.

Though Compton is a former social worker, the absence of any social care professional on the advisory panel sparked concerns that the review would be health-dominated.

Northern Ireland Association of Social Workers chair Lesley McDowell said: “I know that this is a concern across social work and social care in that the focus appears to be very much on health. There appears to be a gap in so far as there is no one with a background in social care.”

She called for a social care specialist to be appointed to advise the review.

McDowell also pointed out that the Northern Ireland Executive had protected the health budget from 2011-15 but was making cuts to social care, despite the fact that the two services are integrated at commissioning and provision level.

“It’s very short-sighted,” she added. “It’s domiciliary social care that prevents vulnerable people from going into hospital and helps discharge them at the optimum time.”

Responding to McDowell’s call for a social care representative to be appointed to the panel, a spokesperson for Northern Ireland’s Department of Health, Social Services and Public Safety said: “The expert panel brings with it a wide range of skills, experience and expertise. And indeed John Compton, who is leading the review, comes from a social work background. 
 
“It is important to note that stakeholders will also be encouraged to engage in this process. There will be opportunities for individuals and organisations to make a contribution throughout the course of the review, including those with a background or particular interest in any aspect of social care.”

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