Providers must collaborate, not compete, to avert social care crisis, says review

Care providers should be incentivised to work together rather than “driven apart by divisive tendering processes” to help avert a crisis in social care.

The call comes as part of a five-point plan to establish a sustainable health and social care system in the face of public spending reductions, rising expectations and demographic pressures, issued by an independent review today. Though the Who Will Care? Commission was established by Essex council to examine the challenges facing the county, its recommendations have nationwide implications.

Its report set out five “high-impact” solutions to the impending care crisis:

• Public services must be more upfront and honest with residents about the challenges of providing care;
• The focus of health and social care should shift from treating disease and chronic conditions to supporting people earlier;
• Services must make greater use of community resources;
• Technology should be used to help people to live independently;
• Leadership must bring the work of public, private and voluntary sector together.

On leadership, it said a care partnership, with an independent chair, should be set up across Essex, to bring together health and social care commissioners and providers to decide how a “single pot” of money should be spent in commissioning services to meet agreed outcomes. As part of this, commissioners should incentivise providers to work together to develop integrated services, rather than compete against each other through tendering processes, on the grounds that this would improve value for money.

The care partnership, which should report to the county’s health and well-being boards, should also develop strategies to deliver the commission’s other “high-impact solutions”.

On early intervention, it said commissioners needed to identify and map people with emerging care needs and then provide them with intensive support before they reach crisis point. In addition, people should have access to a care co-ordinator of their choice to help them take responsibility for meeting their needs, with this service likely to be provided by the voluntary sector. It said there was “great scope and need for a new skilled workforce to support this recommendation”.

The commission’s chair, Thomas Hughes-Hallett, said encouraging individuals and communities to take greater responsibility for their care and support would be a vital component in averting a social care crisis.

“Carrying on as we are is not an option because we’re on the verge of a real crisis in care for families in Essex,” said Hughes-Hallett, former chief executive of Marie Curie Cancer Care. “It is clear to us that the ability to take more control over our care really is the only game in town.”

To deliver this, the commission called for the creation of an accessible guide to accessing care in Essex, and for GPs and other professionals to be given tools to help people manage their own care.

In addition, commissioners should offer seed funding and training to help local schemes provide care and support on a voluntary basis and establish a county-wide Neighbourhood Watch-type scheme to ensure that every household in Essex has a team or individual charged with spotting early signs that someone may need support.

Essex council leader David Finch said he was going to ask the council’s health and well-being board to develop plans on how to take the commission’s recommendations forward.

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