By an adults’ social worker
When frontline workers in my local authority raise issues regarding the current crisis in adult social care, our senior managers and politicians throw back at us that there is a commitment to integrating services fully with the NHS. “Integration” has become a watchword, a talisman that will bring about a new dawn in the provision of care.
This is all well and good (and we have been working productively with NHS colleagues for a long time), but it’s blatantly obvious that the ongoing financial deprivation that the government is imposing on local authorities and the NHS is making this very difficult, if not nigh on impossible. The situation is worsened by the fact that workers struggle to engage in productive integrated-working when, for much of our time, we’re able to do little more than “firefighting” in maintaining those services that are still available and desperately seeking to fill the gaps.
All this has been brought into sharp relief by recent local events. Our local NHS Trust is (secretly) formulating “Sustainability and Transformation Plans” and, despite a stated objective of reducing the length of hospital admission, important and successful (and, I would suggest, cost effective) preventative resources are being shut down due to funding restrictions.
‘Earmarked for scrappage’
A rehab ward, described as “excellent”, was closed last week, despite sustained campaigning by the public, unions, service users, professionals and political parties. The ward provided a fine service for patients and played a major role in care planning and the reduction of delayed discharges. Staff, which comprise a social worker, reablement workers and assistant practitioners, now face redundancy or redeployment and even more pressure will be imposed upon acute hospital wards and their staff as well as upon social care systems.
Alongside this, the last Admiral Nursing service in the county has now been earmarked for scrappage. This is following a recent “promise” that the service’s future would be secure. Admiral Nurses are dementia specialists who work with people with dementia and their carers in the community. The service has repeatedly proved that it is more than fit for purpose.
These examples are only the tip of the proverbial iceberg. Add to this situations such as social workers having to go cap in hand to panels to get clearance for even the most basic of services to be put in and you have a picture of health and social care systems that are under the kind of pressures that should have no place anywhere in the 21st century, let alone in a highly developed country like ours. Staff morale is on the floor.
I suppose that at least one positive note is that the grandees who oversee our creaking health and social care systems are beginning to acknowledge that the crisis is almost wholly down to systematic underfunding by central government. It’s also heartening to see the rise in grass roots activism by service user and community groups. Of course, more of this is needed, and, as a union rep I’m always encouraging colleagues to join and become active in defending services and working conditions. At the end of the day, though, the buck stops at Downing Street and Parliament and, until we get a government that pays more than lip service to decent health and social care, things can only get worse.
Also, until then, integration between our services (which are currently barely integrated within themselves) will be nothing more than a selling point.