By Ralph Cook, Channel 3 Partner.
When I watched the first episode of “Inside the care crisis with Ed Balls”, a new two-part BBC documentary hosted by former MP and Shadow Chancellor Ed Balls, I was struck on many levels – with admiration, emotion and frustration in equal measure. Admiration for the care staff at the frontline, emotion from the personal stories they shared and frustration that we are still failing to grasp the reality of the UK’s social care challenge and deliver a new model of health and care that is fit for our age.
When you hear frontline staff framing themselves by saying “I’m just a carer… in a dead-end job…” and reflecting that they don’t feel valued by society at large, you can see the scale of the challenge. The programme highlighted that a key first step is to improve the nation’s understanding of adult social care (ASC) and the challenges it faces. Only then will the impetus for sustainable change be realised. This is something the sector has known for some time yet has failed to accomplish.
Further, when carers demonstrate their skills, empathy, passion and a relentless work ethic, we must question how this profession is not rewarded with similar levels of pay and career progression that exist over the fence in the NHS.
As much as these current challenges are real and significant, the programme also struck me on a more fundamental level.
The principles of supply and demand are at play. The care home model is not sustainable in its current form. Put simply, fewer people want to go into care homes. This is leading to spare capacity, which in turn undermines care homes’ financial sustainability. The reality is that care homes will continue to play an important role in the future model of health and care (likely in support of more specialist conditions) but their role will be smaller. We know that most people aspire to remain independent in their own homes for longer and that in future many will choose alternative housing with care and support options that can better meet their needs.
Many of the existing 11,000 care home settings are simply not fit for purpose and undermine the sector’s ability to deliver the highest quality care. Seeing the fear on the face of one resident in the programme as she tried to descend the stairs brought this to life in stark form. The wider challenges of adapting the existing estate to make it more fit for purpose and embedding the latest digital and care technologies will only add pace to the strategy of moving away from the current dependency on the existing care home physical infrastructure.
The sector is in transition to a new model of health and care where more people will be supported to remain independent at home and where there will be a greater number of alternative forms of ‘care ready’ and technology-enabled housing options. Digitally-enabled social care will enable us to deliver better lives and better care – realising the following outcomes:
Predictive analytics and technology-enabled care will support more people to remain independent at home for longer and prevent some from ever needing formal care and support.
When people do require formal care and support, they will retain higher levels of independence through technology-enabled care and housing.
There will be a step change in the experience of people, families and carers engaging with the social care as a digitally-enabled operational environment improves intelligence, capacity, collaboration, agility and personalisation.
There will be a considerable improvement in the lives of those who do reside in ‘care ready’ and technology-enabled housing options through improved quality of care.
The sector will continue to rely heavily on the passion, skills and empathy of frontline staff. But by deploying them in these alternative settings and digitally enabling them to work more effectively, the sector can dramatically improve the quality of care it delivers and the outcomes it achieves.
However, delivering this transition will be both disruptive and costly. Disruptive because a care home is just that – a ‘home’. Moving people from one setting to another is not a simple matter like changing hotels. It can seriously affect the wellbeing we are trying to improve. Costly because of the significant investment required to change the model of health and care, to digitally enable the support of more people at home and build alternative forms of care ready and technology-enabled housing options.
The future for health and care can be bright. Given the system is currently looking after our parents and one day we will all rely on it to support us or our loved ones, you would think we would give it the priority of focus and investment it both requires and deserves.
Ralph Cook has over 20 years of consulting experience within the public sector, more recently specialising in designing and delivering complex transformation programmes across health and social care.
Before joining Channel 3, Ralph held positions at Syntegra, BT Global, PwC and latterly IMPOWER where he was the national lead for Adult Social Care and the interface with Health. In recent years Ralph has helped the sector pioneer thinking in the areas of demand management, sustainable change in complex systems, behavioural science and intermediate care. Ralph is passionate about working with the public sector to tackle the most complex problems and improve lives.