Reflections on the last decade
In the last decade, we have had significant changes in legislation, which created opportunities to put wellbeing, prevention, personalisation and integration at the centre of the way the health and care
sector works. This is a great move away from the wholesale approach of care management to something more personal. However, putting policy aspirations into practice in the face of austerity is proving really difficult. It seems austerity has overshadowed supporting people to have a better life. For example, 28 years ago, as a local authority manager, I was paying care workers more per hour than most are paid in actual terms today. As a sector we have literally devalued our workforce.
Projections for the next decade
I don’t think anyone needs a crystal ball to make headline projections for social care over the next decade. Doing things the way we do them now will not be sustainable with more demand and limited resources, which many people who use services would say is a potential opportunity.
At Think Local Act Personal (TLAP) we support a new approach. We see the solution as one of enabling people to work with their support providers and community to make best use of available resources. For example, the take up of individual service funds as a good alternative for those who do not want to manage a direct payment.
Personalisation is also gaining momentum in health through personal health budgets. I believe this is the way to achieve integration driven by the needs of the individuals with lived experience.
TLAP as a partnership has existed for eight years. I became Director in December 2015 and since I have been here, I have been incredibly impressed by what can be achieved when the whole sector works together. The challenges in the sector are now so great that no one party has the answer. This brings the opportunity for providers, people and communities to have more influence both locally and nationally.
At TLAP, we work co-productively so everyone is around the table from the start. Working this way saves a lot of wasted time and energy.
In my life, it’s my fantastic, long-suffering, supportive family. In my career, the amazing people who work in the sector and use services with their mix of compassion, good humour and determination.
The most important lesson I’ve learned is that we all need to listen to people who use services, their families and carers and build good relationships with them. Whenever I have been involved in reviews of untoward incidents or read reports from high profile enquiries, there were always individuals who tried to tell the professionals or organisations that there was something wrong, but they were ignored.
The best advice I received was in the form of a challenge. When I worked for Ian Winter CBE at the London Joint Improvement Partnership, he always challenged our plans and proposals with the words, ‘and what difference is that going to make to people who use services?’ It’s what we should all ask ourselves.
Organisational values and culture flow from its leaders. If the culture in your organisation is great, then share the credit with everyone involved. If it’s not, take a long hard look at yourself!
The notion of ‘us and them’ is, for me, the single most corrosive attitude in health and social care, whether that is between organisations, leaders and staff, or professionals and the individuals we all serve. People who use services, families and carers are the ones who have the greatest investment in us all succeeding. See them as a resource and support. At TLAP, they are my constant inspiration and source of constructive challenge.
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