During the festive break the headlines regarding the crisis in A&E departments have come thick and fast – almost on a daily basis. Hospitals are at breaking point with unprecedented demand especially from older people with complex needs. Waiting times are at an all time high and government targets have gone out of the window. I’m sure that there are many contributing factors that have impacted on this crisis but the cuts to social care services, intervention and rehabilitation must be key contributors. Building a more robust social care sector is part of the solution it seems clear to me.
I am currently studying towards an MBA and have discovered an interesting idea generation tool that I feel could be put to good use to unravel the current social and health care crisis. Known as ‘negative (or reverse) brainstorming’ the concept in simple terms is to look at the worst way to approach the achievement of objectives. One that is likely to result in their failure. Having identified these negatives, the theory is to then to look at the reverse of these points to discover the best way forward. So I thought I’d apply it to our sector and see what I came up with. I pondered the worst possible way to develop social care in order to meet the needs of a growing population and reduce the impact on health services. Here is what I came up with.
- Ignore the fact that social care is being under-funded. Reduce available budgets year on year even though the demand for services is rising. Promote personalisation, control, independence and choice as the right of all individuals when requiring care but provide budgets that make these ‘rights’ aspirational.
- Publicly push the intention to integrate health and social care but continue to make budgeting and planning decisions in silos. Fail to see the bigger picture of social care’s potential contribution to reducing the demands on the health service at a time when A&E departments are reaching ‘breaking point’. Throw more money at the NHS to resolve the resultant crisis rather than investing in social care services that could intervene much earlier in the demise of an individual’s health.
- Continue to leave social care budgets without a ring-fence including new potential funding streams, for example the NHS Transfer money. Ensure that complicated financial systems prevent the tracking of how and where such funds are spent and how efficient or effective the expenditure has been.
- Increase social care eligibility criteria to benefit only the most vulnerable in society and commission brief home care visits for the majority of older people. Place reliance on families or neighbours to fill the voids where possible. Accept chronic loneliness and social isolation as collateral damage from budget cuts and society’s problem.
- Tender for contracts from providers that promise quality home care but provide the service at a price that does not afford the minimum wage for care workers.
- Consider care homes and nursing homes as a last resort that form no part in resolving the issues of growing pressure on NHS admissions or discharges. Fund such placements at a sub-market level that affords minimum wage for their employees to make recruitment and staff retention problematic. Ignore the fact that the fee levels and the consequences of such have the potential to impact on the quality of care provided.
So now all that I need to do is to look at the reverse of these points and that should provide me with a pathway to understanding how to achieve the set objectives. But hang on a moment….is it just me or do these ‘negative’ points sound familiar? Perhaps the powers that be forgot to carry out the second part of the exercise!
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