When the former Secretary of State for Health and Social Care announced that the social care Green Paper was to be delayed until Autumn, there was a collective sigh of resignation, exasperation, frustration and, at some level, a note of desperation. This was the Green Paper that had been due to make an appearance in 2017 – pushed forward to Summer 2018 and now promised as the mists roll in and the nights get longer.
Of course, since this announcement, we now have a new Secretary of State, Matt Hancock, and it will be of great interest to see how he views the Green Paper and, crucially, its relationship with the NHS ten-year plan. The two documents should demonstrate strong synergy and support the development of greater integration.
Early indications about the new leader suggest that he is very interested in the role of technology in both health and care, and this has potentially significant implications for the sector in how future revenue and capital investments move forward. As politicians regroup after recess, further details will need to emerge as to how Government intends to run the forthcoming Comprehensive Spending Review process, and the sector will need to have a united voice to influence this key political milestone.
If we were to solely focus on the technology – what are the things that we should be ensuring are clear and present within the Green Paper? The first has to be the news that social care is both ready for and, in some areas, actively involved in a radical transformation from the adoption of technology.
I regularly talk to providers who are piloting and rolling out technological transformation in care planning, medication management, back office and key areas of recruitment and retention. I have seen the introduction of virtual reality to support people with reminiscence or involvement in experiences they cannot physically join in, or to enhance training and learning by providing opportunities to ‘walk in someone’s shoes’. The growing presence of robots, such as ‘Pepper’ leading Zumba sessions and robotic pets including seals, horses, cats and dogs offering comfort and connection are all breaking down perceptions of the potential role of robotics and the response of people living within care settings interacting with technology.
We know that we can adopt and utilise technology; but we also want the Green Paper to be clear about how we know that it makes a difference.
One of the biggest challenges for social care is collecting and interpreting validated data on the impact of provision. This challenge includes understanding just how important this data will be in enabling the flow of central and personal resources into social care and encouraging truly person-centred care.
We know that the data sources for individual decision-making about social care are relatively unsophisticated, and recent research indicated that word of mouth continues to be one of the strongest drivers around choice of care. However, the recent draft guidance published by the Competition and Markets Authority, with greater demand for transparency and ‘key fact’ comparators, will only drive more requests for data on provision. In health, we have got used to preparing for our own medical interventions by comparing key statistics on success rates, post-operative length of stay, failure rates and more. Social care needs to be in the driving seat of specifying, gathering and interpreting the data that the sector will share and must equip itself to analyse that data to ensure that it learns from what works in a planned and evidence-based way.
Finally, we need the Green Paper to recognise that these seismic shifts cannot happen without support. There needs to be central infrastructure funding to make this happen. This is not the ‘funding gap’ that is so often talked about in relation to day-to-day revenue costs; this is the funding chasm that, unless filled, will cause an ever-growing fissure between the ambitions of integrated health and care and its reality.
I hear too often the rebuttal that central government cannot or should not be seen to invest in independent providers, but of course, without this short-term investment, the long-term vision cannot be achieved. The Government has on many occasions seen fit to invest in independent providers – including GP surgeries, pharmacies, technology start-ups, universities, housing associations and more – why not social care? Whether that funding appears directly to individual providers, or via mechanisms such as a Local Enterprise Partnership is the kind of detail that the Green Paper will need to thrash out – but it must not shy away from its role in maximising this unique opportunity to turbocharge social care transformation.