Social Care and Health working together 00A – 31 Jan Care at Home in England 4 th February 2010, Edinburgh Janet Crampton DH National Programme Manager, Ageing Strategy & Intergenerational Project

Social Care and Health working together 00A – 31 Jan The English story …. …Building a Society for All Ages 1.The Older People & Dementia branch of the Department of Health’s Social Care Directorate 2.The context which is informing the need for change

Social Care and Health working together 00A – 31 Jan Building a Society for All Ages National Dementia Strategy Partnerships for Older People project Dignity in Care (With Respect) Green Paper on future funding of social care NHS reforms NHS Operating Framework End-of-Life and Palliative Care

Social Care and Health working together 00A – 31 Jan Building a Society for All Ages 1.The Older People & Dementia branch of the Department of Health’s Social Care Directorate 2.The context which is informing the need for change

Social Care and Health working together 00A – 31 Jan Building a Society for All Ages 2.The context in which is informing the need for change : demographic, economic and political challenges an ageing workforce strategic shifts from acute to prevention greater investment in home-based solutions move from buildings/service-based to individual needs

Social Care and Health working together 00A – 31 Jan Building a Society for All Ages 2.The context in which is informing the need for change (contd) : role of housing and home-based services Increasing using of telecare sharing risk and giving people more control partnership working to deliver better outcomes commissioning ‘fundamentals’ – Getting it right, because it matters!

Social Care and Health working together 00A – 31 Jan

Social Care and Health working together 00A – 31 Jan % increase in older people in England Rapid growth of over 65s in next 10 years

Social Care and Health working together 00A – 31 Jan 34% of the population will be 50+ in 2009 – with concentrations in ‘retirement areas’

Social Care and Health working together 00A – 31 Jan By 2029 over 40% of the population will be over 50 - and virtually everywhere in the country will look like current ‘retirement areas’

Social Care and Health working together 00A – 31 Jan Why does England need to change? A reminder of the present system – Based on matching a limited range of services to people’s assessed needs – not meeting growing expectations – Costs are rising and services are under increasing demographic pressures - Many services are still very ‘traditional’ – Many people assess the current situation as being ‘in crisis’

Social Care and Health working together 00A – 31 Jan Building a Society for All Ages Local authorities' response – Commissioners are still buying commodities and focusing on unit costs – time/task etc – and NOT outcomes - Looking to make efficiency savings (including shifting large volumes of in-house services to the private and voluntary sectors) (Different in England to Scotland) – Changing eligibility criteria to restrict access. The current system of social care is not sustainable

Social Care and Health working together 00A – 31 Jan The Cost of Healthcare NHS spending represents 7.3% of UK GDP £20bn efficiency savings needed in 2011/14 (equivalent of 6% of NHS budget) Parliamentary moves to reduce spending on healthcare, social care and public spending generally People are to take more responsibility for their own health, their own care

Social Care and Health working together 00A – 31 Jan The Cost of Social Care (PSS) Diverging patterns of social care commissioning across UK £20.7 bn on PSS in 2007/08 £15.3 bn on adults and older people’s PSS - 48% on residential care - 43% on domiciliary care 40,000 new referrals every week 1.77m clients receiving PSS in 07/08 Fewer and fewer people to provide services More and more people needing services

Social Care and Health working together 00A – 31 Jan Living – and dying – with LTC We need less  inappropriate referral to unnecessary treatment  hospitalisation for the elderly with dementia  traditional response and ‘medical model’  End-of-Life care in institutionalised settings  avoidance of the sensitive but essential issues  unhelpful bureaucracy and poor regulation

Social Care and Health working together 00A – 31 Jan Living – and dying – with LTC We need more and better pain management ensuring the right to a ‘good death (but) giving people a live, not a service focus on real needs and people’s choices innovation and creative solutions staff training more telecare and smarter use of all available resources keeping people active, healthy and happy

Social Care and Health working together 00A – 31 Jan

Social Care and Health working together 00A – 31 Jan Thank you for listening    Janet Crampton National Programme Manager Department of Health’s Social Care Programmes