Care at Home in England 4 th February 2010, Edinburgh

Social Care and Health working together

00A – 31 Jan

Care at Home in England 4th February 2010, Edinburgh

Janet CramptonDH National Programme Manager, Ageing Strategy & Intergenerational Project


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


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


00A – 31 Jan


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


00A – 31 Jan


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


00A – 31 Jan


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!


00A – 31 Jan


00A – 31 Jan

% increase in older people in England

Rapid growth of over 65s in next 10 years

<10% Increase

10%-18%

18%-26%

>26% Increase


00A – 31 Jan

34% of the population will be 50+ in 2009 – with concentrations in ‘retirement areas’


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’


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’


00A – 31 Jan


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 largevolumes 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


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


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


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


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


00A – 31 Jan


00A – 31 Jan

Thank you for listening

Janet Crampton

National Programme Manager

Department of Health’s Social Care Programmes

+ 44 7789 653196

[email protected]

Documents

Care at Home in England 4 th February 2010, Edinburgh