By Mark Raeburn, Managing Director, Capita One
It seems as if everyone is talking about the integration of social care and health at the moment. And for good reason. When professionals can work in a truly integrated way, vulnerable adults can be better supported, even in a climate of stretched resources.
The Four Futures for Health and Social Care Report considers four potential future landscapes for integrated health and social care, examining scenarios of centralised and devolved frameworks. A further associated report considers the role of software systems and related technology in making these four possible futures a reality. Let’s take a quick look at what this might encompass.
The four futures
In the centrally-directed future of Regulated consumerism, individuals are means tested against national criteria, allocated a personal health and social care budget, and use benefits and payments to access their chosen care. Large-scale national citizen portals and e-marketplaces are likely and shared services would require intuitive professional portals for staff to access systems. There’s significant personal choice, but those without family to help them apply for care could struggle and may need support from local communities.
Me in my place is also a ‘user-centred’ future, but with locally directed provision, where services are commissioned by authorities working with local providers. Self-service portals used by citizens to manage their care and personal budgets are more localised. Data analytics would be a key technology factor to support with the commissioning and targeting of services. The advantage of this could be more effective early intervention, but it’s likely that regional variations mean services are better in some areas than others.
The future closest to where we are currently is Local drift, with health and social care driven by regional sustainable and transformation plans (STPs). This could be, arguably, the least sustainable future as it lacks a strong drive in any particular direction. It may, however, support one of the other futures as a blended scenario, applying self-service elements to empower citizens in care choices, whilst ensuring the most vulnerable are protected by social workers.
In the centrally directed future of Care as a benefit, profession-led social care could become part of the welfare system, funded by national universal credit benefits, with IT integrating social care, revenues and benefits data to provide a shared portal for everyone involved. This future envisions a reduction in social care funding, with less opportunity for preventative or joined-up work - it could be a cultural shift for social care, with assessments of need similar to benefits assessments rather than holistic care considerations.
A blended future
It’s difficult to predict which future is most likely. The concept of self-management and personal budgets, with local provider engagement, is popular, pointing to the Me in my place future, but I think we’ll end up with a blend of this and Local drift – the scenario similar to where we are now. This would entail elements of regional direction and joined up working, with authorities being able to commission services to meet local need.
Whatever the future holds, truly collaborative joined-up working will be key, with flexible technology integrating with other systems to support shared information. Easy-to-use online self-service options and business intelligence tools will also be vital to ensure services are cost effective, sustainable, and help protect the most vulnerable adults in society.