Lord Darzi’s NHS report provides hope for social care

Written by Jess McGregor, Director of Adult Social Services at Camden Council and Vice President of ADASS.

Lord Darzi’s greatly anticipated report into the state of the NHS will attract the full range of admiration and criticism from those of us with a stake in our health and care system. We should be cautious about criticising the report for sticking to its NHS brief rather than addressing our longing for more positive action on social care reform from the new government. 

Like the Secretary of State’s much quoted “3 Big Shifts for the NHS”, the Darzi report describes with compelling clarity a set of challenges that we know cannot be fixed without parallel reform to build a new National Care Service.  

Darzi’s call to action is built on compassion and humanity that chimes with our vision for social care and provides a powerful starting point for building integration. The report opens with the role the NHS plays in our most heartfelt moments of joy and sorrow, highlights the ways in which the workforce’s enjoyment of work has been crushed and closes with a call to put people at the heart of the NHS. Darzi evokes emotions and values that have been muted in recent health policy focused on structure and reorganisation. These are values that we share and can build on together. 

A diagnostic that points to our mutual challenges of deteriorating health, a fragile social care system, years of austerity and a failure to shift resource out of hospitals into the community can also guide us to mutual solutions. 

Perhaps with an eye on the growth mission, Darzi sets out a compelling case for the contribution the NHS could make to national prosperity opening the door to the conversations we want about working age adults and their aspirations for ‘gloriously ordinary lives’. This could be our opportunity to push for cross departmental work on employment support and make the case for local integrated delivery. 

Looking forward, Darzi calls on us to ‘lock in the shift of care closer to home’ and to ‘simplify and innovate care delivery for a neighbourhood NHS’. This is what we want too. It speaks to our third ADASS priority and the incredible work that many local authorities are already doing together with health partners across the country. 

Adult social care is uniquely positioned to make a strong contribution to the recovery of the NHS through the work we already have underway to build our new National Care Service. We have considerable sector wide consensus about the vision for social care. We have a fantastic roadmap in Time to Act that is already delivering incredible examples from across the country and demonstrating what’s possible.  

If we see social care reform and fixing the NHS as separate or competing priorities, we will miss our chance to deliver the change that people who draw on social care are entitled to. 

Darzi presents us with a choice. We could choose to point out what is missing from his analysis and dispute his conclusions. Or we could focus on the opportunities presented by building on his findings. The latter presents us with the chance to put social care and integration at the heart of NHS reform and bring hope and momentum to our own ambitions.