20/06/2014 Leave a comment
On Monday I blogged about my Mum’s passing and how ‘far too close to home’, I saw the system of health and social care, policy, commissioning and providers work, in our case, rather well. But as the various systems kicked in I thought to myself you know what, this is precisely why we must get the policies, funding and the way we set up the system, right. This stuff does actually matter for those vital moments in our lives when we need the system to take good care of us.
Last Wednesday I attended the Local Government Association’s Community Wellbeing Board meeting in London and in amongst a packed agenda was a discussion on Better Health and Social Care integration. One of those think tank pieces put together before the next parliament to give the Westminster politicians food for thought as the return after the general election, about the policies they need to enact to hopefully improve the system rather than hinder it.
Geoff Alltimes and Richard Humphries from the King’s fund were in attendance to discuss with us the Barker Report, as it will be known after Kate Barker who is heading it up, as they go about the evidence gathering stage. Here is a link to a short video explaining the commission and its remit http://www.kingsfund.org.uk/audio-video/kate-barker-commission-future-health-and-social-care-England
The report certainly pitches a wide variety of ideas about the future funding of the NHS and what is the role of social care in amongst its mix. Amongst them is such headline grabbers as charging to see your GP or attend A&E alongside the less sensational but more fundamental about the notion of a free NHS and how it sits so uncomfortably with the financial assessment and charging for Social Care. It was quite bizarre as the NHS element of Mums’ care was delivered and you could ‘watch before your very eyes’ the money being spent and yet when it came time for a small element of social care to be planned, out came the forms for this assessment and who is going to pay and the charging mechanism. This is not a criticism of those who very involved as they handled it very well but for such a small element of Mum’s care suddenly the system changed and it was jarring.
At the Board meeting we also discussed the governance and accountability of the NHS and I made the point hat there are so many, many structures in the NHS with vast armies of friends, governors and structures to delivery such things that in reality does it really work or it just a maze where no one, including those who designed it, quite knows who is responsible for what and when it goes wrong across an array of services, well!!. Because in my experience whenever you ask a question of any aspect of the NHS someone seems to point at someone else, just look at the Francis report on ‘Mid Staffs’ Hospital.
In an earlier blog I explored this with new Directors of Adult Social Services, how in local government, Councillors are the first point of call for residents because they elect them. The line to Directors to respond, is one email not a vast system of accountability. In making my point I was stressing to both Geoff Alltimes and Richard Humphries how I saw the future of an NHS delivering services but local government being far more involved with elected representatives being the key local way in which the NHS is provided with accountability and governance. It will be interesting to see their final report and I’ll blog it when it’s published in the autumn.