Transcript The Shifting Carpet

The Shifting Carpet
The policy context and challenges
facing Adult Social Care
James Bullion & Jennifer Holland
Assistant Directors, Community Services,
Norfolk County Council
Positives
•
•
•
•
•
Longer life, wealthier, well informed
Good technology
More satisfaction
Holistic services
Prevention and integration
More positives…..
•
•
•
•
Increased government investment
Growth in spending on older people
Growth in spending on disabilities
Direct accounts now 5% of spending
Challenges - lots
• Efficiency savings
• Better, simpler, faster
Diminishing resources
• ‘Community’ and ‘health’
Rising expectations
integrations ..
‘irrational, confusing & unjust’
• Localism & Place
Earlier prevention
• Shared back and front
People in control
offices
Account holders
• Enabling communities
Carers paid for care
to do more
Shaping markets
• People in control
Holistic and micro
• Quality and Value
commissioning
• Changing population
•
•
•
•
•
•
•
•
•
• Service failures
Care in 10 years
•
•
•
•
•
•
25% plus under the ‘care’ system
2-3% GDP
NHS – simplify
Online, digital, 24/7
Increased migratory work patterns
Strains on infrastructure
Care in 10 years continued…
•
•
•
•
•
Planning for care & prevention
More ‘account holder’ than eligible?
Understanding of availabilities
Advice, brokerage & care arranging
People more targeted for interventions
Also in 10 years
•
•
•
•
Increased isolation
Increased disability support needed
Increased dementia
More ethnically diverse population
Need versus resource
People with learning disabilities: demand will increase
dramatically over the next 5-10 years
Coalition policy context for
health care
•
•
•
•
Breaking down barriers
Establishing a commission on long-term care
Extend roll out of personal budgets
Improve access to respite care through community
based provision
• Primary Care Trusts accountable to elected
councillors
• Separation of commissioning from provision
• New emphasis on public health issues
Working with Culture and Sport
•
•
•
•
Supporting prevention
Helping people live independently
Access to services through personal budgets
Delivering the Five Steps to Happiness –
connect, be active, be curious, learn and give
connect
be active
be curious
learn
give
How do we engage with one
another?
• How do culture and sport ensure their
contribution is understood and is included
in commissioning opportunities?
• How do care services get to know what
culture and sport can offer and include
them in commissioning opportunities?
"Instead of seeing the rug being pulled from
under us, we can learn to dance on a
shifting carpet."
Thomas Crum