Towards an Integrated Health and Social Care System

Transforming our health and social care system after coronavirus requires us to think imaginatively about the principles and values that must underpin our most important public services. The Tories have failed to give the NHS the funding it needs. At the 2019 General Election, Boris Johnson pledged to give the NHS an average increase of 3.3% per year – less than the historical average and, according to experts, only enough for the NHS to ‘stand still’ and social care had been pushed into a state of crisis due to budget cuts. £7.7 billion has been taken out of local authority social care budgets since 2010. Around 1.5 million older people are going without the care they need.

The pandemic has thrown into sharper focus than ever before the differences in how the NHS and social care are treated. For too long social care has lacked the priority, focus and attention of the NHS, and care workers have been undervalued and underpaid. In Devon we have a depleted workforce and are constantly having recruitment campaigns to fill vacancies. Retention rates are poor. The social care system in this country is highly fragmented with a mix of local authority, private and not-for-profit provision. We want to see an end to the kind of outsourced contracts that have undermined communication, accountability and efforts to develop a strategic response.

Devon is developing an Integrated Care System in which they plan to set strategic objectives and outcomes to improve the health and wellbeing of the Devon population and should for the first time incorporate a strategy for social care.  Devon GPs are now formed into primary care networks and we see them as the key clinical part of a set of local services ready to respond to the full range of a person’s needs. We will need to sharpen the focus on tackling the specific challenges faced by our diverse communities in Devon be they urban, rural, large or small, ensuring that health inequalities are addressed. An integrated system focusing on health wellbeing and independent living will demand effective partnership working at neighbourhood level. Increasingly public funding across local government and the NHS will be seen as one community pot. There is therefore a need to ensure active and effective public participation and a system that is accountable to the population of Devon.

Key priorities:

• • Be vigilant in ensuring the implementation of the Integrated Care System in Devon maximises democratic accountability in its decision making about meeting the health and care needs of the different localities across the county.
• • Promote joined up primary, community and social care at local level.
• • Encourage the development of community hospitals as local health hubs connecting up doctors’ surgeries with other health services in neighbourhood settings.
• • Support the need for integrated and early discharge home from acute hospitals provided it is based upon a comprehensive assessment of personal needs and full funding for sufficient medical, skilled nursing and social care staff to provide appropriate levels of care.
• • Fight to improve and sustain mental health services
• • Embrace new communication technologies that will help to deliver services in new ways.
• • Support the integration of care workers into Community Health Teams
• • Promote homecare workers’ regular training and quality conditions of work.
• • Support people with personal budgets to ensure they receive good quality and reliable care
• • Encourage the development of co-operative solutions to domiciliary care needs
• • Make sure the places in residential and care homes funded by the Council offer the highest quality of services
• • Work with private providers to make improvements and maintain good practice ensuring that they have clear accountability procedures for care workers to raise concerns about the wellbeing of the people they care for.
• • Support the development of dementia cafés and dementia friendly communities
• • Press for the best deal for carers to be supported and provided with respite when needed

Reducing Health Inequalities and Promoting Well Being for All

Responsibility for promoting the health and wellbeing of Devon people is a formidable challenge for the County Council particularly because of the government emphasis on protecting the nation’s health from infectious diseases. The National Institute of Health Protection brings together Public Health England and the NHS Test and Trace budget with the Joint Biosecurity Centre and is focusing on tackling COVID-19 and protecting the nation’s health. The new organisation‘s primary focus is public health protection and infectious disease capability.

The government’s decision to change the structure of Public Health England will impact the budget for prevention measures and could reduce the budget for promoting better health for people of all ages. We must challenge any reduction to this budget. Programmes to reduce obesity, cut smoking, reduce alcohol and drug abuse, improve sexual health, reduce teenage pregnancy and combat domestic violence and abuse should be developed not cut, and should be targeted at those most at risk wherever they live in Devon.

Working together at community level by all those interested in health and wellbeing is the only sustainable way forward. We will strengthen the bringing together of existing public services, the voluntary sector, neighbours and carers, recognising that residents want to maintain an independent life for as long as possible. Maintaining Devon’s network of libraries, supporting community facilities, encouraging active lifestyles and supporting cultural activities are all essential for healthy communities.

We will:

• • Campaign for prevention programmes to be properly funded
• • Seek to improve public health by promoting participation in sport and active lifestyles that improves both mental and physical health
• • Promote a food justice action plan that provides affordable and nutritious food
• • Support Devon’s network of libraries as cultural and educational systems.
• • Encourage the development of community hubs for the use of voluntary organisations whose main agenda is health and wellbeing.