Health and Social Care Reform – East Cambs’ Focus

As someone that has been involved in and around social care for almost quarter of a century (gulp!) I have lost count of the number of Royal Commissions, reviews, reports, Green Papers and White Papers that have been carried out by successive Governments on the future of social care.

So it is good to see a decision at last from the current Government about changes to the funding of social care.  Whether or not you agree with the National Insurance rise, I think most people do accept that good quality health and social care needs to be properly funded and that general taxation at a national level is the right mechanism.  

Whether the changes announced will deliver sufficient funding remains to be seen; my own view is that it could be enough, but only if the way that social care and community health services are delivered undergoes massive transformation.

The work that I introduced and oversaw at the County Council, known as Neighbourhood Cares, shows that it can be done.  We embedded 5 well qualified staff, including social workers and a nurse in Soham for 2 years.  We told them not to break the law and not to break the budget!  Other than that, we freed them from their bureaucratic handcuffs and we let them do their thing.  

They reached out to the community, they got to know everyone and everything that was going on, they got in touch with all users of social care, all potential users of social care and every one over the age of 80 to say “hello, we are here to help you”.  Based in Soham Library they were immediately available with walk in access, and they just got things done for people.  They walked to their appointments to see people in their own homes, meeting people in the street on the way, having a chat, being involved in their community.  They did anything and everything that was required – things as simple as putting a pint of milk in the fridge when someone was coming home from hospital, or looking after someone’s dog so they could go to a GP appointment.  And they undertook profound and moving work too, helping someone with no family or other support to have a good death.

And of course, they helped people to navigate the complicated systems that exist in our health and social care services – they put in intensive support at the beginning, early on, before people got into crisis, helping them get set up well, helping them get plugged into community groups, helping them to stay and live well at home.  

And they supported, encouraged and facilitated a revolution in community based organisations, made up of local people who wanted (in huge numbers) to support other local people.  

They turned potential social care users into volunteers, people found joy in helping others.  And the staff that were involved?  They loved their jobs – no longer were they sitting at a computer for hours every day, interacting with people and families often just once, often remotely.  Now they were able to have continuity, remaining meaningfully involved with the people and organisations they were supporting, doing whatever was right for that person or that family, helping people to have better support, better lives.

It took time, it was more expensive up front, but it delivered some of the best social care outcomes to be seen anywhere in the country and I am proud of all that it achieved.  It also showed that it could save money for the health and social care system as a whole – preventing hospital admissions, stopping needs from escalating, avoiding people having to go into care homes.  But most importantly of all, it helped people in difficult circumstances to have as good a life as possible.

We are building on its legacy in East Cambs.  Working together, the County and District Council is developing a service called Happy at Home, taking the principles and learning from Neighbourhood Cares to try to make it a reality across our District.  To do it well, and to realise the savings for the system as a whole, we could do with some of Boris’s new money filtering down to the very local level, but whether or not that happens, we will plough on with these reforms in East Cambs, simply because they are the right thing to do for our residents.