Social care is 'missing puzzle piece' from long-term NHS plan

NHS England has unveiled its ten-year plan which will focus on prevention and shift money away from hospitals to community care, mental health services and GP surgeries.

But there is little mention of social care, with the charity Independent Age warning that "until the government addresses the crisis in social care the success of the NHS plan will be severely limited".

The NHS plan outlines how the extra £20bn funding pledged last June will be spent with a more strategic focus on prevention and early detection in an aim to save half a million lives.

Community care will be improved, older people with receive more personalised care and digital health services will be mainstream with GP booking and prescriptions all managed online. There will be earlier detection of cancer and patients are promised 'same day emergency care'. In addition, people will be helped to improve their own health by exercising or stopping smoking. Social prescribing will become more prevalent with GPs recommending gardening or art instead of traditional mediciine.

Dementia UK welcomed the plan as a "step in the right direction" but suggested "in order to put weight behind these proposals" there needed to be "a serious commitment to providing more access to skilled professionals, such as dementia specialist Admiral Nurses".

They also stated that the "missing puzzle piece" from the plan was the social care green paper, which was needed to "relieve the pressures on a struggling NHS".

‘Looking ahead to the Health Service’s 80th birthday’

Simon Stevens, chief executive of NHS England admitted there will be challenges in delivering what is promised, despite extra funding and changes in strategy. He highlighted current pressures on the NHS such as a large ageing population, staffing issues and ‘increasing inequalities’.

He said: “The NHS has been marking its 70th anniversary, and the national debate has rightly centred on three big truths. There’s been pride in our health service’s enduring success, and in the shared social commitment it represents.

"There’s been concern – about funding, staffing, increasing inequalities and pressures from a growing and ageing population. And there’s also been legitimate optimism – about the possibilities for continuing medical advance and better outcomes of care.

“In looking ahead to the Health Service’s 80th birthday, this NHS Long Term Plan acts on all three of these realities. It keeps all that’s good about our health service and its place in our national life. It tackles head-on the pressures our staff face."

The new ‘route map’ for care ‘priorities’ includes the following:

• GP and community services have been given £4.5bn of the funding

• £2.3bn will be spent on mental health, with pledges to expand access to services for children.

• New, faster targets for A&E for urgent cases such as strokes or heart attacks with longer time targets for less serious cases.

• Expansion in personal budgets so patients with chronic health conditions can choose how the money is spent.

• Genetic tests for all children with cancer.

So, where’s the social care?

Many, however, have struggled to see how a ten-year plan for the NHS could make no mention of adult social care, or the promised social care green paper, which has been postponed many times and is now due to be released in January.

George McNamara, director of policy and influencing at Independent Age, said: “One of the biggest health challenges we face today is how best to care for an ageing population.

“The NHS long-term plan must clearly set out the necessary funding and reforms to ensure older people can live healthier lives for longer. It is absolutely right to focus on prevention, but until the government addresses the crisis in social care the success of the NHS plan will be severely limited.

“Health and social care go hand-in-hand. Failure to do both will put the sustainability of one of our national treasures at risk and push more older people into crisis, putting avoidable pressures on an already stretched NHS.”

Paul Edwards, director of clinical services at Dementia UK agrees. He said: “The NHS 10 Year Plan is a welcome step in the right direction and it is pleasing to note that there is attention paid to preventing long-term health conditions such as dementia.

“However, in order to put weight behind these proposals, there needs to be a serious commitment to providing more access to skilled professionals, such as dementia specialist Admiral Nurses, as well as moving away from cuts which have long marred the public health landscape.

“The long-awaited adult social care green paper also represents the missing puzzle piece in this area. It is all well and good to focus on preventing conditions like dementia, but we need to give due regard to people who are facing health challenges in the here and now. This is where social care comes in to help people through community support and timely help in the home.”

Professor Tahir Masud, president of the British Geriatrics Society, welcomed the pledge to have multidisciplinary teams embedded in primary care and for more services to be available closer to where older people live. He said: "We warmly welcome those aspects of the plan that will help to make this a reality. However, we believe the full benefits of the plan can only be realised with sufficient investment in the workforce in all settings, and urgent investment to ensure sufficient capacity exists in social care."

NHS funding should be ‘available for local authorities’ for social care

Local government have also been paying close attention to the plan, with Cllr David Williams, health and social care spokesman for the County Councils Network welcoming the move from "reactive acute care to care in the community, primary care, and mental health services".

However he added: "If today’s reforms are to be successful, then preventative services and adult social care need to be fully funded, whilst councils need to be given a clear role in integrating care services in their communities." He pointed out that councils face a funding gap of over £1bn by 2020 in adult social care and said: "It is disappointing that the social care green paper has not been published in tandem with today’s NHS plan".

Boost for mental health services

Paul Farmer, the chief executive of charity Mind, welcomed an increased focus on mental health services in the long-term plan, but emphasized services needed to be accessed easily.

He said: “We are really pleased to see that mental health is such a key focus in the NHS long-term plan and we welcome the £2.3bn set aside for mental health services.

“This is the kind of sustained investment we need to see to put mental health on an equal footing with physical health and, if delivered, this plan will make a difference to the lives of thousands of people with mental health problems.”