Does the NHS long term plan help fix social care?

Posted on: January 7th, 2019

Will the increase in funding help fix the social care services? Spencer Gardner reviews the recently published NHS Long Term Plan.

The NHS Long Term Plan has been published today with Theresa May saying the 10-year plan would “provide the best possible care for every major condition, from cradle to grave” using the £20.5 billion a year funding boost promised by 2023/24.

There is a sharp focus on community care and mental health which, along with GP services- are the three areas getting the largest increases in funding. According to the Government, this will be the first time in the history of the NHS that investment in primary, community and mental health care will grow faster than the overall NHS budget. There is an emphasis on health bodies working alongside local government to provide joined up care.

The plan shifts the focus away from hospitals to prevention and care in the community. There is a commitment to deliver more care to people in their own homes, freeing up space in hospitals for those who need it most. Ensuring that every hospital with a major A&E department has ‘same day emergency care’ in place has been set as an urgent short term priority. These ‘ambulatory care units’ are already commonplace in many A&E departments, allowing patients to be treated and discharged without needing an overnight stay. The timely provision of the right package of care being in place for a return home will require reliance on an effective social care service.

On personalised care, the Department of Health and Social Care has boasted of an expansion of personal health budgets and a “comprehensive model for personalised care”- allowing those receiving treatment more choice about the care they receive. This is planned to be extended to 2.5 million people over five years. This will include 500,000 personal health budgets- up from fewer than 40,000 currently. My own experience is that there can be reluctance from services to embrace personal budgets as a more innovative model of service delivery.

Physical health commitments come alongside investment in mental health services, rising to at least £2.3bn a year by 2023/24. It is planned that around two million more people who suffer anxiety, depression or other problems will receive help over the next decade as a result of the extra investment, including new dads as well as mums. A 24 hour access to crisis care via the NHS 111 service and improved mental health services in schools will be among the list from the extra investment. Some have expressed concern that the proposals do not make adequate provision to provide more mental professionals on the ground, particularly in Child and Adolescent Mental Health Services (CAMHS) where access is certainly patchy.

The plan is ambitious as it is seeking to build a new service model for the 21st century against a number of barriers. These barriers include funding pressures, resolving the workforce crisis (which is tied up with the UK’s exit from the European Union and its ability to retain and recruit foreign workers), and the even greater funding challenge posed by social care and the ageing population. The Government’s long awaited plan on long term social care has been postponed several times, such is the size of the task.  Only once this is published will we have a complete picture on how health and social care services will look going into the next decade, with integration between health and social care likely to be a central plank of that reform.

If you have any questions or queries please don’t hesitate to contact Spencer Gardner in our Court of Protection Team