interviews

24.10.18

How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months, the new president of the Royal College of Physicians (RCP) has suggested.

In an interview with NHE, Professor Andrew Goddard said that the general public “does not really understand” the inner-workings and benefits of the social care sector— despite 1.5 million care staff members working in the UK currently, and 85,000 providers of social care across the country.

On Monday a new report by NHS Providers noted that there are “clear warning signs” that the demand in the coming winter will be even worse for NHS trusts than last year, where many believed the influx in patients made it the most difficult winter on record.

Last week the RCP, alongside several other health faculties and royal colleges, addressed a letter to Philip Hammond, calling on the chancellor to use the autumn budget to invest long-term in adult social car and health services, or “risk the NHS failing to meet demands.”

Prof Goddard noted that social care is the most worrying issue on doctors’ minds currently: “The thing that most doctors are worried about is social care—there was a survey I saw presented at a conference a couple of weeks ago, and 40% of acute medicine consultants’ biggest worry was social care.

“Not having the capacity in social care to get patients out of hospital, which is a really risky environment—hospitals are not good places to be if you don’t need to be there—is one of our big challenges.

“If you talk to the emergency medicine guys, they would say if you could sort out social care then that would make their lives so much easier because it changes the flow in hospitals dramatically.

“One of the solutions to winter is much, much better social care—we tend to focus on hospitals because we can see the hospitals queuing outside, and you don’t really see ambulances queuing up outside nursing homes—it’s not quite as good a picture on the front page of the patients—but perhaps we ought to do that and focus on nursing home care.”

Prof Goddard added that the NHS has a much-beloved identity in the UK, but the general public does not always feel the same way about social care. He suggested that a dedicated social care service would help both promote the value of social care in the general public and also relieve the burden on acute care wards.

“The NHS has an identity doesn’t it, everybody says that the public loves the NHS, but people don’t really love social care in the same way,” said the RCP president, who took over from Professor Dam Jane Dacre last month.

“If there was a national social care service then that might help. There’s a such a wider disparate group. I think the public doesn’t really understand social care—it’s means tested of course, it’s not free at the point of entry, so there are challenges there.

“A national social care service would probably be a good idea. Other nations have tried to bring social care and their health service closer together, I think that’s the idea that’s been proposed with Sustainability Transformation Plans, and certainly the college and I support the move towards that. How you get a higher profile for social care and more support, that’s a challenge of our generation.”

Last week a report by the Public Accounts Committee noted that the government is still “a long way” from achieving an effective strategy for integrated health and social care.

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Image credit: RCP

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