Jill Mason, Partner and Head of Health & Care at Mills & Reeve, explores whether England’s 10-Year Health Plan lives up to its ambition — and what its silence on social care really means.
The sector may well have been initially disappointed with Fit For The Future: The 10 Year Health Plan for England (the Plan) – and rightly so.
When you search the Plan for ‘social care’ you get 59 ‘hits’. That sounds quite impressive – until you realise that many of those relate to the ‘social care’ part of the Department of Health and Social Care’s (DHSC) name. When you search for ‘care homes’ you get two hits (and one of those is in the social care list). There are no results for ‘dom care’… Yet, it was always a plan with ‘Health’ in its title.
We know that Baroness Casey will chair an independent commission into adult social care but until both phases of her review are complete in 2028, what detail can social care take from the Fit for the Future plan?
The Plan
The sector will be familiar by now with its content and the three shifts – hospital to community, analogue to digital and sickness to prevention.
Welcomed by the likes of the Care Providers Association and Care England, the Plan has short, medium and long-term targets and deadlines, which have to be embraced. With national and indeed international funding gaps and workforce shortages, what is the alternative? As the Plan itself says: “it’s change or bust – we chose change.”
So what’s under the bonnet?
The chapters of greatest interest are two – the new NHS Neighbourhood Health Service – and three – Analogue to Digital.
Chapter two
The key aspects of this chapter relating to social care include:
- Greater involvement in rehabilitation, recovery and frailty prevention.
- Enabling care professionals to carry out more healthcare activities.
- Improvement in pay, terms and conditions for social care staff through Fair Pay Agreements.
- The creation of a National Care Service to support better integration of health and care services.
- Improving the coordination of care through the use of wearables and other monitoring technology. ‘Call before convey’ will avoid unnecessary transfers to hospital.
- Supporting more people to die where they choose to – in their own home – through community-based advice.
Patients are a key focus under the proposals laid out in the Plan, with the Neighbourhood Health Service making patients active partners in its delivery. As the Plan states: “We will expect all care plans to be co-created with patients and cover their holistic needs, not just their treatment.”
Digital technology will also play a key role, with patients being supported to manage and direct their care digitally through the NHS App. For many people, this will mean they can access all they need from their neighbourhood team.
Chapter three
The NHS App has been billed as a virtual assistant – a doctor in your pocket.
My Care is designed for those who need intensive support, such as people with long term conditions or other complex needs and, over time, will increasingly link to services outside the NHS – whether that’s in the voluntary sector, social enterprises, social care, community groups or local government.
In order for this to work, innovation and digital transformation must be matched by real, practical action to enable social care technology to sit at the core of delivery, not on the sidelines.
While the introduction of technology has been met with some scepticism, when designing the NHS App the intention is to proactively identify people who may have lower digital literacy and, for those who prefer or rely on in person care, that choice will remain.
Fit for the future
It’s clear that greater collaboration will be key under the proposed neighbourhood health plans, with a firm emphasis on ensuring skills and experience in neighbourhood and community settings, as well as social care, is built into future training for medical professionals such as nurses.
The delivery plan is expected in early September, and the three-year planning framework is also due later in September.
Legislation will be required for many aspects and regulatory provisions will need to be reviewed, particularly in terms of accessing and sharing data.
While the 150-page document may have been light on reference to social care, the shifts between hospital and the community and analogue to digital can only be beneficial to the sector.
As Wes Streeting stated: “I am sometimes told that NHS staff and our social care workforce are resistant to change. In my experience, they are crying out for it.”
Image depicts Jill Mason, Partner and Head of Health & Care, Mills & Reeve.