The Shifting Carpet The policy context and challenges facing Adult Social Care

The Shifting CarpetThe policy context and challenges

facing Adult Social Care

James Bullion & Jennifer HollandAssistant Directors, Community Services,

Norfolk County Council

Positives• Longer life, wealthier, well informed• Good technology • More satisfaction• Holistic services• Prevention and integration

More positives…..

• Increased government investment• Growth in spending on older people• Growth in spending on disabilities• Direct accounts now 5% of spending

Challenges - lots• Changing population• Diminishing resources• Rising expectations• ‘irrational, confusing & unjust’• Earlier prevention• People in control• Account holders• Carers paid for care• Shaping markets• Holistic and micro

commissioning

• Efficiency savings• Better, simpler, faster• ‘Community’ and ‘health’

integrations ..• Localism & Place• Shared back and front

offices• Enabling communities

to do more• People in control• Quality and Value• Service failures

Care in 10 years• 25% plus under the ‘care’ system• 2-3% GDP• NHS – simplify• Online, digital, 24/7• Increased migratory work patterns• Strains on infrastructure

Care in 10 years continued…• Planning for care & prevention• More ‘account holder’ than eligible?• Understanding of availabilities• Advice, brokerage & care arranging • People more targeted for interventions

Also in 10 years

• Increased isolation• Increased disability support needed• Increased dementia• More ethnically diverse population

Need versus resource

People with learning disabilities: demand will increase dramatically over the next 5-10 years

Coalition policy context for health care

• Breaking down barriers• Establishing a commission on long-term care• Extend roll out of personal budgets• Improve access to respite care through community

based provision• Primary Care Trusts accountable to elected

councillors• Separation of commissioning from provision• New emphasis on public health issues

Working with Culture and Sport• Supporting prevention• Helping people live independently• Access to services through personal budgets• Delivering the Five Steps to Happiness –

connect, be active, be curious, learn and give

connect

be active

be curious

learn

give

How do we engage with one another?

• How do culture and sport ensure their contribution is understood and is included in commissioning opportunities?

• How do care services get to know what culture and sport can offer and include them in commissioning opportunities?

"Instead of seeing the rug being pulled from under us, we can learn to dance on a

shifting carpet."

Thomas Crum