Another Autumn Statement, another disappointing result for social care. No additional money, despite the protestations of a growing number of organisations and sector leaders. It is hard not to be despondent.
So what next? The fight for money for social care will no doubt accelerate, as it should. But that doesn't mean nothing can be done. Every week, SCIE comes across examples of excellent practice, often delivered in the face of seemingly insurmountable odds. Improvements are possible, but with time against us and demand for care and support rising, we need more far-reaching solutions.
Much of the good practice we know about is at a small scale, peripheral rather than commissioned for large populations. I have written before about why this scaling-up of what works is a difficult trick to pull. But we need to redouble our efforts, building a shared commitment across local areas to scale-up what works.
To help facilitate a way forward, SCIE has just published Total Transformation of Care and Support which examines what we need to do to take what is best in social care and scale it up, saving money and improving outcomes. To do this we started with the question: "What does a good life look like in this area and what are we willing to do to achieve it"? This led us to a vision for care and support which is about promoting independence and building on people's skills and capabilities - what is sometimes called an 'asset-based approach'. It also led us to identify five areas - ranging from preventative care for those with low support needs to more intensive support for those with complex needs - which we need to work on together to build a good life for adults.
The next step was to take a number of promising models of care and see what would happen if we scaled them up. Would they lead to savings and better outcomes? With the help of Birmingham City Council, who gave us real service data, we scaled up three models of care: Shared Lives, a service which provides family-based support for people, the Age UK preventative Living Well initiative and a hospital discharge programme in Kent. The result was nearly £7m savings for adult social care and £2m for the NHS in Birmingham. Outcomes also improved. Not insignificant, although we acknowledge in the report it's never as simple as this; there are always costs and barriers associated with setting up a new model of care. But at least it shows the potential 'size of the prize' if we are serious about transformation.
We have also produced a template to help leaders structure these local conversations, so that everyone shares ownership of the innovative models of care upon which their area focuses. Since we published the report, we have also been told about great examples of practice; about a social prescribing scheme in Wigan which aims to improve the health and wellbeing of their population by linking them to local assets; and an example of how community enterprises are developing to create better choice and support for local people in Worcestershire. Read about these and other examples on our site.
The next statement like this could be different; the sector may finally get more money. But no one is holding their breath. So until then, one thing to do is to develop local visions for transformed care, and put in place practical steps to scale up what works so that it reaches larger numbers of people.