What next for Adult Social Care?

Over recent weeks, Health and Social Care systems have faced unprecedented challenges which will undoubtedly have an impact for years to come. One of the few certainties at this time is that councils will face huge financial challenges going forward from increased costs, aborted saving plans and lost revenues. 

However, despite the seemingly impossible challenges, Health and Social Care organisations have responded incredibly. Collaborative, responsive working has led to rapidly redesigned processes and remodelled services, delivering innovation and transformation in days or weeks that in normal times would take months or years.

It is now essential to take a collaborative approach with staff at all levels, to capture learning and ideas from those who have experienced it at the frontline. Acknowledging the hard work and commitment of staff throughout the crisis and driving motivation and enthusiasm going forwards will be key to ensuring sustainability. From this collaborative approach, comes huge opportunities to learn from these new ways of working and build innovative and sustainable Health and Social Care services for the future.

Through our insights and support to our clients during the COVID-19 crisis, we have identified some of the key opportunities for Health and Social Care organisations as they plan for the future.

Harnessing Community Capacity

Recruitment and retention has been one of the biggest challenges faced by social care organisations in recent years, yet the influx of volunteer and community capacity seen by councils, health and volunteer organisations during the COVID-19 response has been overwhelming.

With the profile of the sector so significantly raised, organisations need to be thinking about how these resources, and the motivation to help, can be harnessed to support service design and delivery going forward, creating long-term community resilience. Key to this will be ensuring that volunteers and new recruits remain engaged through consistent communication, even if they are not currently being utilised. Technology has a key role to play in this and supported by Techforce19 funding we are working to create an app that will enable local authorities to manage the various streams of volunteering initiatives to actively engage volunteers quickly and easily.

A further area being explored by many Peopletoo clients is the possibility of converting volunteers and additional paid workers, recruited during COVID-19, into personal assistants to facilitate the ambition of increasing more creative self-directed support solutions within Social Care.

Digital Transformation

Everyone has had to adjust to working and interacting differently in response to the COVID-19 crisis, and opportunities to harness digital solutions in Health and Social Care have been more obvious than ever. Staff are working remotely, video conferencing is being utilised to communicate both internally and with citizens, many aspects of care and support are being delivered remotely and digital solutions to support people in their own homes are being embraced.

Gone are the days of endless digital strategies that sit on a shelf for years and procuring expensive, large scale solutions that are not fit for purpose. Now is the time to embrace real innovation and change to solve real world challenges in Social Care, centred around the people that matter the most, the citizens.

User centred design, led at service level and focused on defining and solving specific problems, will be central to the approach for delivering sustainable digital change in Social Care that can drive the maximum benefits both to people needing support and in terms of a return on investment for the service.

Comissioning Differently

Instability in the provider market is not new to social care, but the impact of COVID-19 is unprecedented with the ramifications not yet known. It is likely that some providers will be unable to continue operating, and some services may not be required in the same way as before. Councils have had to make rapid financial decisions on sustaining providers throughout this crisis. During this time though, many local authorities have developed closer working relationships and increased transparency and trust with providers, presenting an ideal opportunity to explore innovative approaches that will ensure financial stability for providers and meet the changing needs of the population going forwards.

This is likely to include increased exploration of opportunities to commission based on outcomes, increase self-directed support, better utilise community assets, encourage independence and progression and integrate technology into care and support settings. Behaviour and attitudes will undoubtedly have changed which is likely to see a shift away from the high use of residential care, especially for older people. This creates a requirement to work with the sector to develop more advanced community-based settings, using technology to manage cost and reduce intrusion.

The first step will be developing a clear picture of capacity and sustainability across the market, including providers used by self-funders and reviewing commissioning plans and market position statements in the context of a changed landscape of providers, community assets and expectations.

Following this, person-centred services can be co-designed with individuals, families and carers, designing and commissioning from the perspective of what matters most to people.

Strengths Based Practice

During the COVID-19 crisis, local authorities have worked tirelessly to manage increasing demand against depleted staffing to  prevent the need to implement Care Act Easements. Social distancing measures have meant that care and support has had to be provided differently which has undoubtedly led to innovative and creative strength-based solutions, harnessing the use of community assets and technology.

In looking towards the future, capturing the learning from these approaches will enable the positives to be built upon and will provide staff with a chance to reflect on their practice both individually and as a team. An Appreciative Inquiry approach will be beneficial in building relationships and trust with staff and managers.

Investing in the workforce, celebrating successes, acknowledging the significant strain on staff and rewarding them for their hard work and commitment, will be key to ensuring a sustainable and enthusiastic workforce for the future.

A Whole System Approach

In a few short weeks during the COVID-19 crisis, many Health and Social Care systems achieved what they have been aspiring to for many years; a joined up and collaborative approach to tackling challenges across the whole system. Health and Social Care organisations have worked together, with other system partners to set up new hospitals and care facilities, manage the incoming demand and responding rapidly to ever changing circumstances. New relationships have been built and existing relationships strengthened, both at strategic level and on the frontline. Organisations have learnt a lot about removing red tape, cumbersome processes and overcoming cultural differences to do what is right for the system and citizens.

Harnessing and building on these relationships will accelerate ambitions around integration. Health and Social Care organisations should use this as an opportunity to review governance and integration plans and reduce bureaucracy. The focus now should be on organic system development, further building a culture of trust and collaboration.

Whilst difficult to imagine during the peak of a crisis, the future looks bright for organisations that are able to rise to the challenge.

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