Scottish Care Service research has highlighted the need to reduce inequalities and complexity in social care and establish ring-fenced funding.
In a meeting of the Parliament researcher Dr Irena Connon reviewed international models of care and presented 10 recommendations for system architects. These include the following:
- Care services should be provided on a consistent basis across all geographic areas to avoid geographic inequalities in provision and outcomes.
- A clear ‘one system, one budget’ approach” will reduce complexity
- Eligibility for access to social care services should remain high to prevent rising inequalities, unmet needs and increased dependency on informal care providers.
- A standardised definition of ‘personalisation of care” would be helpful
- Mechanisms that address cultural differences between locally accountable social care services and centralised health services will improve integration
- Budgets intended to support integrated care should not be used to offset overspends in acute care
- Financial savings should not be viewed an immediate objective of integration
- Forward planning and significant investment are required to meet future care needs.
On workforce, Dr Connon recommended the Nordic model, which accredits professions and service delivery. She explained: The idea… that caring is something that people can do naturally, without particular training, has prevailed for decades and still influences the lack of funding for social care. [This] is increasingly being challenged.
Social worker Nick Kempe added: “It is difficult to work with a person with dementia…. To have the patience to get through to the person and to form a relationship with them is extremely challenging, so we need to resource staff to do that.
“It is shocking to me that, at the moment, a person can walk into a care job when they have had no training and no preparation and no understanding of the health problems that could be causing the client to act as they do.”
The debate also looked at funding eligibility and the panel was told that a broad eligibility allowed many people to qualify and lots of services to be provided. “That would reduce the reliance on informal care and ensure that there are as few inequalities in accessing care as possible,” Dr Connon said.
She also suggested that it would take about 15 years to see the generational impact of integration.