What the Future Holds
How will care develop in the coming decades? What is the main challenge? Matthew Airey of Wessex Care has some thoughts.
Prior to opening my own care homes more than 17 years ago, I worked in health and social care for 25 years, spending over 10 years in senior management roles in social services. I was responsible for delivering services to children and families in need of support, care and protection in large cities and latterly in Wiltshire and Hampshire. During this time, I have watched the social and economic changes in our society and believe I can offer some insights into how the care of older people will change and evolve in our lifetime and a personal significant concern I see in the current political climate.
The future of residential care for older people
Today we are living longer, resulting in a larger population of older people, which has been exacerbated by the post-war baby boomer generation. [way too much fun in the 50s and 60s, so I hear!!]
This is fantastic news, which we should celebrate. Something successive generations have striven for in the developments of public health, medial, health and social care advances [although some pundits would make you think otherwise].
Longer life can, it’s not a prerequisite, bring with it the need for additional support and this is putting incredible pressure on our world class Adult Social Care & NHS services. We, as a nation, are addicted to having ever-expanding expectations of these services and, as a result, this produces ever spiralling costs. The answer in part, I believe, will be found in helping older people to live well and live longer in their own homes, taking the direct burden off Adult Social Care & NHS, whose role will change predominantly to provision of acute service and commissioning of all other services.
The way we deal with caring for our ever-aging population, which includes me, will look radically different in the next 10 to 20 years. Our communities will have to be mobilised and energised, we will all need to embrace new technology, to ensure older people can and do have a real choice to continue living in their own home without this becoming a form of isolation, ‘out of sight out of mind’ fix to the financial pressures on the agencies concerned.
The role of the traditional care home has been changing rapidly. Care homes will develop to offer services which have traditionally been delivered by the NHS. Principally, hospitals are and will become centres of excellence for acute services and all other after-care and post-acute services will be commissioned from highly specialist prevention and rehabilitation services, as well as long-stay, high- dependency and end-of-life care, provided by what will become ‘Care Centres’ in our communities.
These centres will work hand in glove with the NHS and Adult Social Care commissioners, with a focus closely aligned, and at times directly combined GP services to provide dedicated, responsive post-acute care or to prevent hospital admissions, enabling older people to stay in their home environment. Care Homes traditionally focused at 65’s and over, but these new ‘Care Centres’ will, and indeed, are developing to provide for a much younger adult age group. The service ‘package’ will develop to be more joined up and more interactive, with the possibility of a one-stop-shop approach for hospital avoidance and post-acute care services.
At Wessex Care, we are developing our own services to meet these new challenges, not by developing pseudo hospitals or hotels with care attached, but by developing the new concept of multi-agency multi-disciplinary ‘Care Centres’ focused on providing the services in the heart of the community for the majority of our community – and crucially at a sustainable cost to us all.
However, and at the risk of seeming political, there is one key factor, outside the obvious funding considerations, which causes us great difficulty in achieving this vision: the key factor is recruitment of well-qualified managers, nurses and principal healthcare assistants who have that rare combination of high-quality clinical care skills combined with excellent people management and deployment skills. In our sector this seriously acute skill shortage has become hijacked by the whole immigration debate, resulting in the increasing inability within the health and social care sectors to recruit these highly skilled individuals.
For many years, indeed since the start of the NHS and the development of Adult Social Care we have supplemented this skill shortage from around the world and more recently from across the EU. Did you know that on average 30% of our health and social care workers were not born in the UK and in our larger city’s this is much higher. These amazing often graduate level individuals have left their families and communities, travelled to our country, often many thousands of miles away, to support and care for some of the most vulnerable people in our society which without them our Adult Care Service and the NHS would simply fail. They work hard, pay their taxes, produce a younger generation that we so desperately need for the future, and often supply financial aid back to their families which benefits large sections of the third world and less fortunate EU nations. They are truly amazing, we should be applauding them and protecting them, no matter what side of the Brexit influences our opinion.
This issue should and must become bipartisan please talk to your MP.
Matthew Airey is the managing director of Wessex Care, chair of the Wiltshire Care Partnership and national director of the Registered Nursing Home Association.