Department of Health
Published: 22 May, 2014
guidance on care and support plans
guidance on the review of care and support plans
Back to care and support plans
Only your name and your comment will be published, the other information you supply here will not be published. Required fields are marked* but it would be very helpful if you could provide the other information requested.
Please note that comments left here are public - you can also make a private submission.
Your email address will not be published. Name, email address and comment are required fields. Please note our moderation policy.
Name (this will be published alongside your comment)
What best describes you or the people you represent?
Health or care professional
Care provider organisation
If "other", please specify:
The integration of care should include the main relative carer, and main care assistant as well as all other care professionals, to have input about the ability of the plan to meet the needs of the individual.
The guidance is supportive of integration of health and care, but has less to say about the integration with other forms of state support such as housing (recognising that housing is not exclusively state funded or provided). More examples of how services and resources from housing, health and adult social care can be integrated around individuals would be welcome. Sitra, on behalf of TLAP, is producing a version of Making it Real aimed at a housing audience and we would recommend that this is mentioned as a forthcoming resource.
The guidance should also reference the audience towards Better Care Fund pioneers, with an understanding of the integration of housing, health and social care.
More direction should be given in the guidance to align the planning systems health, care, housing support.
We believe that the draft guidance goes some way to supporting the integration of heath and care, but that the combining of plans should be encouraged more strongly than the guidance currently suggests. Aligning the planning systems will require much greater direction and will also need to be reflected in other initiatives such as the Better Care Fund
No, because it will take more than guidance to make this happen particularly in relation to funding.
I believe the integration of health and care as it is currently being enacted is simply a way of easing more private providers into the NHS. This massive reorganisation, which has not been supported by any pilot schemes to test its efficacy, will effectively blur the boundaries between health and social care to normalise paying for health services. The huge administration costs of the Health and Social Care Act could be put to much better use to provide frontline services.
Erosh believes that the guidance needs to include housing as a fully integrated partner with welcomes the inclusion of housing with health and care and not just come under ‘any other state support’. In places also In places in the Act, housing is also referred to as a ‘health related service’ which undervalues the significance of housing as an equal partner with health and social care. ‘Registered providers of social housing are mentioned in the Act (6(3)(d))as as one of the appropriate ‘persons’ with whom a local authority would co-operate with but there is very little mention of housing other than this and insufficient recognition of the complex and interrelated range of services and accommodation which make up much supported and sheltered housing. The integration of housing with health and social care is what we have been arguing for not least because it provides better outcomes for older people.
The guidance could be made clearer to ensure health and other sectors are aware of their roles in the integration agenda. Change to culture and methodology will be needed rather than just a shared care record and guidance to achieve true integration.
The Housing LIN notes in paragraph 10.60 that the guidance seeks to align health and social care so that they there is a more coherent and streamlined system to avoid any confusion across to the two different systems. However, integration is so much more than with health and social care economies and decisions made within acute, community or social care can also have a significant impact on the way housing services are commissioned, funded and managed. Indeed, evidence from the Netherlands (below) suggests that if personalisation is merely seen as a means for rationing services and/or cutting budgets, this can both restrict individual choice and/or create uncertainly in the market. For example, exposing providers to financial (capital and revenue) risk.
The Long Term Care Revolution: A study of innovatory models to support older people with disabilities in the Netherlands
This study was undertaken to see what can be learned from the experience of the Netherlands about long term care in order to inform policy, research and practice in the UK.
It found that while the two countries are very similar in demographic profile and the experiences of the older generation, it is notable that according to official statistics older individuals remain disability-free for nearly half a decade longer in the Netherlands than in the UK. However, with a rapidly ageing population, there is mixed evidence on the cost effectiveness of Personal Budgets for older people and they have been ended for new users since 2010. These changes have been implemented mainly to save costs to the state-sponsored social insurance fund; but they might put more pressure on informal carers.