With numerous delays to the publication of the social care green paper, everyone in the health and social care industry has had ample time to truly consider what should be in the long-awaited document.
The government has consistently skirted around the problem of two entirely separate health and social care systems, where families don’t know the support they’re entitled to and services don’t know which system should take responsibility for care for long-term health conditions like dementia.
If the government is still unclear on what needs to happen, then it’s up to us to put forward the changes that we would like to see. The green paper has the potential to provide a shift to an environment which has so far only seen aspirational documents coming to the fore.
1. To acknowledge the true scale of dementia
Firstly, the document needs to truly acknowledge the scale of long-term health conditions like dementia. The NHS Long Term Plan only made a couple of cursory references to dementia, however, we need this document to go a lot further. We need dementia to be seen as more than just an afterthought for the families and health and social care workers dealing with its challenges. This can either be through its own subsection, detailing strategies and targets for families, or reference to it wherever applicable.
2. To provide a roadmap pre and post diagnosis
A key issue for families facing dementia is not knowing what services and support are available for them to turn to. Families should have a clear roadmap for each step of the way, from diagnosis of dementia to end of life care, and this can be a key part of the strategy stated above. More investment should be provided for timely advice and signposting to the appropriate services.
The government needs to build up more awareness of roles like dementia specialist Admiral Nurses, whose numbers are increasing throughout the UK, to help families facing dementia cope during the toughest times.
3. To have the proper funding arrangements in place
Proper funding arrangements must be set out in the green paper which identify how it will provide for families with dementia in the long term. We either need a taxation system which clearly ringfences money for health and social care or a long-term insurance system, as in Japan, to provide the necessary security as we age. Laying the foundations for systems like this will not only help to bolster services but also fuel more jobs and innovation within health and social care.
4. To bridge the gap between health and social care
We also need to truly bridge the gap between health and social care and this document has a prime opportunity to do just this. To put this into perspective, the Department of Health and Social Care rarely talks about social care within the NHS. A key part of this should be the focus on preventative health measures, which an increase in community support would provide. This can take many forms, such as exercise or gardening classes, which get people talking to others in addition to preserving healthy lifestyles.
Whilst the NHS Long Term Plan should be lauded for its policy shift towards more community support, we need to ensure that these proposals are sustainable to help families in the long-term. More local initiatives and programmes can provide the answer but are nothing without a commitment to the long-term funding.
Families with dementia urgently need clarity, compassion and respect. As professionals working in dementia care, we know what families should have in place to support them and it’s high time the government did too. The government has a real opportunity to get this right – to both support families facing dementia, and to build a wider society replete with jobs and the right funding models for a population ageing with dementia.