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The Shifting Carpet The policy context and challenges facing Adult Social Care. James Bullion & Jennifer Holland Assistant Directors, Community Services, Norfolk County Council . Positives. Longer life, wealthier, well informed Good technology More satisfaction Holistic services
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The Shifting CarpetThe policy context and challenges facing Adult Social Care James Bullion & Jennifer Holland Assistant Directors, Community Services, Norfolk County Council
Positives • Longer life, wealthier, well informed • Good technology • More satisfaction • Holistic services • Prevention and integration
More positives….. • Increased government investment • Growth in spending on older people • Growth in spending on disabilities • Direct accounts now 5% of spending
Challenges - lots • Efficiency savings • Better, simpler, faster • ‘Community’ and ‘health’ integrations .. • Localism & Place • Shared back and front offices • Enabling communities to do more • People in control • Quality and Value • Service failures • Changing population • Diminishing resources • Rising expectations • ‘irrational, confusing & unjust’ • Earlier prevention • People in control • Account holders • Carers paid for care • Shaping markets • Holistic and micro commissioning
Care in 10 years • 25% plus under the ‘care’ system • 2-3% GDP • NHS – simplify • Online, digital, 24/7 • Increased migratory work patterns • Strains on infrastructure
Care in 10 years continued… • Planning for care & prevention • More ‘account holder’ than eligible? • Understanding of availabilities • Advice, brokerage & care arranging • People more targeted for interventions
Also in 10 years • Increased isolation • Increased disability support needed • Increased dementia • More ethnically diverse population
Need versus resource People with learning disabilities: demand will increase dramatically over the next 5-10 years
Coalition policy context for health care • Breaking down barriers • Establishing a commission on long-term care • Extend roll out of personal budgets • Improve access to respite care through community based provision • Primary Care Trusts accountable to elected councillors • Separation of commissioning from provision • New emphasis on public health issues
Working with Culture and Sport • Supporting prevention • Helping people live independently • Access to services through personal budgets • Delivering the Five Steps to Happiness – connect, be active, be curious, learn and give
How do we engage with one another? • How do culture and sport ensure their contribution is understood and is included in commissioning opportunities? • How do care services get to know what culture and sport can offer and include them in commissioning opportunities?
"Instead of seeing the rug being pulled from under us, we can learn to dance on a shifting carpet." Thomas Crum