Today the Government’s Health and Care Bill receives its second reading in the House of Commons with its ambition to integrate health and care. As I have commented before, it is difficult to argue against the improved integration of services across health and social care which has the potential to improve people’s lives. However, much of the discussion continues to focus on systems and legal frameworks, leaving out the very human implications of a fragmented or disjointed system.
The social care sector also continues to wait for the much-promised reform of social care, without which integration risks remaining within the pages of the Bill rather than in practice. At its very heart, this Bill is about people, about you and me, who may at some time in our life course need the support of these services. We need the government to put people at the heart of this system change and thread personalisation throughout their proposals.
At The Disabilities Trust, the people we support with an acquired brain injury, autism, and/or learning or physical disabilities are at the heart of everything we do and we recognise that everyone has a life course, often with different phases of need.
We also recognise that the transitional periods between phases can be very challenging for those with complex health needs and this is when people are most at risk of falling through the gaps.
Good rehabilitation focuses on the impact that a health condition or disability has on a person’s life, rather than focusing just on their diagnosis. Effective partnerships across teams, voluntary agencies and community resources are central to providing the right support in the right place for each individual. Transitioning between these systems and exiting or re-accessing support can be a critical time for people and their families. Good networks and communications between the different sectors are therefore essential and need to be dependable and consistent.
When needs are unmet, individuals may be at greater risk or become increasingly vulnerable. We are very proud of the fact that 70% of people leaving our brain injury services went on to more independent settings, with increased participation in social activity. This is achieved by the hard work of our multi-disciplinary teams working together to ensure that the people we support don’t fall between the gaps as they transition to their next phase of rehabilitation, however, this is not the case for many.
It is during these transitions where we hope that the Health and Care Bill will change people’s life course for the better. This whole effort risks being destabilised if the Government doesn’t meet its promise to reform social care. Transitions into a system that is chronically underfunded, suffering workforce shortages and desperate for reform, risks destabilising the ambition of integration. If this enterprise fails it will be people who will suffer, so lets ensure we take the opportunity to build an integrated system that does not let people fall through the gaps and puts people at its heart.