Thank you to Cheshire West and Chester for hosting this year’s County Council Netwwork Conference, they are a council who - along with Manchester, Essex and the Tri-boroughs - have paved the way for the groundbreaking social care fund.
These pioneers have set a really high standard for what all of you here today can hope to achieve.
Today I want to talk about how you can change the adult social care system and make a big difference to your communities.
I want to share a story with you, which for me outlines all of the reasons why we have to take this opportunity. This is a true story that I used during the Spending Review and the budget.
One evening a friend of mine came home to the news that her mother in law, Beryl, had been admitted to hospital. Beryl is 88. For a number of years Beryl has had 1 or 2 health complaints – problems with her heart were causing swollen legs and reduced mobility.
Under the care of her husband Arthur, who is 87, they were generally coping quite well. However, in the hot weather we had over the summer, her legs were so swollen she couldn’t move. Arthur was going to have difficulty helping her to the lavatory. So Arthur phoned the GP.
Who told him to phone social services.
Who told him to phone the physio.
Who told him to call the local hospital.
Who put him back onto the GP.
This referral ping-pong meant that Beryl ended up in hospital later that day. Beryl didn’t want to end up in hospital, and Arthur just needed that extra bit of support at home, someone he could rely on to help.
Of course when elderly people are admitted to hospital, it can cause all sorts of additional stress and anxiety.
Most frustratingly of all, with Better Care, Beryl’s experience could have been very different.
Beryl’s story is by no means unique. Sadly, ‘we all know someone.’ Someone who has had to battle to be heard, or is bored of repeating themselves – someone who simply deserved better.
Between now and 2030, our over 65s population will increase by 95%. And I am one of them.
That is the size equivalent of Birmingham.
We cannot stop the population from aging – but we can take control of the capacity and quality of the care they receive. When only 4 in 10 members of the public think that social care and health work well together, something has got to change.
My challenge to you – is to turn this around. Start drawing up your plans now. Think with a great deal of innovation. And make sure that the experience of the patient is at the front of your mind.
A good, joined-up system in practice is a GP who can offer access to physiotherapy within 48 hours – not 4 to 8 weeks.
It is 24/7 access to social care – making the transition from the hospital to home quick and easy.
It’s a 1-hour home visit rather than 2 days on a ward.
Most of all, though, it is about using common resources and common sense.
Health and social care must work in partnership to be ‘altogether better.’ That’s the name of Cheshire West and Chester’s pilot of the social care fund which I had the opportunity to look at before the conference.
With the patient at the heart of their system, Cheshire West and Chester have:
- co-located district nursing, occupational therapists and social workers with GP’s – creating better relationships and better communication
- improved their discharge team, so that the chances of readmission are slashed
- made sure that the health and wellbeing boards and clinical commissioning groups listen to the views of carers, to help make their lives easier
Home care is often preferred care, and Chester have revolutionised their home care offering.
Telecare and Telehealth are giving the elderly and long-term ill an autonomy they haven’t experienced before. You can almost feel the pressure being lifted from our over-stretched nurses and social care staff.
Research by the King’s Fund has shown that over two-thirds of emergency beds are occupied by unplanned over 65s admissions. If hospitals improve these emergency admissions to the standard of the top 25%, this will save £462 million per year.
We aren’t talking about the odd bed here and there – we are talking about freeing up thousands of beds.
That’s why the NHS is going to be one of the major beneficiaries of Better Care.
One local Chester carer, who has spent 16 years looking after disabled wife, said:
the clinical commissioning group wants to build bridges and welcome me across, rather than build brick walls.
This is the sort of great feedback we want to hear from service users, and that will mark out your success
In a few weeks, the guidelines that your success will be measured by will land on your desk. We will be asking to see some simple and sensible outcomes – ones that won’t need reams of explanatory notes to understand:
- reduced hospital admissions
- an improved patient and family experience
- a 7-day working plan, so that care on a Sunday is just as good as care on a Monday
And don’t forget, a proportion of this fund is going be awarded based on how well you can perform.
You told us that pioneering pilots, flexible budgets and more joint working would be the solution to providing better care. So, the Health Secretary Jeremy Hunt, and I, have now put everything in place for you to deliver.
My challenge to you is to turn £3.8 billion into better care for society’s most vulnerable. In doing so you will rescue many elderly folk from the excess cost and stress of their boomerang hospital bed admissions.
We have already seen the success of other localised budgets.
We gave you the Troubled Families Initiative. In the first 15 months of the programme, 14,000 troubled families had their lives turned around - bringing down the £9 billion per year cost that families put on the taxpayer. I had the opportunity to talk to the local team, who talked of people being able to live independently.
We gave you the Enterprise Zones - locally driven partnerships have created nearly 5,000 jobs.
Business rate exemption has encouraged start-ups and boosted local business activity.
Together we have Better Care – your next success story. It is the next step in getting the money we have got, to work better.
This is why you got involved in local government – to be advocates.
We are putting our faith in you, and it’s a risk that the government is taking.
Councils want to offer a good service – and the best of you are protecting the frontline – you’ve kept weekly bin collections, and you’re filling the potholes. But our adult social care – the way we look after society’s most vulnerable – that is the mark of a good local service.
It is the mark of our humanity. The human happiness element of this is absolutely our priority. But we cannot ignore the enormous savings potential. Cheshire West and Chester are looking at a projected saving of £30.3 million in their first 5 years. That amount nearly doubles once the project has stabilised.
The 4 areas combined are looking at a whopping saving of £463 million.By investing now, we will save the public purse millions later on.
So now it’s time to put it to the national test.
When the public require a solution, they look to their civic leaders to solve it.
This is a once in a generational offer.
Get this right – and this is the future.
Get this right – and more services will be locally devolved.
Get this right – and there are people not very far from this conference hall - people who you might never meet - whose lives you are going to change and change for the better.
The cost of living is a real concern for the individuals and families in every area that is represented here today.
Under the last Labour government, Council Tax more than doubled - they forgot about the people behind the pot of money. By contrast, this government continues to stabilise bills for families. As the monthly Council Tax bill has come down by an average of 10%, the public satisfaction ratings have gone up. We’ve kept the Council Tax freeze on the table for you.
However, if you want to hike up Council Tax you can. You just need to secure the consent of your local residents.There’s no excuse when holding the poll can be done at minimal cost alongside this year’s Euro elections.
If you think you need more money, take it to the people. Just remember the big 6 energy firms are under fire for the sky-rocketing cost of heating a home. And the fact of the matter is, people are paying more in Council Tax every month than they are for energy.
You have made amazing progress in bringing the deficit down by a third - while helping families with the cost of living.
The Better Care fund will ease financial pressures on a creaking social care system.
We’ve all got a responsibility to address the cost of living, and the most immediate way you can do this is to commit to freezing Council Tax for another year.
Beryl and her family don’t care about different budgets.
They don’t care about organisational obstacles.
Neither do they care about geographical boundaries.
Frankly, neither do I.
There are times when we just know, that despite the bureaucratic headache, the red tape, the paper shuffling – there are things we just need to make happen.
The carousel of care stops here.
Today I have set out your challenge.
I want you to take Better Care out to your communities and change lives for the better.