MHP Health Mandate’s Managing Director, Mike Birtwistle, was invited to speak at yesterday’s Community Care’s annual conference on dementia care to discuss the findings and recommendations from MHP and the Alzheimer’s Society’s recent report, Common and complex: Commissioning effective dementia services in the new world. Ahead of the conference this guest blog was written by Mike Birtwistle for Community Care and published on their website.
Among the claims and counter-claims, the summits, pauses and consultations it can be easy to forget about the range of measures contained within the government’s NHS and social care reforms that both supporter and opponent would have little difficulty agreeing on.
Even those who cry foul of the Health and Social Care Bill would struggle to object to the White Paper’s original ambitions of improving outcomes, bringing care closer to home and revolutionising the collection and publication of data in the NHS and social care. Amendments to the Bill to focus on integration rather than competition also reflect a shared ambition.
With the legislation still likely to go through, albeit heavily amended, the focus of those working in the NHS and local authorities is already switching to how the reforms can deliver improved care in key areas at a time of funding constraints.
Dementia is one such area where improvements will be needed if the reforms are to be judged a success. Dementia already costs an estimated £20 billion a year and by 2021 the number of people in the UK with the condition is set to rise to one million. As our recent work with the Alzheimer’s Society found, the reforms do provide health and social care commissioners with a range of tools to deliver improved dementia care.
People with dementia often find their care fragmented. The focus in the reforms on integration particularly through health and well-being boards at a local authority level, presents an integration imperative that can provide more joined-up care for people with dementia, reducing costs and delivering care closer to home.
Data on dementia are patchy and of poor quality, hindering attempts to assess the effectiveness of services. Plans for an "information revolution" in health and social care data should allow commissioners to mark areas for improvement and support patients and carers in exercising informed choice.
The lack of good data also hinders attempts to quantify the cost of dementia across the care pathway. Existing structures and budget silos further hamper funding arrangements and the creation of more joined-up working through the health and well-being boards should help create a forum to deliver more innovative and joint funding methods for dementia services, simultaneously improving outcomes and delivering necessary efficiencies.
Finally the mantra of "no decision about me, without me", coupled with plans to increase the use of personal budgets, should help ensure that care is more person-centred, as well as allowing frontline staff to deliver care that is more tailored to an individual’s needs.
Whilst there is no doubt that the reforms and the legislation behind them remain a political football, that game will soon end and a new process of delivering improved care will begin. How they deliver for dementia will ultimately be a key barometer for whether or not they are a success.