Thursday 18 January 2018
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ADASS calls for overhaul of direct payments for frail and/or demented older people

ADASS published today The Case for Tomorrow: Facing the Beyond - a document which reviews the Association’s seminal 2002 publication Inverting the Triangle of Care  in the context of the imminent implementation of the Health and Social Care Bill; an emerging social care White Paper, and government responses to the Dilnot Commission on Care Funding, and the Law Commission report on social care law.

The document stresses the absolute importance of government:

  • Investing more in social care. The government should work with ADASS and other partners to address the Dilnot issues; explore how the market for personal social care insurance can be developed, and ensure that the “NHS is able to provide or pay for the full range of continuing care support.”
  • Making sure choice and control can work: review the implementation of personal budgets and direct payments with older people and identify how they can be overhauled,
  • Reducing barriers to integration. The report says: “we are not convinced that further top-down changes in the structure and organisation of the health and care and wellbeing services will achieve the aspiration for better working practice.”,
  • Incentivising community-based care and wellbeing services and encourage clinical commissioning groups to invest more in community-based health and social care, “and reduce the use of acute provision for older people, particularly those with dementia.”
  • Helping to  change assumptions about old age, then draw on the Law Commission findings to put in place legislation, supported by clear guidance and advice, about what older people can expect from the state, and what they will be expected to contribute,

ADASS President Peter Hay warned of possible contradictions between implementation of the Bill and the delivery of integrated social care, and that the way the Bill is implemented potentially undermines the shared aspirations for integrated responses in localities that were so much a part of the thinking of the NHS Future Forum.

He said: “We have heard many calls for better integration between health and care from many politicians over recent months. ADASS continues to share frustrations at the current state of integration: we haven’t weakened in our aspirations to improve the situation. ADASS will call for a greater level of debate on how we reach our shared ambition of strengthened and better care in our communities. And a health care system that drives out the inequalities in outcomes that the Bill rightly challenges.”