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Care provision – pressure to innovate?
The organisation provides an annual survey of care providers to assess their confidence and optimism about the business sector. The latest results covering 2014/2015 reveals a gloomy picture. The organisation summarises it as:
' The survey results point to evidence of a widening gap between key policy initiatives that promote better services and improved outcomes through partnership, prevention and early intervention, and the reality for care and support providers, who continue to be faced with significant local authority funding cuts despite growing evidence of the positive impact of their services on personal outcomes. '
And the trends continued throughout 2016, with reports of difficulties in continued cuts in funding, tendering and commissioning difficulties, staff costs, problems of recruitment and retention, and costs of new policy initiatives from the Government, all affecting a new low in optimism and confidence among its members.
Combined with Audit Scotland reporting recently that implementing alternative models of care, such as shifting the balance towards home support, is making slow progress towards government objectives for public welfare. The monitoring body puts this down at least in part, to a lack of national leadership and clear planning for the care sector.
These financial and policy vulnerabilities have been called a 'perfect storm' for the care sector. It is occurring ironically when the overall quality of care is improving year on year as measured in the quality grades awarded by the care regulator, the Care Inspectorate, in Scotland. A further irony is that the Care Inspectorate is itself currently facing a need to reduce its expenditure by up to two million pounds this year.
The national picture
Nationally in the UK as well as in Scotland, the rate of care home failures and closures is accelerating. Traditional care services are facing increasing difficulties with falling profits (or often, increasing deficits), an increasing demand, while alternative care models are too slow in arriving.
The Inews website reports that 5000 care homes in the UK are currently at risk of closure, with a 24 times increase in insolvency rates in the sector since 2010. In Scotland, it is reported that more care places were lost in the first two months of this year than in the whole of 2014.
The way forward?
However, there are opportunities. CCPS itself is organising a series of workshops and seminars for the care sector on resilience in the face of decreasing resources and increasing expectations and demands. The organisation emphasises the need for innovation and change in service models to meet changing needs and expectations. Possible changes of direction may be modelled on the self -directed support approach; on greater involvement and partnership with community and voluntary working; and increased collaboration and integration of services to focus on national demand and increasing rights-based demand for new services.
This brave program, in facing the issues is in line with public policy of transforming how services are delivered. It is to be hoped that the funding storm and crisis will pass and leave us with a more viable, innovative and responsive approach to meeting the health and social care needs of our population.
Tony Clarke – QCS Expert Scottish Care Contributor