As the dust settles on the 2019 general election the focus shifts to a new government that has ensured the electorate is conscious of the need for investment into health and care. We all know that the issues are more than additional investment, so here’s twelve Christmas actions for a health creating New Year.
Peter Hay, Treasurer, New NHS Alliance
Action 1: think about how the 3 C’s help create value
The election debate has been about traditional big levers of government, particularly taxation and spend. It’s seen little about ways in which citizens can engage as participants in health and care. The New NHS Alliance commitment to health and care systems pivots on the capability to have confidence and control as well as being able to connect, supporting the big levers from the bottom up.
Action 2: let’s get people involved
Being invited into the process and finding ways in which people can participate takes time. But it does build a better approach which doesn’t sound so long term when contrasted with watching for money to show up in your locality.
Action 3: well, it’s Christmas, so we could commit to a journey
Participating and making our own health and well-being does not come ready made.
We could lead with a question about what it might take to meet the needs of people today in the best ways? (If you know all the answers already then proceed directly to a top down plan. If you know some of the shape but still need to find some answers then going on a question-led journey may work for you!) As we have never had today’s demographics be wary of the former!
Action 4: what would new hospitals look like?
40 new hospitals will be new capacity. Let’s try and avoid this meaning 40 more A&E’s that are full of older people for the want of something more imaginative or those in heightened mental distress as there is nowhere else. What do hospitals look like that are designed for the needs of people now rather than being more of what we have?
Action 5: can we find the younger adults (please?)
Social care is important to older people and is equally important to adults with needs arising from their mental health, learning disability, substance use or a whole range of needs which require support in day to day living. We need to ensure that the debate about social care is inclusive for all people whose needs require support.
Action 6: think broadly about assets
A debate framed around not using your home to pay for the costs of care starts from the wrong perspective. Where we live and the houses we live in can change the way we age. We know from the research of Extra Care Charitable Trust and Aston University that extra care is life improving and creates better health. And we also know that 80% of older people want to stay living in their existing home. We need to think about using our housing choices and our community connections to change our life experiences. (If defending the financial asset is important, let’s not attack the best from of defence?)
Action 7: profitability does not guarantee quality
It’s uncomfortable but quality does not automatically follow money. There are profitable businesses that should not be allowed to hide behind the cloak of severe cuts of recent years.
Last year the Guardian reported how inadequate care homes were being run by very profitable companies. This is also an issue in children’s care: look at action taken by Ofsted against a profitable company where children had to share a single toilet roll across six bathrooms and one child had a weekly ‘diet’ of approximately 122 chicken nuggets and 14 litres of fizzy drink.
We have to challenge the use of money as much as the allocation.
Action 8: well, it’s Christmas, so what about thinking about morality?
We need to find a language about ethics and morality that is entwined with the regard that we show people. The era of spin, fake news and a casual approach to evidence presents a challenge to how people trust, engage and think about organisations. How are the organisations in health and care different?
Action 9: bring in public health
There were some election commitments about broader thinking on wellbeing and how regulation and wider levers for change might be used. We need to think how we plan to make public heath the centre of population and place-based approaches.
Action 10: well, it’s Christmas, so let’s bring in the Tiny Tim’s (and Timina’s …)
Children are 25% of the use of the NHS – but you wouldn’t think it. There are serious issues to be faced from mental health to lifelong approaches to disability and more. These issues need some considerable attention and children need more visibility.
Action 11: have a Christmas wish …
What one thing would make the biggest difference for you? For me, perhaps the end of the use of seclusion for people with learning disabilities and mental health?
Action 12: Enjoy! Have a Happy Christmas and a health creating New Year.