"The immediate theme for 2013 will be much the same as for 2012 – and probably for 2014 and well beyond – and that’s the ongoing pressure on costs. There is, quite simply, no end to austerity in sight. The pressure on costs isn’t levelling off – it’s continuing to grow.
“So for providers, maintaining the right focus on quality and on the needs of the people we care for becomes an ever more important principle. More emphasis is being given to meaningful, regular reviews of support plans that are truly personal, that focus on improved lives with reduced interventions and which demonstrably help individuals achieve their goals.
“As individuals, we will all want – and have the right – to invest personally in a service which helps to ease our difficulties, which keeps us in our homes with flexible support and interventions and which gives us the ability to move up to more regular and more complex support under our own control. Where the public sector doesn’t meet these needs we should respond flexibly and sensitively with self funded options.
“There must be a continued and inexorable drive to optimise efficiency – by both commissioners and providers. Beyond this there is an imperative to find better solutions. We’re seeing opportunities, virtually every week, to deliver the services which address commissioners’ immediate ‘pressure points’ in a strategic way, which support timely discharge and which ensure access to communities which are increasingly difficult or costly to reach – such as rural communities affected by rising fuel costs.
“We’re responding by encouraging care workers to guarantee availability and commit to services in the long term by offering access to sponsored cars to meet transport needs, guaranteed hours, improved terms and conditions and help with housing. Innovation starts in the workforce.
“The most effective response to the pressure in costs will, however, come from a more developed, strategic conversation between local authorities, health commissioners and providers. We must all be transparent about intentions, outcomes, and how to at least start to remove the barriers to integration. Specialist, niche services are essential to fully personalised care – but will have to be purchased across boundaries. Both commissioners and providers will need to share best practice and reduce duplication and over-engineering in delivery.
“The key principle for 2013 – and beyond – must be for the individual, not the service, to come first. That’s the principle that should drive us all, whether commissioning, providing or using care services.”