Investing in social care to reduce healthcare utilisation

Abstract

BACKGROUND With increasing age, people are more likely to live with multiple health conditions, be prescribed more medications, and require support from a wide range of services within the health and social care sector. In the context of constrained budgets, it is a challenge for the UK to deliver a welfare system that supports older adults living with frailty within the community. It is certainly not unique across developed countries to be facing this paradox. 1 The authors' wish to highlight the potential case for investing in the creaking social care system, following recent policy changes promoting spending in adult social care through the Better Care Fund and broader changes in funding streams. 2 THE PRESSURISED SOCIAL CARE SYSTEM The challenges facing the UK's social care services is well documented, with an Age UK report estimating that, in England, 54 000 people-or 77 a day-have died while waiting for a care package in the 700 days since the UK government declared in March 2017 that it would publish its social care green paper. 3 This remains unpublished, with the government now missing five consecutive deadlines. The issue has been brought back into the political limelight after the House of Lords Economic Affairs Committee published their report titled Social Care Funding: Time to End A National Scandal, in July 2019. 4 The committee recommended an immediate injection of 8 billion GBP, followed by a further 7 billion GBP a year to extend NHSstyle free personal care to all by 2025/2026, paid for out of general taxation. There is a clear precedent, with free personal care already provided in Scotland for those aged 65 years and over, and younger patients with degenerative neurological conditions. In the UK, social care is funded and delivered through local authorities. In England, a significant proportion of funding for social care flows from Government on a formula basis, with local councils able to use local taxes in addition to central state funds. Locally delivered social care services

Profiling chronic diseases and hospitalizations in older home care recipients: a nationwide cohort study in Sweden

“…Second, HC and health care are disintegrated in many countries [ 31 ] including Sweden which implies that PC staff, for instance, may not even be aware that a patient receives HC (Box 1 ). Contrary, qualitative studies have reported that HC staff lack opportunities to report their observations to medical professionals [ 32 , 33 ]. Since the integration of PC and HC is indispensable as both partners have important knowledge to share, integration and communication should be promoted.…”