The Care Quality Commission have today published a report looking at how older people move between health and social care services.
Based on research carried out over 20 local council areas researchers found examples of health and care organisations working well together – and of individuals working across organisations to provide high quality care.
Researchers also found cases of ineffective co-ordination of health and care services, leading to fragmented care. This was reinforced by funding, commissioning, performance management and regulation that encouraged organisations to focus on individual performance rather than on positive outcomes for people. The lack of a shared plan or vision resulted in people not receiving the right care in the right place at the right time – with consequences ranging from care being provided at greater expense than necessary, to increased pressure on services, to people’s quality of life being significantly diminished.
The report Beyond barriers sets out a number of recommendations designed to encourage improvement in the way agencies and professionals work to support older people to stay well, including;
- The development of:
‒ an agreed joint plan created by local leaders for how the needs of older people are to be supported in their own homes, helped in an emergency and then enabled to return home; supported by:
‒ long term funding reform
– involving national care leaders as equal partners
– in order to remove the barriers that prevent social care and NHS commissioners from pooling their resources and using their budgets flexibly to best meet the needs of their local populations; underpinned by:
‒ a move from short-term to long-term investment in services, and from an activity-based funding model towards population-based budgets which encourage collaboration between local systems.
- A single joint framework for measuring the performance of how agencies collectively deliver improved outcomes for older people. This would operate alongside oversight of individual provider organisations and reflect the contributions of all health and care organisations – including primary, community, social care and independent care providers – rather than relying primarily on information collected by acute hospitals.
- The development of joint workforce plans, with more flexible and collaborative approaches to staff skills and career paths. National health and social care leaders should make it easier for individuals to move between health and care settings – providing career paths that enable people to work and gain skills in a variety of different settings so that services can remain responsive to local population needs
- New legislation to allow CQC to regulate systems and hold them to account for how people and organisations work together to support people to stay well and to improve the quality of care people experience across all the services they use.