National Personalisation in Health and Care Conference25 September 2013

The future of health and social care

Richard HumphriesAssistant Director, Policy, The King’s Fund

r.humphries@kingsfund.org.uk

How is social care viewed by the public?

Overview:

Overview Personalisation in context65 years of change – what past & future trends means for the future of servicesthe Barker CommissionQuestions

Real terms spending on adult social care is falling -

£0bn

£2bn

£4bn

£6bn

£8bn

£10bn

£12bn

£14bn

£16bn

£18bn

03/04 05/06 07/08 09/10 11/12 13/14 15/16

Real terms expenditure on adult social care (2011/12 prices)

The latest: 5% drop since 2010

Source: NHS & Social Care Information Centre

Fewer people receiving adult social care services…

Real terms spending on older people

Older people in

community care

Older people in residential

care

70

80

90

100

110

120

06-07 07-08 08-09 09-10 10-11 11-12 12-13

Real terms spending on working age

adults

Working age adults in

community care

Working age adults in

residential care

70

80

90

100

110

120

06-07 07-08 08-09 09-10 10-11 11-12 12-13

Changes in expenditure and numbers of care users, by user group and care setting(index 2006/07=100)

,.

A significant rise is expected in chronic and multiple chronic disease

Arthritis up 100% to 17m by 2030

People with 3+ LTCs up 100% to 2.9m by 2018

Diabetes up 29% by 2025 to reach 4 million

People living with cancer doubling by 2034 to 4m

14

The landscape has changed dramatically

The issues in summary:

More of us, living longer, with more things wrong us– mixture of physical & mental health and care and support needs

Traditional model of care is based on acute treatment, reactive & crisis driven

Shift from public to private delivery of care services

Shift to private and co-payment funding of care services…..whilst NHS remains largely free at point of use

Who pays for what - ad hoc, arbitrary, confusing

Financial sustainability & equity of separate systems

The NHS and adult social care ‘offers’ continue to diverge

A new narrative for integrated care

• Focus on coordination of care around individual needs

• Pioneer programme• Transformation fund - £3.7b

• (£1b performance related)• Two year plan (for 2014/15 & 2015/16) must be

in place by March 2014• Plans to be developed jointly by CCGs & Las,

signed off by each other & HWBs

Integrated care – what’s new

The Commission will examine the way in which health and social care is organised and funded and will consider whether the systems could be better aligned to meet the needs of patients and service-users. It will consider three broad questions.

• Does the boundary between health and social care need to be redrawn? If so, where and how? What other ways of defining health and social care needs could be more relevant/useful?

• Should the entitlements and criteria used to decide who can access health and care be aligned? If so, who should be entitled to what and on what grounds?

• Should health and social care funding be brought together? If so, at what level (ie, local or national) and in what ways? What is the balance between the individual and the state in funding services?

Chair: Kate Barker CBE, a business economist who is a former member of the Bank of England’s Monetary Policy Committee and now a holder of a number of non-executive posts. Geoff Alltimes CBE, chair of the Local Government Association’s multi-agency task group on health transition and previously Chief Executive of Hammersmith and Fulham Council and NHS Hammersmith and Fulham. Lord Michael Bichard, cross-bench peer and Chair of the Social Care Institute for Excellence. Baroness Sally Greengross, cross-bench peer and Chief Executive of the International Longevity Centre UK. Julian Le Grand, Richard Titmuss Professor of Social Policy at the London School of Economics. Mark Pearson, Head of Health at the Organisation for Economic Co-operation and Development, will act as the Commission’s international adviser. Nick Timmins will be the Commission’s rapporteur. Richard Humphries will be the senior lead for the Commission within The King’s Fund

Timescales:Call for evidence: May to September 30th

Public & stakeholder engagement: Autumn 2013Evidence gathering: Autumn 2013 > early Spring 2014Interim report: Spring 2014Final Report: Autumn 2014

http://www.kingsfund.org.uk/projects/commission-future-health-and-social-care-england

#barkercomm

barkercomm@kingsfund.org.ukr.humphries@kingsfund.org.uk