The challenges in our health and social care system have been well reported. Across Scotland and the UK, media stories frequently highlight delays and pressures, portraying a picture of a system creaking at the seams. Here in Edinburgh the scenario is very similar and more acute in some respects. Our aspiration of providing the right care in the right place at the right time is a long way from being realised.
More than 170 people are currently unable to leave hospital despite being well enough to do so, mainly because we are unable to offer a package of care, find a place in a care home, or carry out adaptations to homes quickly enough. Around 1500 people, having expressed a need for a social care service, are waiting to be assessed. And they are waiting too long. 700 people having been assessed as needing support are still waiting to receive it because we are unable to source a package of care for them.
These delays remain, despite the fact that over the last two years the Health and Social Care Partnership has provided an increase in care hours from an average of 40,000 per week to 53,000 per week, a remarkable increase of 32.5 per cent.
Behind each statistic is a person, usually older and often quite vulnerable, plus family members who are anxious to see their loved ones settled and cared for.
Demand for services is increasing, funding is reducing, and while more money from government would be welcome, this may not solve all the problems we face.
It’s also important to note where we’ve seen success – the move to locality working, a shortened assessment, and closer working with hospital staff to reduce delays. We also shouldn’t overlook the commitment of our passionate and dedicated workforce.
Supporting people to live as independently as possible in their own home and community means we need to think carefully about how our invaluable health and social care services are provided. Shifting the balance of care to more community-based services won’t be easy, and I suspect the debate about how this will happen will continue for some time to come. I believe that working more closely with communities and third sector organisations could deliver real benefits, both in shifting the balance of care and building community capacity to provide services in different ways. There is a history of innovation in the third sector and many successful projects are delivering better outcomes for people. We need to build on these.
We also need to do more to tackle health inequalities and address some issues that are detrimental to health, such as obesity, poor diet, smoking, alcohol and drug misuse. Investing in prevention and early intervention is essential in supporting people to maintain their health for as long as possible.
There are no easy answers to the challenges we face, but by embracing the concept of integration and “doing things differently”, we have some excellent foundations on which to build.
Councillor Ricky Henderson, chair of Edinburgh Integrated Joint Board