16 September 2016

Inequalities in access to care – older people disadvantaged again

The King’s Fund and Nuffield Trust have produced a report outlining the current crisis in social care for older people, showing that access to care depends increasingly on what people can afford – and where they live – rather than what they need.

The report, Social Care for Older People: Home Truths, shows that under-investment in primary and community NHS services threatens to undermine the policy goal of keeping people independent and out of residential care.  The report also outlines how the Care Act (2014) led to a range of new demands and expectations for older people and their families that local authority funding has not kept pace with.

Blogging about the report, King’s Fund Social Care Policy Fellow Patrick Hall said, “the combination of under-investment in primary care and district nursing, as well as social care, means older people are more likely to end up in hospital and get stuck there if the right community support is not available”. Hall has called for “real investment to scale up emerging better, more community-focused models of care” warning that without such moves “our aspirations of keeping people well in their own communities will remain just that.”

The report goes on to recommend a series of policy interventions to bring equity back to the provision of social care and achieve better care outcomes with fewer resources – for example, through better commissioning and more integrated care.

Commenting on the report NCHA Policy Officer Jakob Stenkvist said, “We all know there is pressure in the system; these challenges are having a negative effect on health inequalities.

“Hearing care is, sadly, a striking example.  The Department of Health, NHS England and NHS Improvement now accept investing in hearing care can help people to age well, stay independent for longer and reduce pressures on social care. Additionally, Monitor and NHS England have shown savings in excess of 25% can be achieved, allowing more people to be treated with the same spend.

“It is a challenging time for commissioners, and some are rushed into rationing services for older people without analysis of alternatives - e.g. commissioning services that offer better value for money. The system is under pressure, but part of that is down to a lack of accountability and transparency. The NCHA continues to support commissioners deliver better value for patients and taxpayers.”