Social care practitioners will form part of the neighbourhood health teams that are to be at the heart of a reformed NHS, under the government's 10-year plan, published today.
Ministers plan to to create neighbourhood health services in every area, designed to deliver care as locally as possible, including in a person's own home where feasible, in order to move provision out of hospitals.
These will include multidisciplinary teams - based in new neighbourhood health centres - each supporting people with similar needs and comprising practitioners from different parts of the NHS and, where required, other services, including social care.
Social care practitioners to be part of neighbourhood teams
The plan said social care professionals would be part of teams supporting rehabilitation, recovery and frailty prevention and those for people living in care homes, which would aim to prevent them from requiring hospital care.Other groups that the plan said would be prioritised for neighbourhood teams included people with long-term conditions, those nearing the end of life, those with severe and enduring mental health problems and people with learning disabilities, though the plan did not say whether social care practitioners would be part of these particular teams.
It also did not specify which social care practitioners would be involved in the teams, though NHS England guidance has previously said that they may include social workers, home care staff, care home staff and occupational therapists.
That guidance also said that best practice would be for the team to include a core group of staff responsible for complex case management, with a care co-ordinator assigned to each person, and an extended team who could be drawn upon for specialist support.
Increased uptake of personal health budgets
Though the 10-year plan did not mention the care co-ordinator role, it set out other aspects of how teams should work, including developing care plans, co-created with the people concerned, involving them and their unpaid carers in their services and increasing the uptake of personal health budgets (PHBs).PHBs, like personal budgets in adult social care, put a cost on people's care and give them some level of choice and control in how this is spent. Currently, 180,000 people have a PHB but the plan sets a target of 1 million having one by 2030 and it becoming a "universal offer" by 2035.
In relation to care plans, it said 95% of people with complex needs should have one by 2027; the plan quoted data showing 20% of people with long-term conditions have a care plan currently.
Closer NHS-local government partnerships
The plan also called for closer partnership working between the NHS and local government, with councils with social services responsibilities working with integrated care boards (ICBs), through existing health and wellbeing boards, to develop neighbourhood health plans.The Department of Health and Social Care (DHSC) also pledged to develop service frameworks, setting out objectives, evidence-based interventions and standards of care for different health conditions, including severe and enduring mental illness and frailty and dementia.
It said the latter would be informed by next year's initial report from Baroness (Louise) Casey's Independent Commission into Adult Social Care, which is developing proposals for the reform of the sector.
The plan also provides for the abolition of Healthwatch England and local Healthwatch branches, which work to gather and represent people's views on their health and social care services, and the transfer of their functions relating to the NHS to the DHSC and ICBs. The social care functions of local branches will be taken on by councils, though the plan did not specify how this would work.
Social workers 'key to success of reforms'
In response to the plan, the British Association of Social Workers (BASW) England said social workers were "central to this shift and must not be overlooked".On behalf of BASW England's adults' group, professional officer Liz Howard added: "This includes social workers using their relationship skills to motivate and support individuals, families and communities to recognise and use their strengths, promoting independence and quality of life, breaking the cycle of crisis and freeing up valuable resources to be reinvested."
"We propose that the Casey Commission considers social workers for a greater role in reforms in order to facilitate prevention in social care."
Pleas to involve and invest in social care
The plan's broad vision was welcomed by local government and care provider leaders, but they warned that it would not succeed without the involvement of, and investment in, adult social care.For the Association of Directors of Adult Social Services (ADASS), president Jess McGregor said it was supportive of elements including giving more power to patients and providing integrated care records.
She added: “It’s vital that adult social care leaders, who are well versed in delivering support at the community level, are meaningfully involved in decisions about where and how resources for neighbourhood health and care are allocated and spent to achieve best outcomes for people."
Local Government Association (LGA) chair Louise Gittins said the plan's ambitions could not be realised without "an adult social care system that is financially sustainable, funded to be properly preventative and rooted in personalised care and support".
"The need to reform adult social care cannot wait until the Casey Commission delivers its final report in 2028, and should be acted on now, alongside the 10-year plan," she added.
For the County Councils Network (CCN) adult social care spokesperson Martin Tett, said it was "vital" that the Casey Commission's initial findings were "reported quickly next year to ensure they feed strategically" into the government's NHS plans, given the importance of adult social care to its ambition to shift services from crisis to prevention.
Neighbourhood teams 'need social care at the centre'
The Homecare Association said it neighbourhood health teams offered "a huge opportunity to deliver truly joined-up care", but were dependent on the government fixing NHS and local authority commissioning of home care, which it said were "too often fragile, fragmented and under-funded".Its chief executive, Jane Townson, said that there had been "very little investment in social care", adding: "If ministers want this plan to succeed, they must back home care as a core part of the NHS future, not a forgotten add-on."
Her counterpart at fellow provider body Care England, Martin Green, said: "Neighbourhood health services could transform how people experience care. But without social care at the centre, they risk becoming a brilliant idea lost in translation. If we’re serious about delivering care closer to home, we must start by backing the sector already delivering it.”
