Social Care and the NHS – Uncertainty rules
The Kings Fund, an independent charity working to improve health and healthcare in England, has published the results of its annual survey into satisfaction with the NHS and its services, including social care. The survey was carried out in the summer of 2012, before the reports into the problems with Mid Staffordshire NHS Foundation Trust.
The fact that only 30% of Respondents were very, or quite satisfied with social care provision is likely to attract considerable press comment. However, while 31% were very or quite dissatisfied, an almost equal proportion (28%) were neutral, while there were 11% “don’t know”. The level of neutral responses was significantly higher than for other NHS services, something that might suggest that there is a lack of knowledge about social care services, rather than a lack of satisfaction among the public.
These surveys also map changes in the public perception of the NHS. However in relation to social care the question posed was changed from previous surveys. While understanding the difficulties that such a survey presents to researchers, the actual question asked, “And how satisfied or dissatisfied are you with the NHS as regards…. social care provided by local authorities for people who cannot look after themselves because of illness, disability or old age?” might, we think, be behind some of the confusion.
As the question suggests the responsibility for the provision of social care lies primarily with local authorities and not the NHS. However, the need for a more “joined up” response to the concerns of an ageing population is increasingly apparent with the publication of every piece of research which touches upon the issue. A greater level of cooperation between the agencies involved would go a long way to resolving many of the concerns. Such cooperation remains elusive and will continue to do so for as long as the budgets of the agencies remain separate, individual fiefdoms. With austerity all round and inevitable increased competition for diminishing resources, a unified approach is unlikely to emerge. To misquote a famous phrase sometimes attributed to Joseph Kennedy (JFK’s father) “When the going gets tough, the tough get possessive”.
The high proportion of neutral and “don’t know” responses to the survey reinforces one of the key findings of the House of Lords Committee on Public Service and Demographic Change to which we have previously made reference. There is a need for improved information and understanding among the public about social care in all its aspects, from what can be expected to who is going to pay. In our own, very small way, we will try to continue to make a contribution to making such information available.