The recent Badge of recognition for Social care workers is a good first step towards recognition. However, may I suggest that what is needed is a credible plan for education to bring health and care together so that older people with long term conditions are not disadvantaged from a health perspective so that all adults can see parity between the two systems. This would include a life course approach to prevention and treatment from a whole person and multi-disciplinary perspective right across Primary, Secondary and Social Care.
We know that behaviour underpins all good care. This is informed by expertise. Both things have to be taught. We have already developed a framework for this learning that can be applied to different groups to deliver the person centred outcomes that matter most to people receiving care in the community, both in a care home and in their own homes, The 360 Standard Framework is an evidence based and relationship focused approach. It underpins a specialist education for those working with older people across the board Elizabeth Care® and provides a clear career pathway.
Several of us believe that now is the time for a much-needed dedicated person to improve care in the so called ‘social care’ sector. This would take a multi-disciplinary perspective to ensure that the social care settings have adequate knowledge, skills and behaviours to work with people with a range of long term co-existing conditions and take account of the impact on their person and their families, including end of life care, dementia and reablement. It is, after all in Social care settings where many of the most complex needs are residing. We think that this dedicated person ‘s role is to improve care for the non-acute care sector and adopt a fully integrated approach so that the health needs of this group are not second in status and resourcing to the acute sector which has absorbed so much of the funding to date. The paucity of status of health workers across the health sectors particularly in care homes who live daily with the highest level of co-morbidity and complex care must now be addressed.
This education and focus on quality could be supported by a chief nurse or other professional in an advisory role which would sit within Primary Care. The role would have the same status as the Department of Health and Care’s Chief Nursing Officer, who advises on Secondary Care. It would balance out the status of both Primary and Secondary Care sectors and give them parity, particularly as the acute sector is some much smaller than the so-called ‘social care’ sector.
In addition, role if the District nurse has been eroded and over the years moved away from General Practice. The former emphasis on prevention and management of people with long term conditions has been subsumed by a reductionist and reactive approach which is very acute focused than pro active and preventative and is one of the missing links in the community. I believe that an Elizabeth Nurse (like an Admiral or MacMillan nurse) and amore holistic care practitioner would be an asset for every Primary Care Network (PCN) and could address prevention better and create a more integrated and holistic population health approach. This is because they will have education in person centred outcomes, maximising quality of life and reablement and long-term conditions including dementia.
We need to ‘grease the runway’ of education that works and instead of always bringing people in from afar, to focus on the employment needs of the country will require making long term holistic socio-health care an aspirational career with its own career pathway with stepping-stones into other professions if desired. We created the brand Elizabeth Care® to demonstrate its worth . I feel the time to give this brand to the nation and work in a new way to bring this to fruition has come of its time.
There is a long-held view that health has moved into the acute sector at the expense of the chronically sick who have been under supported for many years now. I hope the sector will come out of this current coronavirus situation surviving and its value realised by both equity of investment and attention to demonstrate that we matter whatever our age.
This is a good time to take another look!