14 May 2021

To fix social care, stop assuming it’s an inevitability

By Sir Muir Gray & Elspeth Briscoe

The Queen’s speech passed this week without providing any more detail on what the Government plans to do about social care. As a result, the chorus of voices calling for change will only get louder. With such mounting expectation, there may be no better time than now to reverse how we perceive social care and shift our approach from one of care to one of enablement.

To do this, wellbeing – taken here to mean the maintenance of strong mental and physical activity levels – must be embraced as a central pillar of our health service and our most effective form of prevention against the growing demand for social care.

‘Social care’ as a concept has changed little since 1948. The introduction of the National Assistance Act that year specified that ‘persons who by reason of age, infirmity or any other circumstances are in need of care and attention’ were to be offered residential accommodation. The continued assumption that social care is a natural inevitability, with double the number of those over 80 alive today, is creating a worryingly dependent population.

As we have been aware for some time now, the money is not there to support this dated approach. The Health Foundation estimates the growing social care funding gap will reach £14.4bn by 2030/31 unless additional action is taken, whilst a report last week from the LSE and Lancet medical journal called for a funding boost of £102bn over the next decade.

The Government’s ongoing hesitancy could prove to be one of the biggest political failures of our time. Many can simply no longer access or afford care, whilst throwing more money at the problem will not solve the underlying causes burdening our social care system.

So what if a significant part of the answer lay in prevention rather than reform? We now know that the normal biological ageing process should not be a cause of significant health problems until the age of 90. Yes, an element of luck is required to avoid certain unpreventable illnesses, but most of the problems routinely assumed to be a result of ageing are instead due to a loss of physical and mental activity which precipitates disease.

The links between a loss of activity and disease are clear: the Lancet Commission estimates that dementia rates can be reduced by 40% just by keeping the brain oxygen-rich and maintaining a challenged and engaged mind.

From an over reliance on cars to get around to the increase in workers at desk jobs, the modern world is sapping activity out of us all. The traditional culture of care compounds the issue by wrongly assuming that when older people begin to lose the ability to do a task, they require it to be done for them. Yet that need not be the case.

Our healthcare system can take the lead in addressing this loss of mental and physical activity but achieving a shift from a culture of care to one of enablement requires an innovative approach – one that encourages people from different fields to come together to find new solutions to old problems. The scale of the task is too great for the NHS to manage alone.

As the first Chief Knowledge Officer of the NHS and a tech entrepreneur, we come from two distinctly different backgrounds whilst sharing a common belief in challenging the status quo surrounding social care.

United around this goal, we have pooled our expertise to create interactive wellbeing courses hosted by Learning with Experts, a social learning provider, that are now being used by Active Partnerships in regions covering 20m people across the UK.

The courses, underpinned by innovative technology, are designed to prevent isolated education by building active communities of people that learn and thrive together. This is a promising start, but there is still some way to go. A nationwide learning and activity program, ensuring everyone has access to learning about wellbeing, can be the catalyst needed to prevent the loss of activity that is driving our care system to the brink.

Although this alone will not be a panacea for social care demand – and there remains a need to reorganise bureaucratic elements of our health service – educating our citizens on the benefits of physical and mental activity could be the difference between many of them becoming dependent on care in later years or living well in their own homes.

By embracing wellbeing as our first line of prevention we can radically alter the direction of social care in the UK, save our health service billions and enable people to live longer, better lives.

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Professor Sir Muir Gray is former Chief Knowledge Officer of the NHS
Elspeth Briscoe is Founder/CEO of www.learningwithexperts.com

Columns are the author's own opinion and do not necessarily reflect the views of CapX.