There has been a lot of change for local authorities over the past couple of years due to increasing demand and spending cuts of 43 per cent across the current Parliament, local government as a whole faces a funding gap of £15.6 billion by 2020. This has invariably impacted on adult social care where budgets have seen a cut of 20 per cent, equating to around £2.6 billion. We know that adult social care needs to be put on a sustainable financial footing – both as the foundation for the care and support reforms and to ensure that services don’t suffer. At such a time, it’s important not to lose sight of the importance of putting people at the heart of our work, and the whole purpose of greater integration of health and social care resources is to wrap them around the needs of people and the outcomes they want to achieve, rather than the convenience of our separate organisations.
It is also really important that local areas take responsibility for deciding what their local health and wellbeing priorities are, and are able to put in place the range of support, services and information that meet their local people’s needs. Health and wellbeing boards, bringing together political, professional and community leadership, can make these decisions. I hope that TLAP sees its role as empowering local authorities and health and wellbeing boards to make good decisions based on evidence of what works in practice and with the people who use services. Working with people and their families to determine what support they want leads to much better health outcomes, and we need to focus on people’s assets and capabilities, what they can do, rather than their deficiencies.
To empower local authorities to do more to create good personalised care by sharing real examples of good practice from other local authorities, including costs and outcomes, is very powerful, especially if they are provided by the people who are working on this agenda every day. I know TLAP already works with councils in the development for many of their tools – perhaps there is an opportunity to start with local authorities to ask them what is important to them on personalisation and what are the blockages are that they need help with. This will be particularly important as we look ahead to the significant amount of work that will be done to support implementation of the Care Bill. At the heart of the Bill is the duty on local authorities to promote an individual’s wellbeing. We support the idea that this should underpin the legislation but it will require us to all work together to turn the aspiration into reality.
I think it’s also important to make sure that TLAP really focuses on local leaders, so that local councillors can understand what personalisation is and how it can improve the lives of their people in their local community. It is through local leaders, as ‘change-makers’, that real improvements can be made, and it is as important to focus on these people as it is to help the practitioners with the nuts and bolts of delivery. Reflecting on this further, as we embark further along the integration journey, the leaders in the local health system will be more important than ever for ensuring the personalisation agenda – and putting people first – is at the heart of the system.
