Priorities for the incoming Prime Minister
Sally Greenbrook joined the BGS in April 2019 as Policy Manager. She has more than a decade of experience in the UK health policy sector, having worked for the Department of Health and, most recently, as Policy Manager for Breast Cancer Now. She has for many years had an interest in the health and care of older people, having written her MA thesis on housing for older people. She tweets at @SallyGreenbrook
Ten have been whittled down to two and it is now for the membership of the Conservative Party to decide whether they want Boris Johnson or Jeremy Hunt as their next leader and, subsequently, the next Prime Minister. Much of the focus of this campaign has been on the future of the UK’s relationship with the European Union. Are we leaving on 31 October or not? Deal or no deal? What exactly are WTO terms? Can I still go to Majorca for my summer holidays?
Negotiating the UK’s exit from the EU will of course be a priority for the incoming Prime Minister. But they will also be responsible for the more ‘business as usual’ aspects of running the UK and this includes health and social care in England. With an ageing population and more of us with complex needs than ever before, it is essential that the new Prime Minister focuses on the needs of our oldest citizens to ensure that they have the care and support they need.
Here at the BGS, we’ve been considering what the new Prime Minister must prioritise to make the UK the best place in which to grow old.
What’s happened in the last couple of years?
It hasn’t been too long since we last called on an incoming Government/Prime Minister to prioritise the care of older people – in fact, it was just two years ago in our 2017 General Election manifesto.
So what’s changed since then? Well, quite a lot and, at the same time, not much at all.
Firstly, the NHS Long Term Plan was published in January 2019, bringing the advent of Primary Care Networks, promoting Enhanced Health Care in Care Homes, the Ageing Well workstream and a whole host of commitments which, if properly implemented and funded, could have a real impact on the care of older people.
The Long Term Plan also came hand in hand with a significant boost in funding for the NHS, to the tune of £20.5billion. While this seems like an unimaginably large amount of money, it almost certainly isn’t enough to do everything that needs doing, and funding across the NHS will continue to be very tight.
We had a new Health Secretary in July 18. Jeremy Hunt was promoted to Foreign Secretary after serving the longest term of any Health Secretary in the history of the NHS. Hunt was replaced by Matt Hancock who was promoted from his role at the Department for Culture Media and Sport, bringing with him an enthusiasm for digital technology.
We’ve also had the Interim NHS People Plan, bringing a lot of ambition around the future of the NHS workforce and plans to make the NHS the best place to work. It did not however bring much in the way of detail of how this would be achieved or any funding promises – this should come with the Full NHS People Plan, due to be published after the Spending Review.
And what hasn’t changed?
The aforementioned Spending Review hasn’t yet happened and therefore there has been no financial commitment for the NHS workforce which in turn has meant no Full NHS People Plan. In fact, the Spending Review itself is in doubt – we don’t know yet when the Spending Review will be or whether it will be a one year or three year review. The latest rumours are that it will be delayed for a year due to the Conservative leadership contest.
We haven’t left the EU – something that was expected to happen in March and may (or may not) happen in October.
And, perhaps most importantly for many of the people that BGS members treat, support and care for, the long-promised Social Care Green Paper has not yet been published. The recent BBC Panorama two-parter, Crisis in Care, shone a light on social care in Somerset. However, the impact on people needing care and their families of the financial pressures highlighted in the programme and the very difficult decisions being made by the council are not unique to Somerset. I’m sure BGS members across the country recognised the impossible situations that the health and care professionals found themselves in.
So with all that in mind, what do we want from a new Prime Minister?
First and foremost, the new PM must provide a lasting solution to the social care crisis. Successive governments have promised and failed to reform the way social care is funded. Older people living with frailty, dementia and other long-term conditions are being let down by the system. Properly funded and coordinated social care is essential if we are to enable older people to lead healthy, independent lives for longer. Too many older people are stranded in hospital – with the deconditioning that ensues – for want of appropriate social care on discharge.
The NHS Long Term Plan has made great strides to integrate services between health and social care and across different sectors of the NHS. Strong links across services already exist in some areas but this will be a bigger challenge in other areas. The new Prime Minister must ensure that the momentum created by the NHS Long Term Plan is continued to enable older people and their families to navigate the services they need.
We were heartened to see a commitment in the NHS Long Term Plan to ensuring that older people living with frailty, dementia and other long-term and complex conditions will be offered targeted support for their physical and mental health. It is essential that this promise is fulfilled in the form of comprehensive geriatric assessment and personalised care plans for all older people who need them.
And finally, none of our calls or the promises made in the NHS Long Term Plan are possible without the workforce. Geriatric medicine is an area where true multi-disciplinary working is essential with clear evidence showing better outcomes for older people when geriatricians, nurses, GPs, therapists, pharmacists, social workers and other health and social care professionals work together. Most health and care professionals will work with older people more than any other population group. It is therefore essential that we have more specialists in the care of older people and that non-specialists have training to enable them to care for our ageing population. The NHS and social care workforce is dangerously under-funded. While there is a lot of ambition in the Interim NHS People Plan, it is essential that this is followed up with prompt action on training, recruitment and professional development, underpinned by funding commitments.
By addressing these issues, the new Prime Minister has the opportunity to change the lives of millions of older people and their families. The question is, will he take it?