Dr. Josefine Magnusson – #Weeknotes

While January seemed never-ending, February has gone by in a flash and we are now almost into spring – despite what the (albeit brief) flurries of snow might have led us to believe this week. In my own (Swedish) opinion, there just isn’t enough winter these days, but that’s another story…

This year, so far, has kept our project work focused primarily on health data as we progress the medical imaging work we are undertaking with the National Consortium of Intelligent Medical Imaging, but this week has also brought a theme of social care.

What happened? What’s next?

On Monday, I attended the first meeting of the new Parliamentary calendar for the All-Party Parliamentary Group on Adult Social Care, the theme of which was “Making sure people have more control in their lives”. Two-panel debates, chaired by Lord Low of Dalston and Helen Hayes MP respectively, focused discussions on who decides what care and support looks like, and how do we make best practice common practice?

Often, for those of us that work in research and policy, these conversations can end up being somewhat high-level and theoretical, and one of the nice things about attending events like this is hearing the lived experiences of people managing these issues in their everyday lives. Listening to accounts of how initiatives that are meant to bring people with learning disabilities closer to their community fall flat because they completely fail to take individual differences into account are disheartening, but balanced with stories of the positive outcomes that can be achieved when such differences are acknowledged and respected shows that genuinely personalised care is by no mean unobtainable. Co-production was the name of the game, and it was inspiring to hear how well this can work in practice – but it almost always means initiative is taken by advocates and interest groups, and rarely from those responsible for commissioning social care.

I had a chance to ponder these issues further on Tuesday as we prepared the groundwork for the workshops that FCC are hosting at the NLGN Stronger Things event on 12^th March. The very talented people from the Social Change Agency are working with us on this and got us all thinking about how various innovations in the health and social care sphere might impact people in receipt of care. It is interesting to see how we readily (and logically) see more value in initiatives that can apply to a wide range of people rather than just a few, and with the APPG discussions fresh in my mind, I was wondering how personalised initiatives can be both promoted and implemented to challenge this narrative. In reality, we probably want a mix of both and how to see this materialise is an issue that I suspect we will continue to grapple with for some time.

Wednesday saw a shift in focus more directly on to the funding of social care, as I attended a roundtable exploring the concept of fairness in social care markets. This, of course, is something that we touched upon in our Data that Cares report in the autumn, and I also got a chance to outline our findings from the Freedom of Information request we undertook to interrogate local authority spending on residential social care. The regional disparities we pointed to then also came up on Wednesday, but as we discussed in our report, it is often very difficult to compare what is actually happening at the national level as reporting isn’t standardised in this respect. Although it makes sense that local authorities are able to develop plans that work for their area, it is equally important that the data underpinning this work is transparent and nationally-comparable in order to safeguard those in receipt of care.

In Data that Cares, we explored the financial stability of residential care providers and discussed the risks associated with care home failure – themes that were echoed in a Local Government Association report on profit-making and risk amongst children’s social care providers. This sector has seen dramatic shifts towards a small number of ever-larger providers which now dominate the market, with serious implications for the most vulnerable children, were just one of them to fail.

What did I learn? What does it mean?

While there has been a discernible thread running through this week’s activities and events, it has also highlighted the implications of looking at a vitally important public service from a macro than micro viewpoint: the high-level questions of what gets funded, by whom and for what purpose versus the direct impacts of variations in services on people’s everyday lives.

For me, there is also something in all of this about striking the right balance – how do we support person-centred services whilst, also, ensuring that reporting between areas can be compared and held to a common standard so that we can be reassured people are in receipt of high-quality services? Standardisation, transparency and comparable data are vital for the latter, but the former requires qualitative understanding and granularity – and how we approach gathering this for populations without losing individual nuances represents a significant challenge.