A new settlement for health and care or ‘Care Covenant’, underpinned by Future Care Guarantees, will offer greater security for everyone in society. We need political consensus upon our direction of travel – a long-term plan to guide the policies of successive governments to improve health and care outcomes, and enable individuals to plan ahead. We will, otherwise, remain forever in ‘fire-fighting’ or ‘crisis’ mode rather than on the front-foot. Whilst some have called for an independent OBR-style check on health and care spend, we believe it pertinent to first ask:
- Where are we trying to get to?
- To what extent can we plan ahead?
- How might any national plan for health and care in future underpin a political consensus – one capable of cementing public support for any increase in and targeting of spend in the years to come?
We invited leaders from the public, private and third sectors to help us explore this terrain in more depth. Their contributions to our report outline what developments we might expect in 5, 10 and 15 years’ time and, in doing so, point toward how we might plan to impact different determinants of well-being in the short, medium and longer-term.
Future Care Guarantees
We believe cross-party consensus in respect of Future Care Guarantees could underpin a new Care Covenant and National Plan for health and care as well as cement the support of the general public. Based upon the developments we might expect in 5, 10 and 15 years’ time, we recommend such Guarantees include:
1. A new funding formula
Government will introduce a new funding formula and national entitlements to health and adult social care services that are funded by the state – the aim: to reduce the postcode lottery in respect of services in both formal and community settings, and create certainty for individuals in planning for their future health and care needs.
2. Healthier, longer lives
Government will introduce ‘health positive’ regulations, personalise public health and invest to compress morbidity – the aim: to reduce the amount of time that people are unable to live in good health and the overall cost of care, both to the individual and the state, with a particular focus upon tackling health inequalities within and between geographical areas.
3. Championing independent living
Government will work with industry to introduce and uphold an Independent Living Guarantee enabled by a transformational programme of investment in ‘pre-care’ measures – the aim: to ensure our homes and communities are ‘designed for age and mobility’ so that more people are able to take care of themselves and their families at home for longer.
4. Tackling loneliness and social isolation
Government will introduce measures and invest to create the environment for local government and civil society to tackle loneliness and social isolation – the aim: to reduce the impact of what is widely regarded as a key characteristic of growing mental ill-health in our communities.
5. An Ethical Technology Commission
Government will establish a dedicated Commission to examine the ethical implications of new and emergent technologies for health and care service provision – the aim: to involve experts and the general public at the earliest possible opportunity in a considered debate and, in particular, explore the extent to which access to services should be predicated upon machine-testing and verification in the future.
6. Co-designing future care services
Government will involve younger generations in the co-design of future care services on an iterative basis – the aim: to help Government design responsive care services, and raise awareness of the need for individuals to plan ahead and make provision for their future health and care needs.
7. Careforce planning
Government will provide leadership and work with training and skills providers to build the capacity of the ‘careforce’ – the aim: to ensure we have sufficient health and care professionals as well as unpaid carers, with the appropriate skills, to meet future demand and deliver high standards of care.
8. Enabling a work-life-care balance
Government will recognise the economic contribution of carers to the overall economy and work with employers to introduce measures to improve carers’ ‘work-life-care balance’ – the aim: to support the growing number of carers at home and in community settings.
We need to plan and design the provision of health and care for every generation if we are to tackle the ‘care deficit’ and secure the future. Agreement upon the direction of travel and Future Care Guarantees to support improved planning by commissioners and providers as well as the general public would represent a significant first step.
About the Editors
Annemarie Naylor MBE is the Director of Policy and Consulting at Future Care Capital. She studied Government and Sociology at the University of Essex. For a large part of her career, Annemarie has worked in public policy and economic development across local, regional and central government.
Emily Jones is a Policy and Research Officer at Future Care Capital. She studied Social Policy at the London School of Economics and Political Science and later worked at the Centre for Analysis of Social Exclusion at the LSE where she developed a particular focus on health and social care research.
The Editors would like to acknowledge all contributors for their time and considered input in the course of producing this report.