Issue 12

CHANGING HEALTH & SOCIAL CARE

By Audrey Birt, Consultant and Coach with health and social care organisations

The need to transform health and social care is a regular call from many sections of society, daily the impact of the demands on our health and social care services is highlighted in the media.

Although our health services compare well to other developed healthcare systems on quality, access, efficiency, equity and cost still it’s clear that is not enough.

Spare a thought then for the teams who deliver remarkably well by those criteria, still we challenge them to change, to do better and to care more. And all this is in the face of growing demand, changing demographics and a population with more complex and increasing needs.

It’s a paradox facing society and one which is not being tackled yet at a community level. Rather, in general, the expectation is that downstream services in health and social care will fix it. Working in the face of such paradox means the workplace of health and social care is facing a unique and overwhelming challenge; a challenge that all the health and care systems across the developed world are facing.

More than five years on from the economic crash, where we bailed out banks and allowed the poor to pay the toll, primary care teams are seeing the impact every day. When told of signs and symptoms that don’t seem to make sense, they know now to ask “are you getting enough food?” In some areas, their job has become about sending people to food banks, their fingers are in the dykes of a tide of human despair and we wonder why they don’t want to stay? If we are to tackle the future of health and social care we cannot ignore the context in which they work.

In Scotland we have taken some bold steps in the past with regard to smoking legislation and free prescriptions, for example. Both developments have been challenging but the impact on society and individuals has been significant; e.g. with free prescriptions benefiting those with long term conditions, many of whom will be the less well off in our society.

This coming election will require bold commitments for health and social care. It won’t be enough to commit to more nurses or GP’s and different targets for waiting times.

This coming election will require bold commitments for health and social care. It won’t be enough to commit to more nurses or GP’s and different targets for waiting times. Improving a system that is no longer working well for the population it now serves, will just perpetuate the problems. It will need more radical thinking and bolder choices and it’s a journey that the whole country will have to travel on. The National Conversation launched recently by Scottish Government is welcome and as part of that we all need to be open to thinking differently. The creative conversations that emerged in the run up to the referendum last year need to be engaged in this discussion too.

We need new ways to approach our future in health and wellbeing. One example is a course called the WEL (Wellness Enhancement Learning) to support people with long-term conditions back to well-being. It tackles the many complex factors that affect our health in modern times; it builds on what’s strong, not on what’s wrong; it builds our inner resources, it brings a fresh approach to food and helps us to understand more about how modern times impact on our health. We need a system-wide commitment to invest in well-being, to mainstream new approaches so they are available to all.

We need new models of primary care that make it sustainable in the longer term, learning from approaches like the Buurtzorg ( meaning ‘community’) model in Holland, where the small self -organising teams put the person and the community at the centre of their approach to care. It’s a transformational approach to organisations and to care, both will be needed to meet the challenges of the future.

Future models need to support and to build on the health and resilience in our people and communities, we need to make integration of health and social care, work for and with communities alongside a third sector supporting community well-being and self-management approaches as true partners in the work.

We need new models of primary care that make it sustainable in the longer term, learning from approaches like the Buurtzorg ( meaning ‘community’) model in Holland, where the small self -organising teams put the person and the community at the centre of their approach to care.

But to really tackle health and wellbeing we will also need to tackle the very powerful influences that mean it’s easier and cheaper to buy poor quality processed food with inadequate nutrition and make fresh food available as a right for all. Foodbanks are a source of shame in our rich country and so too is the food many of our children rely on for their development and wellbeing. This isn’t simple, we won’t change this overnight but we do need to start and when better than now?

Audrey Burt is a consultant and coach active in working with health and care organisations

By Audrey Birt, Consultant and Coach with health and social care organisations

Issue 12

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