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a result of spiralling social care costs - the estimated funding gap for adult social care

by the end of the decade is £4.3bn (29 per cent of the budget).52

It is clear from these figures that the existing model of health and social care is

unsustainable. While pumping extra cash into the system can plug gaps temporarily,

it is not a long-term solution. Indeed it may mitigate against a longer term approach,

with short-term funding boosts inevitably going to be directed towards those patients

with immediate pressing needs rather than those whose care needs are currently at a

lower level but are likely to escalate in the absence of preventative steps. To quote NHS

England Chief Executive Simon Stevens: "A growing and ageing population means

we're going to have to supercharge our work on prevention, on care integration, and

on treatment innovation".53 However, we argue that prevention can only happen if

health, housing and social care are closely integrated at a local level.

2.5 Change is hard

Given the magnitude of the symptoms described above, no one in Westminster

quibbles with the need to make the care system work better. But, as we have seen,

this has been acknowledged as a problem for many years yet remain unresolved.

The scale of the systemic flaws which we describe in the next chapter is such that it

will take years of continuous political effort to get the requisite momentum. In other

words, acknowledging the problem is the easy part, effecting change has proved

rather more tricky.

So it is worth noting that, while recent government policies take important steps

towards reforming services, many of those policies will not take effect for several

years. For instance, many elements of the Care Act are not due to be implemented

until April 2016,54 leading to the possibility that whoever forms the next Government

may find themselves toning down the more controversial elements of the proposed

reforms.

52 LGA, ADASS, Adult social care

funding: 2014 state of the nation

report (October 2014)

53 Williams, D, "NHS cash boost

includes funds for out-of hospital

care" LGC (2 December 2014)

54 LGA, Care Act clause analysis

(accessed November 2014)

Chapter 2 - What Are The Symptoms? Or What Are The Problems Facing

Older People In Health And Social Care?

15

Index

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