to promote career development. In a world where carers are better trained and

supported, the Government should consider whether more care could be provided

by qualified carers, as opposed to NHS-funded nursing care.

Recommendation: Government to develop carer support and

training along the lines set out in the Cavendish Review, as a basis

for replacing a proportion of nursing care provision with support

worker provision.

Impact: This would:

• Allow for a more qualified and confident care workforce, better tasked to

provide early interventions to prevent unnecessary admissions to hospital.

• Help meet the expected growth in demand for care as a result of demographic

change.

4.13 Strengthening the powers of Local Healthwatch - an

honest broker?

Finally, a check and balance is required. To boost powers at the local level,

some measure of reassurance should be provided - this should not be about topdown scrutiny,

but a bottom-up challenge over whether the needs of patients and

residents are being met. While a local Healthwatch representative is already a

statutory member of Health and Wellbeing Boards, Northumbia, amongst others,

have taken their representation one step further by making them the Board Vice

Chair.

But more than simply keeping partners focused on patient/resident need at a

strategic level, a more empowered Local Healthwatch could act as the broker

between local partners, helping them feel more comfortable in giving up

commissioning power and/or budget responsibility for the wider good.

Recommendation: Give Local Healthwatch the responsibility to

promote integration.

Impact: This would:

• Make sure that patients of the health and social care system have a voice.

• Bring local partners together.

Chapter 4 - What Are Our Proposed Solutions?

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