One of the reasons I enjoy working in health and social care policy so much – beyond the obvious gratification you get from knowing you are working in a sector that is literally saving lives – is that it is fast paced and always changing.
These changes can be small and come in the shape of new technologies or treatments, or they can be more fundamental and far reaching, like a new funding settlement and a corresponding Long-Term Plan.
So, in a year that looks set to be defined by the dreaded B-word, what does 2019 hold for health and social care?
The first and most obvious place to start is with the aforementioned Long-Term Plan. Originally due to be published before Christmas, Brexit delayed its publication until the new year. Yes, the Plan has been developed, but there is as much scope, if not more, to shape its implementation this coming year.
The NHS sets out how it proposes to tackle the myriad challenges it faces, from the workforce and adoption of technology, to clinical priorities like cancer and mental health. But it will need support and guidance from the rest of the sector to help implement and deliver the plan. The Plan is best interpreted, less as a silver bullet to the NHS’s problems, and more as the start of an on-going conversation about how the health service future proofs itself.
The next big development the sector expects to see in 2019, and I use the words “big” and “expects” with caution, is the publication of the Social Care Green Paper, nearly two years after it was originally proposed. It too, has been delayed by Brexit (are you seeing a theme yet?), and the government’s desire to avoid anything mildly controversial.
It does present a good opportunity for social care providers, however, as it’s understood that when published, the Green Paper will be more about taking in the views of the sector than presenting any concrete ideas itself. This gives social care providers greater influence in shaping the possible outcomes and allows them to be more radical with their proposed solutions.
Although the government may be in listening mode on social care in 2019, it doesn’t mean it will be an easy sell. Arguments with the Treasury over further funding will have to be well-made and relationships with those in the NHS maintained or even improved, as GK has previously written,
Whilst we didn’t see much in terms of the green papers we anticipated this year, we did see more collaboration and cooperation within and between NHS providers and commissioners. This is mirrored in the huge increase in CCG and hospital trust mergers that took place over the last year and in the formalisation and growth of integrated care systems (ICSs), which reversed much of the decentralisation that had developed within the NHS over the last decade.
Over the next year we expect this trend to continue and those in the sector hope this will be supported by legislative change, something many, including the Prime Minister herself, have hinted at. It is understood the Health and Social Care Committee, who have recommended the changes be led by the sector, will begin scoping proposed changes in March 2019.
And finally, we turn to technology.
2018 was a big year for tech with the appointment of technophilic Matt Hancock as Secretary of State for the Department for Health and Social Care and the rapid growth of apps such as GP at Hand. GK’s own research has shown there has been a 99% rise in the number of patients searching for online GP and prescription services and a staggering 566% increase in searches for mental health apps since 2014.
Technology looks set to play a bigger part in the care of patients that ever before, but as I wrote about last year, this is contingent upon Hancock improving the adoption and spread of innovation and not further alienating the sector over his endorsement of Babylon.
Reflecting back on 2018, last year’s big loser sadly seemed to be the UK’s domestic policy agenda. Regardless of the outcome of the dreaded B-word-that-shall-not-be-named, here’s hoping 2019 is the year domestic policy reform is reignited, and the year the Social Care Green Paper is finally published.
by Andy Peel