Simon Stevens, the new chief executive of the NHS, has given an interview to the Telegraph in which he has called for a return to cottage hospitals. The current system, he says, is robbing patients of “dignity and compassion”. Care is better delivered in the community by the community.
By coincidence, Wye Parish Council is just submitting its application for an Our Place grant, aiming to “nurture a more age-inclusive community that is more resilient and responsive to the needs, age and social profile of the parish and stimulates a healthy, caring and sustainable community”.
How can one explain such a coincidence? Well.. it’s fairly likely that Simon Stevens and Dave Martin, who wrote the Parish Council’s application, have been looking at similar figures.
Simon will have been looking at figures for England as a whole: between 2010 and 2030, the numbers of those over 65 is projected to rise by 51%; those aged over 85 will rise by 101%.
Dave will have been looking at the data for the borough of Ashford: a 69% increase in the over-65s between 2010 and 2030; and a 132% increase in the over 85s. (Currently here in Wye we have 787 residents over the age of 65 (34%)).
Then they will both have been looking at the existing system of care.
In Simon’s case, the huge network of centralised hospitals, the GP surgeries, the 111 service, the ambulance service, the integration (or lack of) with the private sector and the social care system, the comparison with different countries, the various scandals… the feeling perhaps that everything has become impossibly large and unwieldy.
“I look at the fact there’s been a 124 per cent increase in the number of people admitted to hospital for less than two days over the last 14 years,” he says, “And that tells me we haven’t got it right, supporting people at the time they need it”.
Dave, meanwhile, has been looking at what’s happening in the village. In particular KCC has identified 28 social care recipients who need care valued at £4,645.63 a week – making an annual cost to the taxpayer of £241,573. These 28 are by no means the only recipients of care. In total KCC identified 89 – but figures on cost are only currently available for the 28, and only for social care. Not for health care.
No surprise then that such a considerable sum should lead to similar conclusions to Simon. The application calls for budgets to be “realigned in a way that people (services users) indicate will be more effective and they will be in more control, but also to aim to employ local people to deliver these services therefore requiring a new business entity to be created.”
In short, some of the money that is currently spent on social and health care by Kent County Council and the NHS (and other providers) could through Our Place be redirected to providers from the local community – who would have a huge benefit over ‘outsiders’ because they would be known to those who are being cared for, and, given that they live in the same place, would speak a common language.
While they are working on vastly different scales, it’s satisfying to see that Simon and Wye have come to similar conclusions. The community has always played a big role in Wye, but here is an attempt through Our Place to reinforce what has been achieved, and to acknowledge and properly support those who are providing our care.
The Our Place application identifies possible ways forward which could enable not only better care in the village but also create intergenerational opportunities to promote understanding across generations and build a more cohesive, supportive community for all ages. For the moment these are just ideas. All will be considered with proper consultation if the Our Place application is successful.
Let’s hope it is.