Who will look after us when we are old?

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Published: 14 May 2008

Who will look after us when we are old?

Health Secretary Alan Johnson has launched a six month debate about the future shape of care and support services.

A rapidly ageing population means that in 20 years' time a quarter of the entire adult population will be over 65 and the number of people over 85 will have doubled.

The growth in the number of people with care & support needs will put tremendous pressure both on services and on the financial support that they receive through benefits and other funding streams.

If current levels of service provision and patterns of care continued, public expenditure on Personal Social Services for adults is projected to rise from £12.7 billion in 2007, to reach £24.1 billion in 2026 and £40.9 billion in 2041 at 2005 prices.

Over the next six months, the government will be asking the public and stakeholders at a series of regional events for their views about care & support to create a new system that:

Promotes independence, choice and control for everyone who uses the care and support system
Ensures everyone can receive the high quality care & support they need
Government support is targeted at those most in need
Is affordable for government, individuals and families in the long-term

Millions of people across the country are involved with providing and using care & support services. This reform is intended to be about finding a new way to:

help people stay active
care for family members
retain maximum dignity & respect and
have the best possible quality of life

Alan Johnson said:

"Society is going through huge change - care and support must adapt to meet the challenges this will bring because the current system is simply not sustainable in the long term.

There is no option of a quick fix.

Radical change is needed to bring together the range of activities, services and relationship that underpin care and support so that people are clear about what they are entitled to and how and where they can get it.

Funding is a vital part of this debate, but it is not just about money (only mostly).

It is also a question of individual choice, enabling people to live as independently as possible for as long as possible.

Today we are rolling out a £31m programme to test the potential of innovative technologies like telecare in supporting care for those with complex health and social care needs.

Improving care with new scientific advances and innovation is vital if the NHS is to continue to offer the very best services, but this innovation must be at the frontline of the NHS to help people manage their conditions better themselves."

The public will be able to contribute to the debate through a series of events and by accessing a new national website.

This week also marks the beginning of the £31m Whole System Demonstrator Programme that will test the potential of innovative technologies like Telecare and Telehealth in supporting care for those with complex health and social care needs.

Telecare and Telehealth

The three Whole System Demonstrators sites (Newham, Kent, Cornwall) where announced in May 2007 following a competition. Since then the sites have been designing the new services and procuring the telecare and telehealth technology they need to go live.

Telecare is the continuous, automatic and remote monitoring of real-time emergencies and lifestyle changes over time in order to manage the risks associated with independent living.

Telehealth is the delivery of healthcare at a distance using electronic means of communication - usually from service user to clinician (e.g. a service user measuring their vital signs at home and this data being transmitted via a telehealth monitor to a clinician).

The focus of the demonstrators will be on three patient/user groups;

People of any age who are at risk of current or future hospital admission due to at least one of the following long-term conditions (telehealth eligible): Heart failure, Diabetes and COPD
Individuals with social care needs (telecare eligible) who are at risk of current or future hospital admission, who have complex health and social care needs (they may have one or more of the above conditions)
Individuals with both health and social care needs as defined above

The demonstrators will run for a minimum of two years and will be on a scale significantly greater than anything undertaken to date in England. The government claims that they will be subject to a rigorous real time evaluation process.

The value of the programme is £31m over three years. This expenditure cover the costs on each of the three sites of providing services to 2,000 people per site (6,000 in total), the complex large scale evaluation, programme & project management, learning dissemination, together with the costs of testing for the first time how health & social care data can be linked electronically in a standardised way.

The pilot is being rolled out across Kent, Cornwall and Newham where people with complex health and social care needs such as diabetes, heart and chest problems and the elderly and the frail will use the technology.

Clients can also trigger requests for help should they fall and automated safety devices will be installed to ensure people are able to live at home for longer.

The programme aims to give people the support necessary to help them retain their independence in the community and greatly improve their quality of life by managing their conditions in their own homes.

Benefits of the scheme are expected to be: