Most care for older people is not provided by the state or private agencies but by family members, at an estimated value of £55 billion annually. However, as the babyboomer generation ages, a growing 'family care gap' will develop as the number of older people in need of care outstrips the number of adult children able to provide it. This is expected to happen for the first time in 2017.
Overstretched services will struggle to provide extra care, with two-thirds of all health resources already devoted to older people and social care services facing a funding crisis. Adult children and partners will take on even greater caring responsibilities and more people, particularly women who outnumber men as carers by nearly two to one, are likely to have to give up work to do so.
Our plan should be to 'build' and 'adapt': to build new community institutions capable of sustaining us through the changes ahead and to adapt the social structures already in place, such as family caring, public services, workplaces and neighbourhoods.
This will require a different role for the state, one that is more about establishing partnerships with families and communities than traditional service delivery. An alternative way forward would be to give more power to people and institutions to improve their own wellbeing, to support each other and to prevent care needs from arising, thereby benefiting from the 'multiplier effect' this would have through volunteer networks. Investing in strengthening community networks across the country now would be a relatively small but sound investment in the future.
The report presents four major recommendations, to be addressed as part of a five-year funding settlement across health and social care.
- New neighbourhood networks to help older people to stay active and healthy, help busy families balance work and care and reduce pressures on the NHS and social care.
- Care coordinators providing a single local point of contact, to replace the 'case management' currently provided by adult social services in every area by 2020, for all but the most complex cases of care.
- The option of a shared budget to enable those using community care to arrange this collectively.
- Stronger employment rights for those caring for people who need more than 20 hours of care a week, to make it easier for family members to combine work and care.
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