Demand is increasing.

In recent months we have become familiar with media headlines highlighting the strain the NHS is under following the pandemic. Sadly, we hear less about the pressures on community services as they respond to similar unprecedented demands for people needing health and social care support. So, in this blog we take time out to reflect on why the demand for social care is rising and look at how services are responding. We also consider the challenges threatening how well some services respond to this rising demand for care and support.

One of the obvious reasons for the increased demand for health and social care is our ageing population. While the public is familiar with the impact of an ageing population on social care resources, they are less aware of how Government policies are fundamentally changing the role of health and social care – placing further demands on already stretched services. Before covid, several strategic and operational changes, as a result of these policies, had begun in social care. However, the impact of the pandemic on the NHS has accelerated the change that had already started.

Most of the changes are about reducing pressure on acute hospital services. For example, Home First services see people, once medically optimised, being discharged to an appropriate community setting – usually home – so that the assessment for care and support continues outside the hospital environment. Urgent Care Response services bring together health and social care teams that provide a 2-hour response to people in their own homes to prevent hospital admission. And Anticipatory Care services are being developed to target individuals who may be living with frailty or long-term conditions, helping them to look proactively at what support they require to remain in their own homes for longer and out of acute services.

Although new services are being developed to support these new ways of working, the reality in many areas is that existing health and social care services are being extended and, at times, stretched to support these new services. For example, in many areas, reablement services are meeting the increased demand to support D2A and Urgent Care Response services. However, the challenge for many reablement teams is recruiting and retaining staff needed to meet the increased demand for the service. The cause of this issue has been much publicised and is the result of wage rises in the retail sector – making social care jobs less attractive.

The demand for assessments by social care occupational therapists is also increasing. This is because the moving & handling and other assessments previously done as part of the hospital discharge process have shifted out into the community setting. While this might initially sound like good news for the profession, it doesn’t help that there is already a recruitment crisis within occupational therapy. One of the consequences of this rise in demand for social care assessments is that older people with low-level needs are having to wait for months for an assessment. And the longer people wait for an assessment, the more likely they are to require more costly care and support – placing further demand on health and social care services.

The positive news is that with these challenges comes innovation in service delivery. For example, assistive technology and artificial intelligence are being used to monitor how well people do on discharge. The data generated from these devices provide early detection if someone is beginning to struggle with caring for themselves, allowing services to be proactive by providing support that stops unnecessary admission into hospital or long-term care. And over the next few years, we undoubtingly see further transformational solutions using technology that will help meet the health and social care demands of an ageing population alongside providing solutions to the current workforce issues we have discussed.