I was listening to the radio the other day and heard them talking about the exploratory space thingamajig, Voyager One.
Still travelling at some ridiculous speed through interstellar space, while people on earth are trying valiantly to send it coded instructions to compensate for a malfunction in order that it can send back meaningful data to help us understand the universe.And I was left wondering who is driving the thing.
The background
Back on earth I’m still collecting my own data to help me and the team at Medequip to work out what’s the direction of travel for the equally complex system of health and social care provision and who, or what, is driving it.
So, I started at the top. Maybe I am being unkind, but apart from the “pressures”, by which I think they mean people, and the money, and more commitments to “sort things out”, none of the main parties seem to have much to say on health and social care.
Local Authorities are supposed to use Market Position Statements and pre-tender market engagement events to communicate their priorities and intentions with the market of providers who are needed to provide the day to day support to people.
Strategies, vision statements, position papers and the like, together with their supporting plans, are also often positioned as “opportunities to get involved” and are supposed to set out a clear destination, and a practical route to get there.
For a large organisation like Medequip there needs to be a clear sense of direction, but as a conscientious user of public funding, how much time can my team spend in different public sector meetings, especially when there seems to be so much inconsistency?
Despite the vision and call to arms in the ADASS Time to Act report, for every Community Equipment, Technology Enabled Care or Wheelchair service specification that references the work and vision of Social Care Futures there are several more that start with reference to an existing or potential Section 114 notice or a more general note on the parlous state of a Local Authority financial position.
The amount and quality of involvement of people who use services varies greatly too.
I have been very public in talking about Medequip’s work in this area being “early stage” but I naively expected any organisation with a statutory duty under the Care Act 2014 to be well and truly committed.
So, I am left trying to explain to the Medequip Board and the owners why it is so important that we continue to involve people and the local communities, and whether the Local Authorities and NHS will want a few large distribution centres, basic equipment and technology and a high degree of standardisation?
Or if, as some commentators suggest, the future is about personalised services and equipment, local connections and small community organisations?
Will there be a continuation of the trend to outsource services, will they be taken back in-house, or is the future about new arrangements and partnerships between statutory organisations, private sector providers, community organisations and the people who use services?
I don’t suppose I will ever find “the” answer, and I suspect, as with most questions about complex systems, it depends on who you ask, what and when you ask, and just as importantly what you want to hear.
I would like to think I am known as a generally optimistic character, and I certainly don’t want to be the guy who says “Houston, we have a problem”.
So, I promise to let you know if I find out who or what is driving social care and the NHS and in the meantime Medequip and I will work with the different points of view to find the best solutions we can.
Unlike Voyager One, we might not be navigating the frontiers of known knowledge, but sometimes it can feel exactly like that.