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Alex Fox

Alex Fox

Alex Fox outsideBirthday presents for some

We’re celebrating the start of Shared Lives week, just as the Prime Minister announces a 70th birthday present for the NHS: £20 billion a year in extra funding by 2023. The NHS being 70 means that social care is 70 too: they were created at the same time, but social care’s birthday present looks likely to be continued cuts. The public – and therefore the politicians they elect – value what they can understand. We understand doctors and nurses healing or curing us, so we’re grateful for what they do.

Radical kindness

Social care is still poorly understood and too often associated with things we don’t like the sound of, like living in a care home, or failures of care. Even within the context of social care’s low profile, Shared Lives is poorly understood. It’s much older than the NHS and social care, with roots going back hundreds of years. In the 14th Century, around the time when the first asylums were being built in the UK, in a small town called Geel in Belgium, a few people were instead opening their homes to people who needed their support. The act of sharing your home and family life is radical, even shocking in a world where we can feel we have less and less contact with each other, but it’s also deeply personal. It goes unnoticed except by the people who feel safe, settled and valued somewhere that feels like a home from home.

Fairness for Shared Lives carers

Much of what makes Shared Lives – and indeed Homeshare – special, is the unpaid contributions which people and families make to each other’s lives. But Shared Lives carers have to live and they are not volunteers, they are trained and paid as part of the UK’s highest-performing regulated care sector. We aren’t expecting £20 billion for Shared Lives. But we are calling for every area to value Shared Lives carers. Firstly, that means seeing and understanding what they do. We are inviting elected councillors and MPs to visit a Shared Lives household in their constituency to see for themselves what goes into making good lives when people need significant support. We have a Charter for Shared Lives and we want every area to use it as a model for their own local Charter, which sets out what local people can expect when they share their lives. And we are not ignoring money. I meet Shared Lives carers who have contributed vast amounts of their time, energy and lives to ensuring someone lives well, but who have not even been considered for a pay increase in over a decade. They do not feel valued in the way that they should, and we want every area to commit to including Shared Lives carers in their workforce development and pay reviews.

The NHS and social care are 70. Shared Lives isn’t far off 700. Isn’t it time we celebrated – and valued – those thousands of shared lives as they deserve?

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Adass responds to NHS funding announcement

Thursday, 12 February 2015 09:16

Wellbeing inequalities

 
 

I was asked last week to speak a conference which was looking at progress in addressing health inequalities since the influential Marmot review in 2010 which identified six ways to address inequalities:

‘The majority of procurement practice is stifled by process and bureaucracy, what appears to be text book practice in reality translates into overly complex, process focused exercises.  Such exercises demand a huge input from providers and commissioners and often miss the point of the intended outcome. Tenders now typically require 30,000 word submissions, and the majority of tendering organisations now support sizable bid teams.’
Tuesday, 17 March 2015 16:57

The Collaboration Test

We’re pleased to have joined the Coalition for Collaborative Care which is attempting to embed models of collaborative care into the NHS. This blog is based on my recent blog for the C4CC.
Thursday, 11 December 2014 00:00

All I want for Christmas…

Anna McEwen, our Director of Support and Development Director, has been celebrating Shared Lives with the Newham scheme. Anna writes:

My Christmas party season started in style at the weekend as I donned a posh frock and joined Newham Shared Lives scheme at a Glitter Ball at West Ham. 

Saturday, 13 December 2014 00:00

Shared Lives in Somerset

If you click on the picture, you should be able to read this article about Shared Lives in Somerset from the Weston Mercury which is also here:
Wednesday, 17 December 2014 00:00

You made us feel important

Thanks to Cathy Gregg, who manages the Shared Lives scheme in Richmond, who shared (with permission) this letter from a family member whose mother uses Shared Lives:
Thursday, 18 December 2014 06:12

Shared Lives is never closed for Christmas.

Shared Lives is never closed for Christmas.
Thursday, 18 December 2014 12:38

Not rocket science

One of the best things about social media is hearing directly from people who use Shared Lives and Homeshare, and their families, about their experiences. I am an avid follower of ‘Doris’, who tweets about her perhaps unique use of Shared Lives day support and a Homesharer to live well with a mental health condition. […]
Sunday, 21 December 2014 07:51

Returning it with interest

I was asked to say a few words about empowering communities as part of the National Voices session with NHS England Chief Exec, Simon Stevens, about his Five Year Forward View. I chose to talk about collaboration. (If you’re interested in collaborative health and care, you will be interested in the Coalition for Collaborative Care. The C4CC is working on joined up, personalised, community orientated healthcare and has strong links with Think Local, Act Personal which has been bringing those values to social care for some years now.) Here’s roughly what I said:

The NHS has many challenges – all of them big, many of them complex, some of them truly wicked. Or at least, seen as ‘wicked’, because they don’t respond to the things that services are currently good at. Of those challenges, perhaps the key one is how the health and care system can collaborate with the quarter of our population who have a long term condition, in order that people with long term conditions can live well. We need to achieve that because the NHS can (and does) do many wonderful things, some of them verging on the miraculous, but it can’t ‘fix’ a quarter of the population. And only people themselves can build good lives in good places; that’s something that services can support and enable, but not do for us.

All health and care interventions can be offered collaboratively, not just community-based interventions like Shared Lives, in which someone gets the support and care they need in an ordinary family home, but also acute and hospital-based services.

Collaborative leaders devolve money and power to enable personal tailoring of services, whilst helping those with personal budgets and Personal Health Budgets to work together to co-design new kinds of services. Conversely, commissioners will always fail the collaboration test when they organise services distantly, for large numbers of people. Professionals fail the collaboration test when they see people as customers and even family carers as just another set of clients with needs. Collaborative professionals have the humility to arrange their work around the capabilities and potential of citizens and carers. They share their knowledge, they make things simple and they are keen to accessible in an emergency.

This ability to collaborate with citizens, families and communities is perhaps the key voluntary sector offer to the NHS. But whilst the voluntary sector is far more capable of achieving that collaboration than the statutory sector, it’s important to admit that charities, social enterprises and community groups don’t always succeed in doing so. Many small community groups are embedded in the right relationships with communities, but lack the health and care expertise. Some large national charities have that expertise but have become unmoored from the communities which built them.

So there is a challenge for all sectors: to demonstrate that we have the insight, courage and humility to make hard, uncomfortable changes towards shared purpose, shared resources, shared knowledge and shared ownership. To recognise that we start to collaborate with citizens and their communities not when we deign to engage or consult with them, but when we return to them, with interest, the power, money and knowledge we have all borrowed.

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