Rt Hon Jeremy Hunt MP speech Tuesday 20th March

The Rt Hon Jeremy Hunt MP, gave a speech Tuesday 20th March outlining the seven key principles that will guide the Government's thinking ahead of the social care green paper, to be published later in 2018.

Borrowing a line by Robert Browning - Grow old along with me! The best is yet to be, Jeremy Hunt went on to explain how the government is set to undertake a large scale review of the health and social care system, with a strong focus on innovation and use of technology.


The seven key principles guiding the review are:


  1. Quality – quality and safety embedded in service provision
  2. Whole-person, integrated care - with the NHS and social care systems operating as one
  3. Control - the highest possible control and flexibility given to those receiving support
  4. Workforce - a valued, well trained workforce
  5. Supporting families and cares - better practical support for families and carers
  6. Sustainable funding - a sustainable funding model for social care supported by a diverse, vibrant and stable market
  7. Security - for those born or developing a care need early in life and for those entering old age who do not know what their future care needs may be


There was a strong commitment to Innovation been central to all of these principles, good news for the TEC industry, “we will not succeed unless the changes we establish embrace the changes in technology and medicine that are profoundly reshaping our world.” stated the minister.


The sentiment of the speech was very aspirational, stating how in modern-day Britain the true litmus test of whether we are a civilised society should be how we care for our most vulnerable citizens.


Mr Hunt sighted some examples of how the Better Care Fund is transforming the way councils and the NHS work together to treat the whole person:


  • Nearly 7 in 10 service users were extremely or very satisfied with their care and support over the last 3 years
  • 81% of adult social care providers are rated as good or outstanding
  • Spending will rise by 9% this year
  • The number of care home agencies is up 55% since 2010
  • The government recently set out a new package of measures to protect care home residents from unfair practices


But he then went on to state that in truth, progress is not yet up to the mark, with:


  • Many families finding it incredibly hard to access the care they want with or without means-tested support from the state
  • Many people employed in the system find themselves working too hard as they struggle with fragmented services coming under unprecedented pressure
  • The CQC has itself expressed serious concerns about the state of the adult social care market and the risks of provider exit
  • Pressure is feeding through to the NHS with A&Es becoming overcrowded because hospitals find themselves unable to discharge patients who cannot access social care support packages


This coupled with the fact that in the past 20 years there have been 5 Green or White Papers, numerous policy papers and 4 independent reviews into social care.


So what did the speech mean for TEC providers, commissioners and suppliers?




For commissioners there will be focus on reducing variation in provision and quality across local authority areas. There’s a likelihood that commissioning will be subject to some form of independent review or rating after the finding of a recent CQC review of how LAs procure care.


The wider aspect of quality will focus on standards, with a commitment to tackle instances of poor care through the application of minimum standards enforced throughout the system to ensure the safe and responsible delivery of services to individuals with complex care needs. Further reading on the subject of standards can be found in a blog by TSA member, Douglas Gilmour, ‘QSF vs ISO why you need both’


Whole-person care


There will be a focus on reducing confusion and fragmentation throughout the system with the full integration of health and care centred on the service user.


Several pilot schemes were announced where users of the social care system will have just one plan, jointly assessed by both health and social care networks. These ‘trail-blazers’ of integrated care in Gloucestershire, Lincolnshire and Nottinghamshire, will mean that over the next 2 years every single person accessing adult social care in these areas will be given a joint health and social care assessment.




The third critical principle is control, giving people the ability to direct the care they receive, and crucially provide the autonomy to enable them to lead the lives they want.


There is a strong consensus that personalisation is the right path to follow, and technology has huge potential in delivering this, enabling people to access care support whenever and from wherever they are.


The Minister recognised that the greater control people have over their care, the better their outcomes and the lower the cost – something that will be music to the ears of TEC providers who are looking at how emerging technology can provide greater flexibility and availability more cost-effectively. With this came a commitment to review Personal Health Budgets in order to achieve better integration for those with the greatest need.




As well as referencing the introduction of the National Living Wage, the Minister also highlighted how the sector needs a coherent workforce plan to improve recruitment and provide a solid career ladder for both registered and un-registered professionals. Training, Continuing Professional Development, associate nurses and degree-apprenticeships can all help shape this agenda.


It would seem that as both the health and care sectors move closer together that flexible and transferable skills will play a big part in workforce development over the coming years.


Supporting families and carers


Mr Hunt stated: “If we can make it simpler to look after a loved one, if we can make it easier to juggle working and caring responsibilities, if we can encourage volunteering – whether by more flexible working, better employer support or harnessing new technologies, then that is what we should do.”


Most of us in the TEC sector can instantly relate to this, as we understand how readily available consumer technology makes modern life manageable by allowing us to work more flexibly, keep in touch easier and manage complex tasks remotely.


Technology has the ability to tackle the loneliness epidemic, as the Minister pointed out “It is truly a scandal that over 30% of people in Britain over the age of 65 say that television is their main form of company.”


Yet we know that off-the-shelf technology exists that enables dialogue – yes, with friends and relatives but also smart speakers, chatbots and voice assistants allow people who live alone to explore the world from their own homes without them having to be particularly tech-savvy.


Sustainable funding


There’s a strong commitment of how the government can prime innovation in the market, develop the evidence for new models and services, and encourage new models of care provision to expand at scale. This is a huge hint at how technology can perhaps be seed-funded, and is further strengthened by the following statement, “We must also recognise the potentially transformative role of new technology. We British are good at innovation.


“So let’s see the brightest and best new ideas put into action to help us tackle the challenges we face and that will help us stay at home independently for longer.”


Mr Hunt also made reference to the Grand Challenge announced as part of the Industrial Strategy and how this needs to play a definitive role to catalyse public-private investment in technologies and innovation, with a total fund of £300 million available across four themes of Artificial intelligence, Clean growth, Mobility and Ageing society.




Whilst the State accepts its duty to provide decent care for those unable to afford it the system has also reflected the principle of personal responsibility for care by individuals and families. Again one can see were technology supports this principle, allowing people to keep in touch, monitor and react to loved-ones needs, involving the emergency services in a controlled way rather than by default – allowing better quality of life and independence.


The Minister rounded off by highlighting how financial wellbeing in old age ends up defined less by service during peoples working lives, and more by the lottery of which illness they get. He hinted at the need for a system that includes an element of risk-pooling and will bring forward ideas as to how to do this alongside their potential costs in the forthcoming Green Paper. As Lizzy Buchan, Political Correspondent for the Independent pointed out in an article recently that there is now less redistribution between councils as spending needs and local tax revenues change over time.


Read the transcription of the Ministers speech here: