The Orders of St John Care Trust is part of a care ethos which dates back nearly 1,000 years. Today, we provide a range of care, support and housing services to older people in over 60 locations in Gloucestershire, Lincolnshire, Oxfordshire, Suffolk, West Sussex and Wiltshire and operate on a not-for-profit basis. Our services, delivered by 4,000 staff, cover dementia care, nursing care, residential care, respite care, day care, intermediate care and extra care housing.

I took part in the roundtable discussion at HSJ’s offices in June with other leaders in social care, NHS England, Integrated Care Systems (ICSs) and local government which was organised in partnership by HSJ and National Care Forum. The discussion was framed around how health and social care can best prepare for winter pressures, with a specific perspective on how ICSs can work better this year to help mitigate strain in the winter months. Looking back at last winter, we consistently had more than 100 care beds available every week throughout our services but found it difficult to communicate this availability to the right parts of our local systems so our capacity could be put to the best use. As a provider, bed availability changes by location and by type on a daily basis, so we have an obligation to share that data in real time, but even so, we wondered, did ICSs understand these beds were available, and that regardless of normal designation, during winter months these beds are able to support individuals of varying need, as long as good communication and agility between partners exists.

If this was our experience, no doubt it’s been reflected elsewhere in the sector, so providers and their local systems really do need to prepare to put the work in to improve timely communications and trust each other more in order to do this better. The immediate benefit should be that existing resources and supply are much better utilised.

As the roundtable conversation widened, we delved into the general involvement care providers feel they have in their local systems throughout the year. For myself and my colleagues at OSJCT, I would say involvement in our local systems feels quite partial and idiosyncratic depending on the locality and what relationships and engagement you might have at a very local level. On a positive note, however, we do have reasons to be cautiously optimistic for the colder months that await us. We have seen workforce pressures lifted over the last five or six months which, although early days, we hope will continue into sustainable improvement.  One thing that could destabilise this would be threats to how we recruit internationally. For many of us, recruiting this way is an important avenue in ensuring all our services are fully staffed while the perception of social care as a career for UK workers remains so negative and the competition from retail, hospitality and healthcare employers remains so high.

We now need to see some commitment on long-term funding for intermediate care services. Emergency short-term pots of funding to solve winter pressures simply do not provide the long-term certainty that both commissioners and care providers need to deliver sustainable intermediate care services to the short-term funding approach. The cycle of six monthly funding/bidding is exhausting and doesn’t allow for proper investment and development of services.

At OSJCT we have become used to standing up discharge to assess, reablement services or intermediate care plus services within days, but surely, the need for these is year-round, with the ability to increase capacity in times of increased demand?  And more broadly, how can we expand our range of services amidst pressures and with new models like peripatetic nursing on the rise?

A lot of the issues behind true integration between health and care comes down to data and intelligence. In the increasingly data driven health environment, we as social care providers have the challenge of not having the necessary tech infrastructure to step up to the plate when it comes to data exchange and our local systems struggle to offer essential and timely data back to us. With the moves within the sector to digitisation of records and creation of a digital infrastructure, we can become a more pivotal part of the creation of shared care records. With better use of data, we can get access to the whole spectrum of information about what’s going on in peoples’ lives, what the cause and effect might be, and share this with GPs and healthcare providers. By working together with health professionals in true collaboration, we can create a fairer system that puts the person at the centre, right where they should be.

This article was also published with HSJ in association with the National Care Forum.  Another long read on winter preparedness is also available on the Nuffield Trust website here.