Book contents
- Frontmatter
- Dedication
- Contents
- Acknowledgements
- Prologue
- Introduction
- one How we divide the world into community and asylum
- two How we create problems by trying to fix them
- three Why failure pays, but success costs
- four Risk aversion and risk indifference
- five The humanisation experiment
- six Shared Lives
- seven Designing a new national health and wellbeing service
- eight Delivering the national health and wellbeing service
- Can we escape?
- Notes
- References
- Index
seven - Designing a new national health and wellbeing service
Published online by Cambridge University Press: 08 April 2022
- Frontmatter
- Dedication
- Contents
- Acknowledgements
- Prologue
- Introduction
- one How we divide the world into community and asylum
- two How we create problems by trying to fix them
- three Why failure pays, but success costs
- four Risk aversion and risk indifference
- five The humanisation experiment
- six Shared Lives
- seven Designing a new national health and wellbeing service
- eight Delivering the national health and wellbeing service
- Can we escape?
- Notes
- References
- Index
Summary
‘Sarah’ had a lifetime of severe mental distress, rejection and addiction problems before she was supported to live independently, funded through a personal budget. Despite having a diagnosis of schizophrenia, Sarah had often been unable to access local inpatient mental health services because of bed shortages and had spent time in prison and residential care. In May 2010 Sarah took on a supported tenancy for a two-bedroom flat provided by the Amber Trust. She had very little self-esteem and confidence so she was offered the opportunity to become involved in the Trust's allotment project. Initially very anxious, Sarah's confidence grew so she could make her own way to the allotment with the friends she had made there, and after two years, become a volunteer ‘buddy’ to support newcomers to the project. Her confidence and independence grew so much that she is moving on from supported accommodation to a home where she will have her own tenancy.
(Bennett, 2014)There are many critiques of health and care services, but few that go on to describe an affordable, politically achievable alternative, partly because, as Shared Lives and the related models described in Chapter Six remain under-researched and easy to overlook, no such model was seen to provide a substantial enough evidence base. That evidence trap remains and many will dwell on the risks of rapidly adopting practices that have not been thoroughly researched. Meanwhile the risks of continuing with the same model manifest themselves in increasingly bleak realities.
In this chapter I will outline the transition I think we need to make and the long-term support system that will result from making it: what kinds of interventions and relationships it will create and contain; how it will be resourced (not just with money but also with time and creativity from those currently seen as recipients or customers), what it will value and what its rules and expectations will be.
Wellbeing: aligning public services around a single goal
It is astonishing that, despite constant talk of ‘integrating’ health and social care, you will never hear anyone suggest that health and care, much less other public services, should share a unified goal. How services could become ‘integrated’ when they have different goals and pay provider organisations for different things escapes me.
- Type
- Chapter
- Information
- A New Health and Care SystemEscaping the Invisible Asylum, pp. 143 - 176Publisher: Bristol University PressPrint publication year: 2018