The decision to leave social care out of the NHS 10-Year Health Plan is a significant mistake that could have far-reaching implications for the healthcare system and the population it serves. Social care, which encompasses a range of support services for individuals with various needs, pretty much all of which relate to people's health, must not be seen in isolation. By excluding social care, the Government risks undermining the holistic approach needed to address the health and well-being of citizens. It flies in the face of every single pronouncement that comes out of politicians about the importance of integration. How can you have integration when you support, plan and fund in silos?

Health and social care are not mutually exclusive; they are interconnected needs that influence individual outcomes. For many individuals, health problems are often compounded by social factors such as inadequate housing, isolation, or lack of access to community services. Social care plays a pivotal role in facilitating a seamless transition between hospital care and the community, aiding recovery and preventing readmission. The Government risks failing to acknowledge the complexities of people's needs and the integrated care necessary for promoting overall health. The consequences of this decision can strain an already burdened healthcare system. Without adequate social care provisions, patients are more likely to experience delayed discharges from hospitals, known as ‘bed blocking', but better titled ‘organisational obsession'. This situation is always presented as people who are medically fit to leave, but are not able to do so due to a lack of appropriate social care support. In recent months, we have seen endless NHS leaders standing before television cameras saying they could not discharge because there was no capacity in social care; this is a lie. In most areas, if you looked at the Capacity Tracker data, you would see there was ample residential and home care support, but there was also a refusal by NHS leaders to use NHS money in any service that was not inside the NHS. This focus on organisations, budgets and processes not only hampers patient care but also escalates healthcare costs, as the system grapples with inefficiencies and an inability to put resources where they are most needed and can make the most significant impact on people's lives.

An ageing population is likely to increase demand for both health and social care services. As more people live longer, often with multiple health and social care needs, the system must evolve to support this growing demand. By considering social care as a fundamental component of healthcare planning, the NHS can ensure that resources are effectively used to address the needs of this population. In contrast, shunning social care could exacerbate the challenges faced by increasing numbers of people with long-term conditions, particularly those who may live alone or lack family support. Additionally, there could be profound implications for the workforce. Social care professionals play a vital role in the functioning of the health system. They are responsible for delivering a range of services that support individuals' daily living, mental health and well-being. As a result, the Government risks failing to attract and retain social care professionals, who often work in challenging conditions and for less money, recognition and esteem, compared to their NHS counterparts. This can lead to workforce shortages that impact service delivery, forcing remaining staff to take on heavier caseloads and ultimately affecting the quality of care provided.

Excluding social care perpetuates a fragmented system in which individuals must navigate multiple agencies to receive the support they need. The current system can be confusing and overwhelming, particularly for vulnerable people who are old or those with disabilities and mental health issues. An inclusive NHS Plan that integrates social care would focus on creating a streamlined pathway for individuals to access support services, thereby reducing barriers to care and improving overall care quality. This integrated approach can empower individuals to take an active role in managing their health and well-being, promoting independence, delivering prevention and improving quality of life.

Acknowledging the importance of interconnectivity between health and social care is a step towards a more sustainable and efficient system. Investment in social care, alongside health, should be viewed as a priority. By adopting an integrated health and social care model, the Government can work towards a more cohesive system that not only meets the current demands but also anticipates future challenges. Addressing the funding disparities between health and social care is critical in rectifying the systemic issues stemming from this separation. 

For far too long, social care has been underfunded, An equitable allocation of resources can enable social care providers to offer more comprehensive services, ultimately enhancing patient outcomes and reducing the burden on the NHS. Excluding social care is a strategic mistake that compromises the ability to achieve better health outcomes, akin to having a cart without a horse.