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Home Truths

Local authorities fail to engage GPs with alternative options

  • Majority (56 per cent) of GPs admit they don’t understand non-residential care services.
  • GPs underestimate their role in social care decision-making.
  • Two thirds (67 per cent) receive little or no support from local councils.

GPs inflate demand for residential care by at least 60,000 older people every year because they don’t understand the alternatives, according to new research by local government consultancy, IMPOWER.

The Home Truths study based on interviews with older people, social care professionals, GPs and directors of adult social care reveals a bold consensus that by not addressing this, local authorities are failing to manage demand for residential care.

Driving demand

Eight out of ten (82 per cent) GPs believe that a large proportion of older people could avoid or delay entry into residential care.

Yet more than half (56 per cent) of GPs admit they don’t understand the wider care services available with just 15 per cent of GPs claiming to understand all the options.

This is a concern as GPs significantly underestimate their influence on social care decision-making. Just nine per cent believe they have significant influence, with more than a third (38 per cent) claiming they have little or no influence. However, patients rate GPs as one of the most influential stakeholder groups (41 per cent) above social carers (22 per cent), partners and spouses (30 per cent).

Jeremy Cooper, Director at IMPOWER, comments: “IMPOWER’s study reveals that GPs, social workers and local authorities are locked in a dysfunctional relationship, with lack of understanding between them generating unnecessary demand for residential care – the highest cost area of adult social care.

“With financial pressures increasing we need a new approach to health and social care integration now.”

Nowhere to turn

Two thirds (67 per cent) of GPs say their local council puts little or no effort into helping them understand all the available care services and two fifths (40 per cent) say the same of social services.

The finding that GPs inflate demand for residential care services because they don’t understand the wider options is supported by evidence from across the local government spectrum. The vast majority (78 per cent) of social workers believe GPs often don’t understand or encourage alternative options to residential care.

Directors of adult social care also admit that more needs to be done. Simon Williams, Director of Community and Housing, London Borough of Merton, commented: “Doctors tend to point to traditional services – they have very limited knowledge of the world beyond GP practices and hospitals.”

Richard Parry, Corporate Director of Adults and Local Services, Cumbria County Council, added: “We need to ‘up our game’ when it comes to delaying entry into residential care and challenge widely held perceptions that residential care is the only option.”

Generating behaviour change

IMPOWER’s report argues that current efforts to integrate health and social care should be re-focused on the individual relationships between the people who provide these services, which hold the key to reducing demand.

IMPOWER conducted rigorous analysis of local government data and found that, for example, by focusing behaviour change initiatives on just the highest referring GPs – on average 52 in every local authority – local councils could keep 60,000 older people out of residential care annually and save more than £600 million a year.

Jeremy Cooper, Director at IMPOWER, comments: “Our research identifies a much bigger potential opportunity to tackle the social care funding crisis – by deflating demand. The £600m opportunity to reduce residential care bills we have identified is just the tip of the iceberg.

“If local authorities focused on integrating people and culture, rather than just structures and services, they could save billions of pounds in provision of more appropriate, targeted health and social care for older people.”

IMPOWER’s white paper has been referenced in numerous online articles including The Guardian, The MJ and

Jeremy Cooper is a Director at IMPOWER. To contact him to discuss the white paper please e-mail or call 020 7017 8030.

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