Tackling rising social care costs

At the end of this month, the world's oldest living person, Emma Morano, will turn 117. The extent of Emma’s longevity is exceptional – but medical advances, an improved standard of living, better nutrition and healthier lifestyles have seen a general increase in life expectancy over the past 50 years.

Combined with falling fertility rates, this trend will see the composition of the UK's population change radically in years to come. The old age dependency ratio, which measures the proportion of working-age people to over 65s, will increase by nearly 50 per cent over the next two decades.

As people tend to require higher levels of social care spending in their later years, these demographic pressures will feed through into the elder care budget. In fact, by the 2060s the cost of financing social care will double as a percentage of GDP.

There has been understandable concern about these trends in policymaking circles, with the recent debate dominated by how the state finances this expenditure. The Government has committed to implementing a cap on social care costs as per the Dilnot Commission's recommendations in 2020. But the other end of this equation is how to improve the productivity of existing social care spending – and the areas for improvement are significant.

Poor inter-agency co-ordination, particularly between health and social workers, means patients often receive the same care twice or not at all. Complicated bureaucratic systems lead to delays in people getting the care they need, distressing families and racking up costs in the process. Meanwhile the lack of care in the community keeps elderly people in hospital when they no longer need acute treatment, causing them to lose mobility and the ability to do everyday tasks - as well as costing the taxpayer £640 million a year.

Resolving these interrelated challenges won't be straightforward. But a private nursing care provider in the Netherlands, Buurtzorg, offers some ideas as to how value for money in the social care sector might be improved.

Buurtzorg nurses tend to the entire range of a patient's care needs, meaning that they employ more highly skilled individuals that undertake both low- and high-skilled tasks. This has not only resulted in a more comprehensive care approach, Buurtzorg has also halved the number of care hours.

Buurtzorg has cut managerial and bureaucratic costs by 40 per cent through a non-hierarchal structure and focus on user-friendly technology. Nurses work in teams of 10 to 12, serving a local population of 50-60 patients. Decisions are made collectively, and there is a good local network of third sectors workers in the area.

Buurtzorg also improves patient quality of life and saves costs through using self-management aids to promote independence. The Royal College of Nursing has recognised that English patients may not have the same access to these as the Dutch. However, finding ways to enable independence will no doubt reap substantial rewards.

We should of course be cautious about transferring a system which is successful in one cultural and political landscape to another. But these Dutch innovations could have a part to play in our battle against the rising costs of social care, and ensuring that people can enjoy a good quality of life in their later years.