Challenges in redefining care support systems

Healthcare reveals a curious paradox: the moments patients remember most deeply often happen between the expensive interventions. What We Prioritize vs. What Patients Value Healthcare systems naturally optimize for what drives revenue and regulatory compliance: patient throughput, length of stay, billable procedures. These metrics shape our workflows, our staffing decisions, and our physical spaces. Meanwhile, the gestures that build trust and create healing flourish in the margins of this measured world. The unhurried explanation, the moment of genuine presence, the extra time to answer questions exist outside our primary optimization targets. The Challenge of Individual Responsibility We often expect healthcare workers to provide kindness and compassion as personal qualities they bring from home, rather than capabilities we systematically support at work. We hope for caring while creating challenging patient loads. We value presence while designing rushed schedules. We want staff to notice and respond to human needs while measuring primarily task completion. This approach places tremendous pressure on individuals to somehow find the emotional and temporal resources for genuine connection despite systems optimized for efficiency. It's asking a lot of people who already give so much. Designing Infrastructure That Supports Connection The most effective healthcare systems don't rely on individual heroics. They build the conditions where human connection naturally happens. This looks like specific, intentional choices: Spatial Solutions: Consultation rooms with comfortable seating at the same level, family alcoves near patient areas, staff break spaces that actually allow for decompression. Operational Design: Scheduling buffers that account for complex conversations, handoff protocols that include emotional context, float staff who can absorb unexpected family needs. Technology Integration: Documentation systems that support eye contact during conversations, communication platforms that help families stay informed without overwhelming staff. Role Innovation: Patient experience coordinators who focus specifically on human needs, peer support specialists who provide different kinds of connection, care navigators who help families understand complex systems. Creating Supportive Infrastructure The opportunity exists to restructure around this insight. Organizations could design schedules that include relationship time. Many have created development opportunities that build emotional intelligence alongside clinical skills. They can measure outcomes that include patients feeling heard and supported, and design workflows that make these outcomes achievable rather than accidental. When we intentionally design for human connection alongside operational efficiency, we discover that our most powerful healing tools have been there all along. We just need to create the conditions where they can flourish.

Stafford Beer, the famous systems thinker, noted that "the purpose of any system is what it does"—meaning if the system isn't delivering what’s needed, it’s not the people's fault but a flaw in the system's design. #Health and #care are riddled with silos and fragmentation. Specialists, services, and apps address isolated parts of our bodies, but no one looks after us as whole persons, within the context of our lives. As society ages and grows sicker, we find ourselves bouncing between disconnected specialists, clinics, and "pathways," often unaware of our histories or other care we're receiving. Integrated Care has long been discussed but rarely delivered. The "sausage machine" model of #healthcare inherited from industry keeps optimising parts, not wholes. Demand rises, resources are strained, and waiting lists grow. Integrated Care Systems (ICSs) were conceived as a new model to bring together health and care into a more holistic approach, supporting wellness, early intervention, and person-centred care for disease or infirmity. For an #ICS to be more than a rebranded silo collection, it must serve as a system-level convener of integrated support, fostering collaboration across health, social care, local councils, communities, VCS, and industry partners. How do we shift from siloed services to holistic support that centres on people’s needs and lived experiences? And how can we view this challenge through a life course lens—Start Well, Live Well, Age Well, and Die Well? Transforming silos into systems requires a shared vision for the future and a collective journey to reach it. One that recognises that it is the relationship BETWEEN the parts that creates a strong and effective system. I’ve been honoured to work with Suffolk and NE Essex (#SNEE) ICS on their breakthrough “Future Shift” programme https://shorturl.at/RCKBM. This unique 3 Horizons programme has united leaders across the ICS to reimagine a future holistic SNEE system and the journey to get there, built on a shared identity and a "Can Do Health & Care" ethos. Stepping back to view the national landscape, we need more of this visionary, systems-based approach—not just additional funding to sustain outdated methods—if we are to build the future health system that we all need and deserve. For the Imperial Programme that develops these ideas further see here: https://shorturl.at/3nsa1 #nhs #socialcare #communitycare #healthpolicy

Through my parents' experiences, I've witnessed both the promise & failings of American healthcare. My father's journey with Parkinson's demonstrated what's possible when care is coordinated & relationship-based. My mother's caregiving – along with skilled home care workers – saved taxpayers between $250-500k over my dad's 5-year journey, while providing care that aligned with his wishes in the comfort of home. Yet our flawed/fragmented healthcare system fails to value this essential work. The attached report reveals the staggering reality: family caregivers provide unpaid care worth $600 billion annually while facing significant financial and personal costs themselves. The report shares powerful stories like Christine Freund's, who calculated spending over 22,000 hours caring for her brother over 15 years – time that also meant missed career advancement and retirement savings. Dorothy Winningham described becoming "a different person" through the strain of caregiving for both her mother & brother. These experiences highlight how caregiving creates "second order patients" who often postpone their own healthcare while supporting loved ones. Our healthcare system suffers from two fundamental structural flaws that prevent us from addressing these challenges: 1️⃣We've artificially separated healthcare funding from social care funding, creating misaligned incentives that drive costs up while failing to support caregivers. 2️⃣Healthcare decisions are made at scales either too large (national) or too small (individual providers), missing the critical regional "goldilocks zone" that would allow for effective reinvestment of savings into community care. What if we reimagined healthcare through community ownership? A model similar to how rural electric cooperatives transformed access to electricity a century ago. These community-owned health plans would operate like utilities, designed to serve their communities for generations rather than maximize quarterly profits. When health plans are rooted in communities, the artificial divide between healthcare & caregiving dissolves. These plans could properly value caregiving through direct financial support, respite care, training, & integration with medical teams. With longer time horizons, investing in caregiving becomes an obvious solution rather than a cost center. Successful community-owned health plan models like the Nuka system & Ashtabula (OH) demonstrate this approach works – delivering better outcomes while creating the "Health Rosetta Dividend" – resources that flow back into communities rather than to distant shareholders. How might your community be transformed if healthcare were designed by those it serves, with caregivers valued as essential partners? Geri Baumblatt - your insights on caregiving have been invaluable. How might community-owned health plans better support the caregivers who do so much unrecognized work? #HealthcareTransformation #CommunityOwnership #Caregiving

The Darzi Review, led by Lord Darzi and commissioned by Secretary of State for Health and Social Care, Wes Streeting MP, sheds light on the pressing issues facing both the NHS and social care systems. For those who rely on care and support services, the message is simple but profound: the way forward must involve genuine collaboration between health and social care to ensure that everyone can access the support they need to live with dignity, independence, and choice. The problems of fragmented services and chronic underfunding are not just policy concerns—they directly affect people's lives. Individuals who depend on care often face complex, overlapping challenges, and the lack of coordination between services leaves gaps in care. This not only places undue stress on families, who often step in as unpaid carers, but also intensifies the pressures on both the NHS and social care systems. The lived experiences of those who draw on care cannot be overstated. These are the voices that remind us of what is truly at stake. They understand, perhaps better than anyone, the importance of integrated, seamless care. A disconnected system forces people to navigate bureaucratic hurdles when they should be focused on their health and well-being. This personal insight is essential if we are to shape a system that works for everyone. The Darzi Review calls for a comprehensive, joined-up approach that treats social care as an equal partner with the NHS. Only through this kind of integration—across health, social care, and community services—can we improve outcomes for individuals and reduce the overwhelming strain on existing services. Early intervention, preventative care, and digital innovation hold great potential to empower people and reduce the need for emergency care. Those with lived experience of the care system have long advocated for these solutions because they understand how transformative upstream interventions can be in maintaining independence and quality of life. Moving forward, the government must prioritize working closely with those who directly draw on care and support. Their experiences and insights are invaluable in designing a care system that promotes well-being, respects dignity, and ensures everyone receives the right support at the right time. Only then can we create a future where both health and social care contribute equally to our collective well-being. https://lnkd.in/eJ5vuRND 10 Top Tips for Co-Producing with Individuals Who Draw on Care and Support Start with Lived Experience Create an Inclusive Environment Involve from the Beginning Acknowledge Expertise Communicate Transparently Be Flexible and Adaptable Focus on Relationship-Building Support Participation Ensure Decision-Making Power Learn and Reflect Together #LivedExperienceMatters #CoProductionInAction #PowerInPartnership #ExpertsByExperience #CareVoicesHeard #InclusiveCollaboration ❤️🙌✨🤝👩🦽💬

Today's announcement brings yet another report on the future of social care, signaling a familiar pattern of discussion without decisive action. With a history marked by multiple government and independent commissions, along with numerous reports, the glaring issues facing social care are well-documented. From inadequate long-term planning and underfunding to workforce shortages and an overburdened system, the challenges are clear. So, why the need for further delays in addressing the obvious? One key aspect that continues to be overlooked is the opportunity for integrated funding. Health and social care, inherently interconnected, operate from separate financial pools. A unified funding strategy could enable the social care sector to tackle pressing NHS challenges such as delayed discharges and bed blocking. Properly investing in social care has the potential to alleviate strain on hospitals, optimize bed utilization, and enhance patient outcomes. The scope of this new report raises questions about inclusivity. Will the voices of those directly impacted by social care be heard, or will it follow a top-down approach? Furthermore, amidst these deliberations, the urgency of the current situation cannot be ignored. Residents, families, and care staff are in immediate need of solutions, not prolonged discussions. The recent allocation of £86m for housing adaptations, while a step forward, merely scratches the surface of the transformative changes required. It is imperative to move beyond rhetoric and prioritize tangible actions. The time has come to revolutionize the funding and delivery of care, placing the well-being of individuals at the forefront of our efforts. #HCMS