A better social care future really matters for people living with cancer

By Fiona Flowers Community Settings Specialist Advisor – Macmillan

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Some people reading this may be surprised as to Macmillan’s presence within the #socialcarefuture movement, as when people think of Macmillan you may think “nurses” and most commonly “health”

But cancer does not just affect a person’s physical health. It can turn their whole life upside down and have a far-reaching impact on their mental health, wellbeing, finances, employment, and relationships to name a few.

Unfortunately, the social care and practical support needs of people with cancer will be an issue that will continue to grow in the next few years. More people are living with cancer for longer, many as a long-term condition and with social care needs that aren’t being met.

We can also see that the narrative around crisis and unmet needs in social care and its narrow definition is not winning the argument. Given that Macmillan is committed to making sure that people living with cancer live their best lives possible, we are looking at social care in its broadest sense using the following definition:

“..the ability to remain at home in clean, warm, affordable accommodation; to remain socially engaged; to continue with activities that give their life meaning; to contribute to their family or community; to feel safe and to maintain independence, choice, control, personal appearance and dignity; to be free from discrimination; and to feel they are not a ‘burden’ to their own families and that they can continue their own role as caregivers” Oliver, 2014

Macmillan provides, partners and influences support around the holistic needs for people living with cancer both nationally and locally (more information here https://www.macmillan.org.uk/) and is working with local authorities and system leaders around this

For the past four years I have been leading a programme called the Macmillan Local Authority Partnership Programme (MLAPP) working in partnership with Local Authorities across England and Scotland. Macmillan recognised that as cancer is a social issue for many, in order to truly enable integrated personalised care for people living with cancer and alongside changes in legislation, Local Authorities’ are in a unique place to broker local solutions for people, their carers and communities given their role of convenors of place.

The programme has been exploring how to spread the development of integrated models of non- clinical care and support for people living with cancer which are personalised, coordinated and promote wellbeing and independence. The programme is developing collaborations across social care, health, communities and other stakeholders such as housing.

The programme has taken the approach that we need to work across systems to understand what assets already exist to build and coproduce the solutions to enable people living with cancer to live good lives in their communities. Rooting this work in coproduction and the experiences of people living with cancer has been crucial to influence the change needed in local areas understand cancer as a social issue, as well as investing in trying to test how we support systems to work in an asset based way and being able to understand how each stakeholder has a key role to play in enabling the person to be supported around their lives.

The programme has been an incredible learning experience for me personally especially around the varied complexities and nuances of local relationships and how to influence them! For Macmillan the learning has shown leadership is critical, alongside the importance of the asset mapping, convening and brokering relationships and enabling continued and meaningful engagement with stakeholders should not be underestimated!

Unsurprising, the MLAP programme has been different in different places to reflect place history, culture, existing assets, infrastructure, needs and experiences of people living with cancer. This is a cautionary tale for those ascribing to scale up the same model.

The latest TLAP report Reimaging Social Care: a study from three places, showcased this so well, and you can see from those areas really making progress that to deliver asset based care there will be multiple ways to deliver in one place but with common key principles.  We all need to be comfortable that there needs to be an asset based “smorgasbord” with multiple models, at multiple levels.

It’s the principles and ability to power share, be comfortable with less control, work in coproduction and work with people’s strengths that are scalable not always the individual solutions themselves.  Kindness, compassion and that “you” matter are key. We are interested how we can support leaders nationally and locally to start taking that leap of faith and be comfortable with this approach.

We recognise that Macmillan are a big charity and so understanding our place in this movement will be critical. Working collaboratively with people, communities and VCS organisations in many different ways will be vital to make sure people get the support they want.

We are joining the #socialcarefuture movement to support development of the new narrative and drive system change not just by using our voice to add to debate but also to explore how we can work collaboratively with others to bring about real change practically to demonstrate what can be achieved.

@FionaFlowers9  

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