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home life
a look back at Transforming Care: learning disabilities has taken place

outside the mainstream.
too damn complex in practice downward pressure but tenacity and
yes, the “system” has created
respectful relationships between people
The official line on government policy to enable more people to linked to those in hospital who should
live in the community is that it has been successful. Some people have a different life is what has made the
difference.
working in the system may disagree, says steph Thompson It worries me because the people
leading Transforming Care are
consistently stymied by resource flows
dog-eared copy of the harvard successful. I think some people working between NHS England, clinical
Business Review is glaring at me. within the system may disagree. The commissioning groups and local
a inside, a feature on tackling numbers can be “interesting”. authorities. It worries me because we still
bureaucracy concludes: “These times call For example, the pressure to have not sorted out what
for a new era of accountability, but not meet discharge targets has meant good community
the end to innovation … let us educate quick fix solutions, sometimes outcomes mean. It worries
ourselves and our people so that the focus involving beds in smaller units me because the demands
can be on ingenuity, not conformity.” rather than the flexible support on NHS leaders to “sort out
With 1.5 million workers, the NHS is in flexible housing that was the the system” can crush
possibly the world’s largest non-military initial vision. positive joint working,
bureaucracy. How on earth does one begin Of course, low-hanging fruit improvements and
to grapple with the size of the NHS and gets picked first. It turns out corporate memory of what
achieve accountability alongside innovation that, for a minority of people works.
and ingenuity? How can we connect the living in NHS beds for a long Last night, I dreamed it
NHS to social care in an “integrated time, moving out was relatively was all OK. I dreamed that
system” (again)? Who has the power and easy. The remaining majority, however, the new accountable care
ability to effect systemic change? are more challenging to support to move systems rode to the rescue of our system,
“ Transforming Care is the against targets is harder. happen. I dreamed that all those people
unblocked all blockages and made change
back into their community, so progress
Targets are essential but one takeaway
One takeaway from
busy trying to manage the complexity out
of convoluted systems were suddenly
from Transforming Care has to be the
able to focus on people with complicated
unintended consequences of
unintended consequences
plans actually became real.
the Home Office, in the wake of
of oversimplifying oversimplifying complex issues. I’m sure support needs. I dreamed well-written
I woke up disappointed. As someone
complex issues ” Windrush, feels the same. long in the tooth in NHS and local
There are parts of the country where
the people leading Transforming Care
government, I have a nagging sense of
is that this is usually down to passionate
NHS must now follow the Bank of England
I choose to be optimistic. To see a have really given it a go. What worries me déjà vu. I increasingly believe that the
learning NHS. To believe that the values individuals, navigating their way through on the path to independence. Because,
and goodwill of the vast majority of its a complicated system to commission politically, it’s all too damn complicated. n
workforce and, yes, of its political classes support for complex individuals in
can nudge our NHS behemoth in the right hospital beds. Steph Thompson is a director of
direction. But … It worries me because, once again, Dimensions (www.dimensions-uk.org) and
With only months to go, the official line great commissioning and delivery of managing director of Waymarks
on Transforming Care is that it has been packages of support for people with (waymarks.org.uk)

highlighted in the The Keys to Life – the For some people living and working in a form of housing and support for their
Scottish Government’s 2013 Learning Camphill community really brings out the individual needs and wishes.
Disability strategy (https://keystolife.info). best in them.’ Living in a Camphill community and
This is an aspirational strategy but it Despite this, The Keys to Life strategy taking part in purposeful and productive
does, however, have some worrying clearly comes out in support of work in that community, even if it means
aspects, particularly in relation to choice independent living in the community. It choosing to move out of your local
and control. also opposes out of area placements in authority area to do so, can be a positive
It emphasises that a range of choices the belief that people with learning choice with positive outcomes, as our
should be available to people with disabilities should be allowed to live close research findings so clearly demonstrate. n
learning disabilities and recognises some to their families and other sources of
of the limitations of the independent local support. Andrew Plant is manager of Supported
living model. It also makes a positive This is the concern – that a strategy, Living Services at the Milltown Camphill
reference to the Camphill communities: discourse or ideology can lead to a Community in Aberdeenshire
‘Not everyone with learning disabilities restriction of the choices open to people (www.camphillscotland.org.uk/
will choose to live in their own home ... when trying to find the most appropriate community/milltown)

www.cl-initiatives.co.uk Community Living Vol 32 No 2 | Winter 2018 21