Opinion: with the political merry-go-round stopping, what should Thérèse Coffey focus on first?

Now that Ms Coffey is firmly in post, Rob Finney, Chief Operating Officer at Tristone Healthcare, offers his views on what the new Health Minister should be prioritising first and speaks to professionals in the industry about the change the sector needs to see. 

It was only a matter of months ago that we were surmising about Steve Barclay and his new role as Secretary of State for Health and Social Care. The Cabinet reshuffle came hot on the heels of a spate of resignations and Boris Johnson’s reluctant decision to step down as leader of the Conservative Party.

Three months on, and with little time to make any impact on the job, Barclay has been replaced as Health Secretary by Thérèse Coffey. After a fiercely fought leadership debate, the political merry-go-round appears to have stopped with new Prime Minister, Liz Truss, and her carefully assembled Cabinet in place. 

As a former Minister of State at the Department for Environment, Food and Rural Affairs, Coffey is a tried and tested minister with responsibility, but her task is sizeable. The first month of her tenure has been understandably interrupted by a period of national mourning, following the death of Her Majesty Queen Elizabeth II, but Coffey has already set out her ‘Plans for Patients’ approach, and a £500m commitment, which has been warmly received for its focus on the end user, rather than staff.

A swathe of tax cuts during last month’s ‘mini-budget’, meant reference to health and social care was no more than a fleeting remark. We wait in anticipation for what those further announcements might be. However, with three MPs having already taken the helm in health and social care in 2022, the need for more consistency is surely key.

During that time, children’s social care has seen numerous reports published and investigations conclude with recommendations of wide-ranging reforms still waiting for action.

As we wait for more information from Coffey, social care leaders on the ground have been cutting through the political rhetoric and reflecting on what they see as the priorities for the new Health Secretary.

Daryl Holkham, Director of Operational Corporate Governance at Tristone Healthcare

‘Josh MacAlister’s Independent Review of Social Care has highlighted some important key drivers for change. The recommendations make sense and, if collectively implemented, they will doubtless have a positive and lasting impact.

‘However, barriers to change are multi-faceted and enduring. For example, we have a regulatory system that is said to focus upon the process of care, and less so upon the experiences and outcomes of children in care. This was recognised within MacAlister’s report, and one that was contested by Ofsted and subsequently countered by local authorities and providers alike.  Almost immediately, we are presented with a roadblock. There is a discontinuity between the defining principles of the regulator and the experiences of the regulated. 

‘There is no doubt that the change required must focus upon factors that will make a real difference to the experiences and outcomes of children.

‘This must be built upon the principles of effective child-centred care that is delivered through joined-up working, transparency, accountability, and a culture of learning that extends beyond the successes and failures of individual settings towards root and branch reform.  The emphasis must be upon reform that will impact upon all agencies involved in the care and support of vulnerable children.

‘To afford positive, meaningful change we need to look at not only what can be improved, but also what works and importantly, how, and why it works. Improvement is driven by shared learning, shared commitments, and effective joined-up working. Things will go wrong from time to time, but the emphasis must be upon solutions and not limited to blame.’

Alison Moore, Managing Director of Juventas Services

‘For me, there is a small but simple solution. The system/sector requires greater enthusiasm on recording meaningful outcomes. This would be one system that all organisations and sectors feed in to, regardless of private, public or charity status.

‘An outcome-focused mindset would assist profit-driven organisations to refocus and align to the meaningful outcomes being created by organisations such as ours. I also believe that there should be a cap placed on organisations to stop them growing beyond a certain amount of homes – this tackles care dilution and communication barriers. 

‘One thing that would add real value is greater engagement between the Children’s Commissioner and the sector to help shape proposals for the improvement of children’s homes. By seeking the views of those people who are working on the ground, by looking at this from the grass roots up, and gathering factual information, we can create lasting change.’

Danielle Piller, Managing Director of Sportfit Support Services

‘One of the biggest changes coming up in the sector next year is the regulation of Post-16 support by Ofsted – to date, our sector has been unregulated.

‘Not only will it remove the misconception that unregulated in some ways means ‘illegal’, but it will also ensure that those providers that don’t offer the quality of care and support to young people, are weeded out of the system. It’s about ensuring that our young people are placed in the right provision at the right time.

‘Obviously, another factor that would hugely impact the care sector is investment in people. Recruitment is a real issue for the sector at present. Investment must be channelled into highlighting the positives that come from working in a role in social care, together with the lasting impact you can make on a young person’s life and the career opportunities available.’

The spotlight will remain on Coffey and her fellow ministers over the next few months, as we understand where and what those changes and reforms will be. It’s clear her task is complex and far-reaching, but greater communication with those people at the coalface will go some way to making a tangible difference in the areas most needed.

On a similar matter, David Brindle, Chair of Ambient Support, has also shared his opinion on how the governments suggested social care strategy is ‘no where near a breakthrough’. 

Photos by Thomas Kelley and CDC