Memorandum by Macmillan Cancer Relief
RELATIONSHIP BETWEEN HEALTH & SOCIAL
SERVICES (HSS 68)
5. THE CURRENT
SITUATION: MACMILLAN'S
RESPONSE
The steady erosion of the role of the hospital
social worker has increased the gap between health and social
service responses to patient needs. As has already been outlined,
the specific nature of the disease means that cancer patients
require a fully integrated care package. Indeed, research suggest
that survival and recovery rates are significantly enhanced when
treatment is delivered through a multi-disciplinary team and encompasses
after-care and support. Macmillan nurses are now carrying out
many of the duties previously carried out by community social
workers and Macmillan has even developed specialist social work
posts in some areas.
By way of example of the problems caused by
the current low level of integration of health and social services,
Macmillan wishes to draw the Committee's attention to its Carers
Scheme.
Macmillan Cancer Relief has been piloting nine
Carers Schemes—a new form of home support for people with
cancer and their carers. The need for such a service had been
identified through a MORI survey commissioned by Macmillan into
the social impact of care. "Macmillan Carers" are specially
trained health care assistants who support patients, their families
and friends. They provide practical care necessary, throughout
all stages of the disease from diagnosis onwards, to enable people
with cancer to remain at home. They also support carers in order
to avoid unnecessary and unwanted admission to hospital.
The Macmillan Carers Scheme offers both practical
and emotional support and carers' work includes personal and basic
nursing care as well as various household tasks. The scheme unequivocally
crosses the artificial boundaries between "health" and
"social" care and "practical" and "emotional"
support.
These pilot schemes have been shown to tap into
an unmet need, and one not adequately provided for within the
current system in 80 per cent of cases. Indeed, research has found
that 20 per cent of patients would have had to go into hospital
without the help of Macmillan Carers[2].
However, it has been evident that every scheme has found the issue
of boundaries between health care and social services both fundamental
and problematic; as one care provider put it, "are we providing
a health bath or a social bath?". Our experience has shown
that in a number of the pilots, the two agencies failed to resolve
the issue of financial responsibility.
2 Key Findings, Clark Evaluation of Macmillan Carers
Scheme. Back
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