2. Delivering and improving wellbeing

Key points:

  • We are best able to live the life we want to live if we are independent, well and live in communities that support and encourage the many aspects that make us unique
  • This is true for everyone but the support we may need is unique to us as individuals and must therefore be personalised
  • Local government exists for this very purpose, affecting multiple dimensions of our communities and lives, throughout our lives
  • Supporting and improving people’s mental and physical wellbeing is at the heart of local government’s work and that of many other local public, private and voluntary sector organisations. It can only be delivered with communities

“Local government has many responsibilities but none more core than creating places that are inspiring of good health, leading improvements for local people, encouraging businesses to grow and creating jobs that local people can get. By being ambitious for the health of local people they can create years full of life as well as life full of years.”

Duncan Selbie, Chief Executive, Public Health England
LGA think piece series, 2018

Our lives are precious and unique and we want to live them as we each see fit.

For the benefit of those who need support to live the life they want to lead, we must start by asking the individual person, ‘What matters to you?’ rather than ‘What is the matter with you?’ However, starting the conversation this way, with the right question and full emphasis on personalisation, means little if we do not have what is required to act on the answer.

Acting most effectively means changing our model of care and support from one which tries to treat the ever-growing burden of long-term conditions and illness caused by demographic and lifestyle factors – doing to the person – to one which helps people maximise their health, wellbeing and independence for as long as possible – doing with the person at all stages of their life. Changing the model in this way requires an equal partnership between local political, clinical, professional and community leaders in which each area develops its own vision and range of services to suit their own unique local circumstances.

Many services support the process of wellbeing. The police service deters, detects and deals with crime. The NHS treats us when we are ill. Our education system helps us learn and be curious. But as essential as these services are, they ultimately only really focus on one element of our lives. And while we alone tend to shape our own aspirations, it is the places in which we live, grow, work and relax that give us opportunities for fulfilling lives and the confidence that the choices we make will result in safe, quality and rewarding experiences.

Local government helps shape the fullness of the places in which we live. From the mix of shops on our high street to the removal and recycling of waste, councils lead and engage with their communities to deliver more than 800 services. This helps keep every aspect of our communities running and improving for the benefit of all people.

Because our lives do not start and stop, neither do councils. Local government services operate both in the background of all our lives and more at the forefront of others’. Councils support people at some of the happiest moments of their lives and some of the hardest.

At the heart of every council’s relationship with its local population is a commitment to improving people’s physical and mental wellbeing. This is a tradition that can be traced back through the decades as local efforts have pieced together to improve our nation’s wellbeing. In more recent times it found expression in the 2014 Care Act, which cemented the idea that a council’s general responsibility in respect of the legislation is to promote an individual’s wellbeing. Helpfully, this was defined in broad terms, recognising that a person’s wellbeing is shaped as much by their participation in work and their personal relationships, to name but two examples, as it is by the practical support they may need with daily tasks such as washing, eating and dressing.

In this way, wellbeing cannot and should not be the preserve of adult social care and support alone. If we are serious about preventing ill health we need a strong public health offer. If we are to help people remain independent at home we need the right kind of housing and neighbourhoods. If we are to encourage physical activity we need vibrant leisure and recreation amenities. If we are to combat loneliness we need reliable transport links, a diverse and resilient community and voluntary sector, and comprehensive employment services. If we are to support people’s mental wellbeing we need to build safe and inclusive communities. The list could easily continue.

Wellbeing goes well beyond local government. The essential input from the local voluntary sector, the care provider market and its workforce and the local NHS all have a clear and fundamental role to play in creating local places where wellbeing can thrive. It is precisely because this is a local endeavour that councils, as democratically accountable local leaders of place, are perfectly positioned to marshal all local aspiration and resources around a common vision for a population’s wellbeing and independence.

What our partners have said

We’d like to thank our partners from across the sector for their thoughts, comments and input into the green paper. Here’s what they have to say…

Foreword

High quality social care and support helps people live the life they want to live. It helps bind our communities, it sustains our NHS and it provides essential economic value to our country.

Executive summary

While it is true that social care and the NHS are inextricably linked, it should be seen an essential service in its own right and the people who work hard to deliver the service should be seen as just as valuable as staff in the NHS.

Who is this green paper aimed at?

Questions about the future of adult social care and support, and the wider changes we need to make to our care and health system to improve wellbeing, should be everyone’s business.

4. The options for change

Why has it proved so hard for successive governments to deliver sustainable long term funding for this crucial service?

5. Adult social care and wider wellbeing

If we are to really tackle the full extent of future demand with quality services we need to refocus our efforts on intervening earlier and preventing needs developing in the first place.

6. Adult social care and the NHS

Joining up care and support and intervening and offering early support to keep people well is a more efficient use of resources but efficiency alone is not enough.

8. Have your say

Answer the questions relevant to you and your organisation and submit your views to be added to our research.