TY - JOUR T1 - The state of social care: the reality of a fragmented system JF - British Journal of General Practice JO - Br J Gen Pract SP - 200 LP - 201 DO - 10.3399/bjgp17X690593 VL - 67 IS - 658 AU - Theresa Eynon AU - Simon Conroy Y1 - 2017/05/01 UR - http://bjgp.org/content/67/658/200.abstract N2 - Some clinical commissioning groups, handed responsibilities by the 2012 Health and Social Care Act, were convinced that proactive, integrated care closer to home was the answer. Inspired by reported success in places such as Torbay,1 GPs were going to wrap a holistic package of health and social care around frail older people.They predicted that patients and their families would plan for crises in advance and hospital admissions would fall. Frail older patients would be discharged earlier and delayed transfers of care would be a thing of the past, with Emergency Frailty Units providing rapid and comprehensive geriatric assessment with early discharge home. Joining with social care in a virtuous circle of quality improvement, hundreds of hospital beds could be closed and the money invested in care closer to home.Local authorities with social care responsibilities put in place a range of programmes to reduce costs, review commissioning, and coordinate services across public health and social care. NHS Better Care Funds were settled on social care departments. Many wished this engagement might lead to marriage and sustainability ever after.Draft NHS Sustainability and Transformation Plans (STP) built on these foundations. Leicestershire’s was published in November 2016 and promised the closure of 281 hospital and community beds. They would not be needed.Allied to Better Care, Leicestershire’s ambitious new Help to Live at Home service was launched in November 2016. Rather than spot-purchasing personal social care packages from a multiplicity of small providers, Leicestershire County Council (LCC) rationalised its contracts, giving responsibility for one district to one provider. This innovative service model would enable a stronger relationship between the purchaser and provider. It would facilitate … ER -