'How can we lock in the lessons of the [Covid] crisis to build a more robust, sustainable, joined-up system of health and social care?'


Shall we start with a question…

How can we lock in the lessons of the [Covid] crisis to build a more robust, sustainable, joined-up system of health and social care?

It’s not my question. It is the question posed by Baroness Cavendish and the title of her report.How can we lock in the lessons of the [Covid] crisis to build a more robust, sustainable, joined-up system of health and social care?

Yes, I know… that leads us to two further questions. Who is Baroness Cavendish and who wanted the report?

Cavendish went to uni with David Cameron and he made her a Baroness in his resignation honours list.

She was supposed to take the Tory whip but as her wiki-page tells us, she resigned the Conservative whip in December 2016 and now sits in the House of Lords as a non-affiliated peer…

… after gaining an unidentified post that required her to sever any party links…

What was the post?


The Baroness was a leader writer at the Times, moved to The Sunday Times and was a McKinsey management consultant. She has apparently been an aid worker. Where and when?


As director of the No10 policy unit, she is credited with getting HMG to ‘do the sugar levy’. The ‘tax’ on sugary drinks to pay for sports facilities for schools. Is there an example of the levy actually paying for a playing field?


Jeremy Hunt commissioned her to undertake “An Independent Review into Healthcare Assistants and Support Workers in the NHS and social care settings”. I thought it made a lot of sense. What happened?


My second question, who commissioned this, latest report? I think it was the DH. What’s the upshot?


The report is, what it is. A report, printed with all the presentational flare of an instruction manual for a 1960s, East German forging press. That aside, is it any good?

Ignoring her gratuitous insults to the NHS;

  • The NHS is still struggling to join up primary and secondary care, and to understand social care. 
  • NHS not ‘human’ enough to get a greater role in social care

We all know there are four things we have to do to get health and social care playing nicely.

First, pool budgets. The Better Care Fund showed the way. There is a promise in the new Health and Care Bill inching its way through the Westminister gas-works, that the concept will be expanded and could well do the trick.

Second, sharing access to each other’s data. Interoperability would be the gold standard but it seems beyond industry to deliver or the public sector to insist on it. So the staff-room-coffee-jar-solution… cheap and instant, sharing will do the job.

Third, declutter the landscape and make it easier for people, residents, carers and families to make better decisions, based on validated information and pay more attention to self-funders.

Fourth, getting everyone singing off the same hymn sheet. Getting health and care on the same footing.  Finding a collective answer to; what are we trying to achieve?

It is this, fourth question, that Cavendish uses throughout, to shape her thinking and create the answer to; ‘building a more robust, sustainable, joined-up system of health and social care’…

it falls down on Page 18 when she attempts solutions. We are told there are five possible answers but only two are explored and one is settled on.

It says;

‘LAs would retain responsibility for commissioning but would be required to develop and use a commissioning framework that focuses on outcomes and prevention, rather than time-on-task. The extent to which they do so would be inspected by CQC.’

I have no idea what this means other than anything with the CQC involved is doomed to failure, inspection, criticism, putting the boot-in and general numpty-ness… 

… but, Cavendish is a former CQC, NED, so you can see where her head is. Also, I’m pretty sure it conflicts with the spirit, if not the intent of the new legislation.

The report is 60-odd pages and worth a cuppa-builder’s read. It’s well written, as you’d expect from a journalist, and picks off some low hanging fruit solutions. It highlights some of the best that came out of Covid.

But… what happens to it now?


News and Comment from Roy Lilley
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