How do we find sustainable and human ways to care for people with long-term needs?
This book reveals the ways in which public services squander the potential of people with long term support needs and the creativity and caring capacity of front line workers.
Drawing on the ethos, practices and economics of human focused initiatives such as Shared Lives, this book outlines a new model for public services to replace the ‘invisible asylum.’ This approach, focused on achieving and maintaining wellbeing, rather than on reacting to crisis or attempting to ‘fix’ people, would both ask of us and offer us more. Responsibilities, resources, and risks would be more fairly and transparently shared. The book offers steps which we all – citizens, front line services, and government – could take to achieve this vision.
“This is a hard-hitting critique of our current care system – an account of why things are the way they are and how they could be different in future. Everyone who cares about health and social care should read it, and respond.” Jon Glasby, Head of the School of Social Policy, University of Birmingham
"...a provocative and highly readable book..." International Journal of Care and Caring
“This is a profound and timely call for a different relationship between people and the services and institutions of the welfare state. It’s a radical and necessary call to arms for a more human, personal and connected society.” Simon Stevens, Chief Executive, NHS England
“In this insightful book, Alex Fox gets to the heart of why attempts to reform our care and health services so often falter, and, drawing on his unique perspective, sets out a genuinely original alternative.” Matthew Taylor, Chief Executive of the RSA
"The Shared Lives model has achieved a very rare combination of warmth and humanity on the one hand, and scalability on the other. Here Alex Fox tells its story and persuasively draws out its radical implications for the future of the whole health and care system." Geoff Mulgan, CEO, Nesta
“This is an original and clear-eyed view of the ways in which our health and care systems put dysfunctional rules and processes between people who need support and those whose role is to care for them. It also sets out the fundamental changes and power-shifts which are needed if our public services are serious about moving to models which would be healthier not just for people who have health and care needs, but for families and frontline workers too.” Nigel Edwards, Chief Executive, Nuffield Trust
Alex Fox OBE FRSA is CEO of Shared Lives Plus, the UK network for Shared Lives and Homeshare. Members include 5,000 Shared Lives carers who share their homes and family life with people who need support and 160+ local organisations. Previously Alex was Director of Policy amongst other roles for the Carers’ Trust, a UK network of carers’ centres. Alex also chairs the NHS England, Dept. Health and Public Health England review of the Voluntary, Community and Social Enterprise Sector. He was awarded an OBE for services to social care in the 2016 New Year’s Honours.
1 How we divide the world into community and asylum;
2 How we create problems by trying to fix them;
3 Why failure pays, but success costs;
4 Risk aversion and risk indifference;
5 The humanisation experiment;
6 Shared Lives;
7 Designing a new national health and wellbeing service;
8 Delivering the national health and wellbeing service;
Can we escape?