- Chris Morris
- Nov 12, 2016
- 7234 Views
Three health charities have called for urgent government investment in social care in order to avoid an impending disaster.
Plugging a £1.9bn social care funding gap should be a more urgent priority than boosting funding for the NHS in this month’s Autumn Statement, according to the Health Foundation, The King’s Fund and the Nuffield Trust.
Addressing this gap will require significant action, following a combination of funding cuts and rising demand.
Thousands more older and disabled people could be denied access to necessary care, “with severe consequences for the NHS”, according to the charities.
And the groups particularly cite a 9% cut in real terms in social care spending by local authorities between 2009-10 and 2014-15, and 400,000 fewer people now access these services.
King’s Fund assistant director for policy Richard Humphries suggested that the situation of social care can be characterised as a crisis.
“Cuts to social care funding are leaving older and disabled people reliant on an increasingly threadbare local authority safety net. For many, the care they get is based not on what they need but on what they can afford and where they live. More people are left stranded in hospital. This government has committed to creating a country which works for everyone, and they now need to match this with action by using the Autumn Statement to address the critical state of social care.”
The gravity of the situation is underlined by the fact that a survey conducted by the County Councils Network (CCN) found that sjust 12% of adult social care directors think their budgets are manageable.
In response to this figure, CCN urged chancellor Philip Hammond to invest at least £700 million in social care.
The new National Living Wage, rising care costs, demographic growth and insufficient funding are all considered issues for the sector.
Some counties will struggle to deliver a balanced budget before the end of this Parliament based on these factors, and the figures collated by the CCN.
Additionally, there is scepticism about the ability of the existing sustainability and transformation plans to deliver adequate savings through integrated health and social care.
Conflicting targets and misaligned settlements between the two services are set to cause problems for social care, according to the CCN.
Suffolk County Council’s Conservative leader Colin Noble, the CCN’s spokesman for health and social care, was keen to point out that the current situation should not be mischaracterised as financial mismanagement, and instead indicative of a funding crisis.
“County authorities are contending with an impossible situation of seeing budgets reduce at a quicker pace than other councils, while coping with the biggest and fastest growing elderly population in UK history”.
- Chris Morris
- Mar 20, 2016
- 5352 Views
Fourteen doctors’ leaders have written to George Osborne asking for further funding for social care in next week’s Budget.
There is a raft of evidence accumulating which suggests that social care is massively underfunded, and that elderly people relying on this critical aspect of the NHS will face massive problems in the coming years.
Responding to this climate, in a letter to the chancellor, they said cuts in social care funding were putting real pressure on the NHS.
The 14 doctors suggested that social care is no less than vital to the success of the NHS, and should be prioritised immediately.
Responding to the comments of the credential individuals, the government stated that it was already giving local authorities access to up to £3.5bn of new funding for adult social care by 2019-20.
The signatories to the letter are led by Clare Marx, president of the Royal College of Surgeons of England, and include the leaders of a number of royal medical colleges and societies.
And the letter paints a damning picture of the current state of social care in the NHS, asserting that it is being critically underfunded.
The doctors believe that health and social care should effectively be considered two sides of the same coin, and that the service is being neglected in the existing health service and its organisation.
They additionally assert that the level of bed blocking in the NHS is frequently leading to cancelled appointments and operations, placing pressure on an already besieged health service.
“This impacts on our ability to provide timely treatment and meet treatment targets, risking patient wellbeing, and is ultimately detrimental to the economy through delayed returns to work,” they wrote.
One suggestion made by the latter is bringing forward the 700 million from the Better Care Fund to the current fiscal year, as opposed to waiting to 2017 when it was scheduled.
A spokesman for the Department of Health defended the position of the government and the NHS, pointing to funding that has already been promised to the social care system.
“We have given local authorities access to up to £3.5bn to spend on social care and councils will have almost £200 billion to spend on local services over the lifetime of this parliament.”
The signatories to the letter are:
Miss Clare Marx, president of the Royal College of Surgeons of England
Prof Dame Sue Bailey, chairwoman of the Academy of Medical Royal Colleges
Prof John Ashton, president of the Faculty of Public Health
Dr Anna Batchelor, dean of the Faculty of Intensive Care Medicine
Dr Liam Brennan, president of the Royal College of Anaesthetists
Prof Jane Dacre, president of the Royal College of Physicians
Mr Michael Lavelle-Jones, president of the Royal College of Surgeons of Edinburgh
Dr Suzy Lishman, president of the Royal College of Pathologists
Prof Carrie MacEwen, president of the Royal College of Ophthalmologists
Dr Giles Maskell, president of the Royal College of Radiologists
Prof Neena Modi, president of the Royal College of Paediatrics and Child Health
Prof David Oliver, president of the British Geriatrics Society
Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists
Prof Sir Simon Wessely, president of the Royal College of Psychiatrists
New research indicates that over 40% of spending in the NHS is targeted at people over the age of 65.
The Nuffield Trust have provided this information, which once more indicates that the greying population in the coming years is going to pose massive demographic challenges for the health service.
Data produced by the trust indicates that an 85 year-old man costs the NHS in excess of seven times more than a man in his late 30s.
Health spending increases rapidly after the age of 50, with people aged 85 costing the NHS in excess of £7,000 per year.
This compares to the average across all age groups of just over £2,000, according to analysis published by the Treasury.
The seriousness of this issue is underlined by population trends of the future.
By 2039, people aged 65 or over are expected to represent 23% of the population, or 17.5 million, according to projections from the Office for National Statistics.
Nearly 10% of the population will be aged over 85 by that date, according to existing estimates.
Commenting on the issue, Mark Dayan, policy analyst at the Nuffield Trust, suggested that although the picture was troubling with regard to the future, the information acquired by the trust actually indicates the success of health policy to some extent.
“People in the UK live longer every year because we have learned to cure or prevent many of the diseases that once cut lives short. Today, the NHS’s staff and technology, and therefore its money, is increasingly focused on treating people in older age groups, with often long-term conditions that we struggle most with. That’s a sign of success.”
But the analyst also suggested that the data also posed massive problems for the future direction of the NHS.
“However, this means that as more people stay alive and grow older, the cost of healthcare rises each year by 1 or 2% on top of wages and costly new drugs. To maintain and improve the health service, we need to constantly find more money or savings, usually both. This basic question of demographics and money lies behind most of the controversies across the NHS.”
Clearly the issues exacerbate existing financial issues within the NHS.
It has been well documented that the health service faces a deficit of an estimated £2 billion by the end of this year.
Strike action from junior doctors is now guaranteed, while nursing unions remain extremely critical of plans related to bursaries.
Elsewhere, there has been huge criticism of David Cameron’s plans for a seven-day NHS culture.
It is clear that the NHS policy is fundamentally flawed at this time considering this convergence of issues.
NHS bosses believe that many elderly patients are refusing to leave hospitals owing to the potentially large cost of care homes.
Recently published figures indicate that the number of pensioners currently occupying hospitals beds who should be accommodated in care homes has increased by over 15 per cent in the last year.
In fact, statistics recently published by the NHS indicates that pensioners are responsible for over one-in-three of all bed blocking cases.
This is making a significant contribution to bed blocking being at all-time highs in the NHS currently.
In November last year, there were 153,000 days of delays in NHS hospitals lost to patients who were medically fit to leave; the second highest figure on record.
While from January to November, 1.59 million days were lost in total to bed blocking. This number is significantly larger than any other figure on record.
Experts and analysts believe that pensioners are effectively imprisoned in hospitals because the government has failed to provide adequate social care funding.
Indeed, numerous stories have emerged over the last few weeks that indicate that the future of social care is very much in the balance.
Ministers have delayed plans to introduce a cap on care costs, a key manifesto pledge.
The cap was due to come into force this April but will now be introduced in 2020 due to concerns over the ability of the government to fund the scheme.
Although there is some debate over the issue, there is nonetheless a political will to address the situation.
Sarah Wollaston, a Conservative MP and chair of the health select committee, has acknowledged the seriousness of the situation, and suggested in parliament that there should be a review of how social care is funded in the National Health Service.
“We can’t see social care and NHS funding in isolation, we need to have a review of how we fund the whole system so that we can deal this problem. The increasing problem is that because the rate of remuneration to social care providers doesn’t sufficiently meet the costs. There isn’t anyone available to provide the care so even if you want to pay for it you find its difficult to find someone who is providing social care in your area. This is a worsening problem and a problem both for social care but also the NHS.”
The latest figures regarding bed blocking have been considered particularly worrying, considering that they are related to the month of November.
This is not even the busiest time of the winter period, and ultimately the figures hint at an extremely serious problem.
Considering the critical importance of social care, this must be considered a worrying issue.
- Chris Morris
- Jan 11, 2016
- 5605 Views
A local authority is considering the idea of removing its mental health social workers from integrating NHS teams.
Somerset County Council believes that the move will not only bring financial benefits, but also enable the trust to improve delivery of the Care Act.
The proposal will impact upon 60 members of staff, and is to be considered and debated by the council of the cabinet at Somerset during a meeting in February.
If agreed, the social workers will be withdrawn from the NHS teams and returned to the local authority’s adult social services department in April.
This move has been partly motivated by the pressure on local authority finances.
Somerset Council has thus been tasked with finding savings in excess of £500,000 from its mental health budget.
But it is also suggested that the movie will enable the region to more satisfactorily comply with the Care Act 2014.
Some within the local authority feel the current integrated arrangement is failing to meet the people’s social care adequately.
Research evidence has suggested that social care is already becoming a massive problem in the UK, and with an increasingly greying population, this is set to intensify in the coming years.
Commenting on the attempts of Somerset Council to improve compliance with the Care Act, a Somerset County Council spokesperson outlined the view of the organisation.
“The proposals would enable us to ensure the positive work that has been underway regarding the council’s operating model fully includes mental health staff. It would enable greater emphasis on prevention, greater professional support and more direct supervision.”
With many staff potentially affected by the plans of the council, it was emphasised that all involved have already been informed.
The trust has been forced to commit itself to a merger with Somerset Partnership in what can be considered somewhat controversial circumstances.
Some staff and analysts have been critical of the decision, but those speaking on behalf of the council have indicated their rationale behind it.
Today, Andy Heron, Somerset Partnership’s acting chief executive, stated: “Our trust is aware that adult social care services in Somerset are facing significant pressures at present and that a number of options are being considered for their social workers in our mental health teams. As we understand it, there is no formal proposal as yet and we would hope that all options are considered.”
The Somerset Partnership is generally considered to be one of the pioneers of mental-health, having originally floated the idea of integrating services back in 1990s.
Fourteen major charities have indicated that it is vital for the government to take action on health and social care.
Macmillan Cancer Support and Marie Curie are among the major charitable organisations who want an independent commission to be set up in order to review the existing system.
David Cameron has been particularly targeted, with the groups signing a letter to the Prime Minister.
The language used in the letter is rather strong, with the charity suggesting that the NHS may not be fit for purpose in these areas.
Although the Department of Health has indicated that £10 billion will be invested in the NHS during the existing parliament, it is suggested by these raft of charitable organisations that this will be insufficient to deal with the health and social care problems.
In particular, the greater population which has been highlighted by this website on numerous occasions, is considered to be a major issue by the charities involved.
The letter highlights figures, indeed provided by the government itself, which indicates that nearly a quarter of the population will be over at the age of 65 in just 20 years’ time.
Thus, the letter addressed to Cameron outlines that bold and decisive action must be taken in the short to medium-term.
“We need to ensure we have an NHS and social care system that is fit for purpose otherwise it is the elderly, disabled people and their carers who will bear the brunt of inaction. Bold long-term thinking is required about the size, shape and scope of services we want the NHS and social care to provide – and an honest debate about how much as a society we are prepared to pay for them.”
The letter continues by suggesting that significant funding increases are needed in the social care system.
“It is vital that you meet the challenge posed by an ageing society, and an underfunded care system, head on and establish a cross-party commission to review the future of health and social care in England.”
The letter also highlights the frequently proffered opinion of experts and analysts that there will be a £30 billion gap in funding in the NHS by the end of the decade.
Although the government has pledged extra monies for the NHS, it is largely intending to plug this gap via efficiency savings.
Increasingly, as numerous credible sources lineup to question Government policy on the NHS, it seems impossible to believe that the government’s plans will be sufficient.
Commenting on the issue, David Sinclair, director of the International Longevity Centre think tank, urged immediate action.
“We need to start talking now, honestly and openly, about what standards of health and care older people can expect now and in the future.”
A Department of Health spokesman was keen to emphasise the investment made by the existing government.
“Since 2010, we have employed 10,100 extra doctors and 8,500 extra nurses and by 2020 the NHS will be a truly seven-day service offering the same world-class care every day of the week.”
A prominent think tank has suggested that adult social care services in the United Kingdom face severe pressure in the future.
The International Longevity Centre describes the situation for social care in Britain as bleak.
In his recent autumn spending review, the Chancellor of the Exchequer George Osborne announced measures that will lead to a rise in care budgets in the future.
However, despite the statements of the Chancellor, the think tank suggested that the spending review measures will do little more than paper over existing cracks.
The scale of the issue according to the International Longevity Centre is rather severe, with the think tank indicating that current provisions lead to 1.8 million people having care needs completely unmet.
A government spokesman said authorities now have access to an extra £3.5 billion to provide care for vulnerable people.
Osborne had made provisions in the spending review for local authorities to raise council tax by as much as 2 per cent in order to protect social care budgets.
In addition, the amount of money available for the Better Care Fund was increased.
However, the report produced by the think tank suggests that the increasing concentration of elderly people in the UK will pose almost insoluble problems to the existing care system in the absence of further funding.
The report stated that 1.86 million people over the age of 50 in England had unmet care needs in 2012/13, a rise of 7 per cent since 2006/07.
Commenting on at the findings of the International Longevity Centre, Ben Franklin, ILC-UK’s head of economics of an ageing society, was rather pessimistic about the social care situation in Britain.
“The future for adult social care looks bleak. The social care settlement will be insufficient to meet the growing care needs of an ageing population and does little more than paper over the cracks which many of those who are in need of care are already falling through.”
Franklin also took the time to comment on the consequences of the existing goals in social care funding.
“While some will be able to rely on family to support their needs, increased prevalence of unpaid caring may have adverse consequences for those providing support, for the economy as a whole due to reduced employment, and without additional investment may even lead to an erosion in the quality of care provided.”
Caroline Abrahams, Age UK’s charity director, was of the opinion that the report should be a wake-up call for both the public and legislators.
“Over the last 20 years, the need to provide a system of childcare has been first recognised and then at least partially met, in order to enable more women to work and support decent family incomes. Now many of those same women, or sometimes their mothers, could find they have to leave work to care for their own ageing parents, because we are effectively dismantling our system of social care.”
Responding to the claims, a spokesman from the government suggested that the Better Care Fund provisions will enable councils with the greatest need to increase social care provision.
- Chris Morris
- Dec 8, 2015
- 6320 Views
The results of the recent government spending review are negative for the future of social care, at least according to two major chief executives in the health service.
Nigel Edwards the Chief executive of the Nuffield Trust and Chris Ham, the Chief executive of the King’s Fund, wrote a letter to the Guardian in which they expressed concern about the existing situation.
According to these two prominent individuals, the spending review represents another major setback for vulnerable individuals across the UK who requires social care.
Although acknowledging that the power to raise council tax could provide the government with some room for manoeuvre, the letter suggests that less revenue will be generated than suggested in the spending review.
Considering the massive variations in the amounts that councils will be able to raise via their tax base, deprived areas will become disadvantaged by this plan.
This will ensure that some regions of the country retain a heightened requirement for publicly funded care.
Additional money provided through the Better Care Fund towards the end of the parliament is welcome, according to the signees of the letter, but they also suggest that the existing situation has become terminal.
Edwards and Ham go as far as to describe social care as being in a state of crisis.
Far from supporting the plans of the government, the two chief executives describe the spending review as little more than sticking plaster solutions.
They believe that the plans of the government are no substitute for adequate funding, and that the situation must be remedied before the end of the existing Parliament.
Edwards and Ham site the fact that public funding for social care will fall as a percentage of GDP by the end of the existing Parliament.
This would be serious anyway, but considering the greying population of the UK, this figure defies demography and will reduce publicly funded social care to a threadbare safety net available only to the most needy and vulnerable members of British society.
Meanwhile, social care providers face huge pressures, with at least one of the big care home operators reportedly close to collapse.
The authors of the latter point out that in excess of 400,000 people have been denied access to requisite social care over the last five years alone.
In addition, thousands of elderly and disabled people face the same prospect going forward, and there is an extremely undesirable situation considering the vulnerability of these individuals.
The situation will only increase pressure on an already burdened NHS, with families and carers also bearing the brunt of the situation as well.
The letter concludes with an assertion that a new settlement which provides adequate funding for health and social care is needed now more than ever.
- Chris Morris
- Nov 16, 2015
- 6289 Views
A recent report suggests that care homes across the UK could faces severe financial difficulties in the foreseeable future.
The ResPublica think tank even reports that the entire residential care system could collapse in the next five years, if £3 billion of annual investment is not made.
In addition to these claims, the think tank that also suggests that in the region of 40,000 beds will be lost due to the closure of existing care homes.
This will occur due to a shortage of £1 billion in annual funding of the residential system.
By the same token, rising demand will ensure that huge pressure is placed on care homes in the coming years.
ResPublica goes as far as describing the current situation as “a potentially fatal crisis”, yet local authority spending on social care for older people has fallen by 17 per cent since 2009.
It is also suggested by the think tank that the introduction of the National Living Wage will increase the burden on care homes, contributing several hundred million further deficit to the funding gap.
The authors of the report were at pains to point out that the national living wage was indeed a great step forward, with the potential to improve living conditions for 6 million low-paid employees.
However, they also emphasised that you it could have a vast impact on the social care sector, with more funding needed to pay employees adequately.
This latest report can be placed in the context of the recent decision by Britain’s biggest care home provider, Four Seasons Health Care, to sell off a string of homes amid financial pressures.
The report has some dire warnings for the future of the residential care system.
“Given the perilous state of the industry, we believe the most likely outcome is the vast majority of care home residents flowing through to hospitals.” It adds: “This would require the NHS to find £3 billion per year by 2020/21 to support frail and aged people who no longer have a home in the residential care sector, and who do not belong – nor wish to be – in a hospital,” the report concludes.
Commenting on the issue, Izzi Seccombe, the Local Government Association’s community wellbeing spokesperson, reflected that the situation is extremely urgent and indeed dire.
“We are heading towards a devastating care home collapse. Health and social care leaders widely recognise that a properly funded social care system is essential to alleviate the pressures on the NHS…it is imperative that the Government fully addresses this in the Spending Review before we see a care disaster unfold.”
Approximately 640,000 people in the UK turned 65; in 2012, the figure was about 800,000. There are now more people in the UK aged 60 and above than there are under 18.
- Chris Morris
- Nov 12, 2015
- 7051 Views
The Virgin Care company and its owner Richard Branson have recently secured a contract to provide community child health services in Wiltshire.
As a result of the £64 million contract, Virgin Care will become the single provider in the region.
Following the completion of the deal, the private healthcare company will take over delivery of the services from the existing public sector providers.
Community child care services in that region where previously provided by three NHS trusts, a social enterprise and a borough council.
Great Western Hospitals Foundation Trust is one of the current providers of children’s services in the area.
Community child health services in Wiltshire currently include children’s specialist community nursing, health visiting and speech and language therapy.
Aside from Great Western Hospitals Foundation Trust, Salisbury Foundation Trust, Royal United Hospital Foundation Trust, Swindon Borough Council and the social enterprise Sirona Care and Health CIC were all involved in the delivery of services in the region.
The central ethos of this new contract is to create an overarching service.
This is intended to clamp down on any form of variance in the way that service models and pathways are delivered in Wiltshire.
With Virgin Care having been named as the winner of the five-year contract, the private company will begin operating in the area in April next year.
The annual value of this deal is £12.8 million, with the arrangement set to run through until 2021.
Although shifting from five providers to one will provide logistical challenges for the delivery of services in the region, commissioners are optimistic about the decision that has been made.
Commissioners said that the new contract would provide patients with “consistent and equitable levels of service and support regardless of where they live in the county”.
Staff working for the existing service will be transferred to Virgin Care under transfer of undertakings; regulations intended to achieve protection of employment.
Commenting on the decision to award voting the contract, Jayne Carroll, Virgin Care’s regional director, was enthusiastic about the prospect for delivering child health services in Wiltshire.
“We are really excited to be working alongside a great team to provide a truly Wiltshire focused service that has been shaped by the people who use it and is focused on delivering outstanding outcomes for children and young people in Wiltshire.”
Virgin Care was also in the running for a children’s community services contract in Bristol and south Gloucestershire. The bid sparked anti-privatisation protests in Bristol.
A consortium of Avon and Wiltshire Mental Health Partnership, Sirona Care and Health and Bristol Community Health CIC was named as preferred bidder for the contract last month.
- Chris Morris
- Nov 10, 2015
- 6429 Views
A major independent review into the social care system has suggested that thousands of elderly people risk being condemned to a miserable last few weeks of their lives.
The research comes in the wake of a government decision to u-turn on its decision to cap funding for the service.
Dame Kate Barker described the decision to shelve the cap as “extraordinary” and said it meant there now appears to be “no strategy whatever” to meet demand for care as the population ages.
In particular, the government policy is set to ensure that middle-class elderly people in care homes will be forced to pay extra fees in order to subsidise others.
Barker described this policy as wrong and perverse.
The decision of the government is set to have a massive impact on care bills and social care in the coming years.
Many countries are having to deal with greying populations, as Western people live longer lives.
Additionally, the relatively small number of children being born in Western countries means that there are less young people around to care for the elderly.
The number of people receiving social care in England has fallen by a quarter – or 400,000 – in the last five years at a time when the elderly population has grown by 14 per cent.
“Tackling the deficit does not need to be at the expense of older and disabled people in need of care and support. These are just awful, awful things that we’re doing to people – and that was before. One feels that those cases will get greater and I think then people will start to have an outcry,” the aforementioned Barker argued.
Currently anyone with assets, including their home, worth more than around £23,250 does not qualify for state support with care.
But reforms passed by the coalition government during the previous parliament, based on recommendations by the economist Sir Andrew Dilnot, promised to raise that threshold significantly and cap the amount anyone would have to pay in their lifetime on care at £72,000.
This decision has been particularly criticised as it represents a sacrifice of pledges made in the party’s manifesto.
It is feared that many British people could be left without care under the terms of the government policy.
As many European nations face social care issues, countries such as Germany have already begun exporting elderly people to care homes in the Middle East.
This is a chilling foreshadowing of what could occur in Britain in the coming years, and it certainly appears that the feud related to this issue is indicative of these problems.
Critics of this latest decision state that it effectively amounts to asking frail elderly people to fund the social care system.
- Chris Morris
- Oct 27, 2015
- 6353 Views
Scientists at the University of Tsukuba in Japan have suggested that physical fitness can have an unexpected influence over brain capacity.
Researchers found that fitter men are able to access areas of the brain that are more associated with youth.
Thus, effectively increasing physical fitness can literally lead to a younger brain.
The study suggested that the left-side of the brain, which typically deals with short-term memory and the meaning of words, is used frequently in our younger years.
By contrast, the right-side of the brain becomes more favoured as we become older.
And scientists conducting the experiment found that fitter men were more able to utilise the youth- like, task-related sector of the brain.
Professor Hideaki Soya, one of the leading scientists in the study, suggested that white matter that connects the two sides of the brain retain better condition if someone is physically fitter.
“One possible explanation suggested by the research is that the volume and integrity of the white matter in the part of brain that links the two sides declines with age,” Soya stated.
The professor continued by commenting that the results of the survey are significant, but also emphasised that corroborative study will be required in order to determine the validity of its outcome.
“There is some evidence to support the theory that fitter adults are able to better maintain this white matter than less fit adults, but further study is needed to confirm this theory,” Soya explained.
A fairly small sample size of men aged between 64 and 75 years were showed a series of coloured cards during the experiment.
In order to confuse the brains of participants, the word of a different colour was written on top. Their ability to say the colour they can see, and not the word they can read, is the Stroop test of brain-function speed.
Participant fitness was also measured by documenting the level of oxygen present in the blood.
It was found that those with superior aerobic fitness consistently had shorter reaction times, leading researchers in the study to suggest that this may reflect more youthful brain structure.
Although the results of the study were certainly interesting, it is also important to note that no women were involved in the experiment, and thus it is not clear whether physical fitness can increase mental agility across both genders.
Typically the ability to complete the Stroop test accurately diminishes with age, but this research suggests that older people can engage in behaviours in order to improve their mental agility.