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So what’s really gone wrong with Care?

As the news breaks today that 200,000 more care homes are needed by 2025 in order to care for the ageing population, we look at what really has gone wrong, and how it affects those we love.

As reported in the BBC News, this isn’t just related to care for older people, but disabled people, and children too, and some are unfortunately suffering more than others.

1. Spending has plateaued

The trend has been that year on year more money has been spent on services. This is due to a growing population, an ageing population, and those with disabilities living longer. Over the past ten years, this has levelled off and Central Government funding for councils was slashed by one third by the previous parliament.

2. Care is being prioritised

In 2015-16, 55% of council budgets was being spent on social care. With this, comes cutbacks to other local services such as leisure centres and refuse collection.

3. The NHS is filling the gap

One third of last years £24 billion budget was spent on children leaving £16 billion for adults. This was supported by a £2 billion grant from the NHS.

Last year saw the biggest grant yet from the NHS, as local authority spending was £900 million less than in 2009-10.

Simply, what happens in social care, directly impacts the NHS.

4. Councils are looking after less people

To save money, care is being rationed to older people rather than those with disabilities.

Between 2008 and 2014, care from the councils for over 65s fell by 25%.

5. Patients are being forgotten

If care isn’t provided in the community, people go to hospital.

Doctors only release those they know will receive care in the community. And if it’s still not available when they’re ready to leave, they’re left on wards.

This means new patients cannot be admitted, directly affecting A&E waiting times and increasing trolley waits.

This has almost doubled over the past five years.

6. People are making their own arrangements

As reported by Age UK, 12.5% of people in care homes now pay for themselves and 30% receive no help whatsoever.

These people still have substantial needs and are unable to dress themselves, and struggle to go to the toilet.

7. Councils are being subsidised

Companies providing the services have reported that councils are being squeezed so much, in some areas they’re working at a loss.

The U.K. Care Association calculated that the cost of helping people at home is £16.60ph, but across the UK, councils are paying on average £2 less than this. Also, the fees being paid by councils are £100 less than the true cost.

This means, those who are self funding, are paying more to make up the difference from the losses ; They’re subsidising the state.

Considering 1 in 10 people has care costs of over £100,000, we are left asking if this is fair?

8. The market is at risk

The Care Quality Commission have highlighted that this is destabilising the sector, as care companies begin to focus on areas where there are more self funders.

This could create a shortage of places in those areas, such as the South East where 54% are self funding.

Over the past six years, the number of homes operating in England has fallen by over 1500.

9. Ageing population

Currently, roughly 18% of the U.K. population is over 65. This is predicted to rise to almost 25% by 2044.

By 65, one in six people have trouble with day to day tasks. By 85, this rises to half.

10. Council tax bills are increasing

Councils have been given permission to raise council tax bills in order to pay for social care.

But it would appear this is limiting, as it is still raising less than 3% of what they plan to spend.

By 2020, the Local Government Association predicts there will still be a shortfall of over £2.5 billion.

Many have tried and failed to solve this, and our current coalition government have suggested a cap on care costs; already pushed back by 4 years.

Will we ever see a solution, or will this continue until the system crumbles and we have nothing left?

Are These The Care Homes Of The Future?

What if care homes were no longer like a home, and more like a community with shops, salons, and cinemas? This could very well be the future for British care.

As reported in the Guardian, Paul Burstow, the chairman of the Social Care Institute for Excellence (SCIE)wrote a report identifying what the government, Care Quality Commision (CQC), investors and providers need to do to change the current structure of our care homes.

Whilst researching for this report, Mr Burstow travelled to the Netherlands and visited a gated village called “De Hogeweyk”. This village is designed for people with dementia.

Mr Burstow reported that nobody wore a uniform, all staff are trained in hospitality, and the village is designed to mimic an actual village with shops, bars and homes.

WCS Care (WCS) has taken this approach, and is now running 12 homes, soon to be 13. The aim here is to encourage them to lead a “normal” life; going shopping, washing up, cooking, setting the table etc.

Their newest home has six households, each with fourteen residents, and their own kitchen. Their meals are laid out in their kitchens, and they’re encouraged to make their choice themselves.

In WCS, everything is run as close to the outside world as possible. The laundrette for example has staff, and they deal with the “customers”, allowing them to do as much or as little as they wish. They also have a Doctor’s surgery, and a dentist, all with waiting rooms and receptionists.

They also believe in residents spending as much time outside as possible and have built in cycle tracks, hairdressers, and cinemas.

These homes are designed around the philosophy that everything is driven by the residents. They only do what they want to do, which ensures they continue enjoying life?

Not only have WCS seemingly improved the quality of care, they’re also overhauling the technology surrounding caring for residents. They’ve introduced overnight acoustic monitoring which monitor the sounds residents make when they sleep. This helps staff assess whether they need to assist the resident, reducing the number of nightly checks, therefore reducing the disturbance for the residents.

This monitoring also offers peace of mind for family members as their loved one is monitored constantly.

This technology has already reduced the number of falls during the night, in one home by 30% as staff can instantly hear when a resident is moving around.

Similarly, using this technology helped staff recognise residents that were struggling to sleep. To change this, instead of ushering them back to bed, they formed a club; chatting, playing games, having their hair styled etc. Over a short space of time, their body clocks adjusted and they were able to sleep.

Due to their nature of keeping the residents quality of life at the forefront of everything, WCS have already received six outstanding CQC assessments.

So can we take their model, their aspirational and innovative model, and make it a reality for the future of British care?

Opera: Can it be used in care?

A number of care homes have opened their doors to the first opera written for the care sector, as reported by the Guardian.

“Six characters in search of an opera”, written by Rachel Barnett is being performed across the South West in care homes, dementia units, day centres and hospices.

The play was commissioned by Davina’s Fund, a charity aiming to bring opera to older people who cannot experience it themselves.

Set up in memory of Camilla Vickers mother, Davina, Camilla saw the effect opera had on her dying mother:

“I could see that my mother felt better, happier, and I, as her carer, did too. It lifted her spirits hugely and there was a lightness to the house again.”

Annie Stevenson, a member of the National Activity Providers Association has commended the play:

“It should be more than bingo or one size fits all activities, and hoping that volunteers come in and do something, which might not be very good. It’s always well intentioned but often activities can be very patronising.

“Professional musicians lift the spirits of the staff as well. They bring so much energy and it’s so powerful for everyone. It’s emotional and can really touch resident’s souls and uplift them. The CQC don’t measure things like that.”

At a particular care home in Dorset (the Old Vicarage), according to the Guardian the audience were said to be enthralled, swaying and conducting with their hands.

The room, full of residents and staff alike was “singing along with smiles on their faces”.

Edna Martin, a 100 year old resident said:

“I really think everyone enjoyed themselves. I used to do a lot of singing, so anything that involves music is up my street. I really have enjoyed this afternoon. It’s been many years since I have been to the opera.”

Although the Old Vicarage proves how successful such activities can be, it is a private care home, and many may not have the resources available to replicate its success.

Jan Millward, the care home’s activity coordinator believes, “There are a lot of people up against it and only have 8p a day to do activities with.”

She’s also called for the CQC to ask more questions and demand better activity provision from homes, “It’s the only way we’re going to get change, because managers really care about their CQC ratings as it effects their bottom line.”

She goes on to say, looking around at all the smiling faces, “This is care at its best, really. The residents are all smiling and happy. That buzz will last, even those with dementia who’ll likely forget the performance, won’t lose how it made them feel.”

The New £10 Note

Yesterday, Tuesday 18th July 2017, saw the unveiling of the new £10 note.

The note, next in the series from the polymer £5 note, features a portrait of Jane Austen and is due to enter circulation on Thursday 14th September 2017.

Along with the note, a limited number of the new £2 coin, also featuring Jane Austen, are also being circulated.

Despite a petition, with over 100,000 signatures, the new polymer note will be made from the same material as the £5 note (containing animal fats), sparking fury amongst vegan and religious groups.

The smaller note, commemorating 200 years since the death of Jane Austen, features the quote “I declare after all there is no enjoyment like reading!”

Mark Carney, Bank of England Governor explains the choice: “It captures much of Jane Austen’s spirit, at least in my mind. It draws out some of the essence of some of her social satire and her insight into people’s character. So it works on multiple levels.”

The new polymer £20 note is set to be issued by 2020.

Security features:

– A transparent window featuring the Queen’s portrait.
– On the front of the note, Winchester Cathedral is in gold foil, and silver foil on the back.
– A quill that changes from purple to orange.
– A hologram that when tilted, changes from “Ten” to “Pounds”.
– A 3D hologram of the coronation crown that changes to multicoloured when tilted.
– A copper foil book that has the letters JA.
– Micro letters beneath the Queen’s portrait.
– “Bank of England” printed in raised ink along the top of the note.

There is also a feature that will aid visually impaired people; Raised dots in the top left hand corner of the note, that were developed with the help of the Royal National Institute of Blind People.

In May, the Bank of Scotland unveiled their new £10 note design featuring Sir Walter Scott alongside the Mound in Edinburgh on the front, and on the back the Glenfinnan Viaduct. It also features a steam locomotive and is due to be circulated in the autumn.

The new £10 notes are expected to last five years, double the current life expectancy of two and a half years.

Are Care Homes Getting It Right?

In a world where the elderly are living longer, are their basic needs really covered when it comes to their care?

The Care Quality Commission (CQC) are the main regulators when it comes to social care. They examine care homes, giving vital feedback to help those under par, improve their services.

Last week, it was revealed in the Guardian that one in three care homes has failed CQC inspections; not something you want to read if your loved ones are in care.

Overall, the CQC report highlights how fragile our care services are. Promisingly, the message was that the majority of care was good, but understandably, this seems to have been lost amongst the worrying statistics.

Some are improving. Some aren’t. And some are going backwards.

Although these examinations are of great importance, does anyone ask those receiving the care what they think? What the CQC measures, may not be important to those in the system.

Over the past year, Healthwatch have visited over 200 care homes, asking for relatives, residents and staff to share their opinions and aid the debate.

Looking at the initial results, they reported there are no huge scandals. The majority of people are happy with the care they receive, but staff are feeling the pressure.

But looking further, it’s the basics that care homes are failing on.

Residents want clean spaces, and to be made to feel at home. They want to choose what to wear in the morning, and eat at a “normal” regular time.

Although the CQC don’t examine these basics, these simple gripes are clues to the wider picture. They suggest that if care homes, even the best, asked their residents what they want, they could improve their services dramatically.

Despite this, social care providers are still reluctant to take such feedback on board.

In a recent poll of the 152 local Healthwatches in England, two thirds have reported that health providers are seeking feedback from them. Compare this to the one third of social care providers, and the 25% of providers that do not even respond, and we begin to see an opportunity being missed (The Guardian).

Listening to feedback, and using it to make changes, will help make people feel more valued, and help care homes become just that; homes.

 

Doctors Beg For NHS Treatments

Rationing of services is leading Doctors to beg the NHS for vital treatments.

As reported by the Guardian today, in 2016-17, the British Medical Journal found that 73,927 requests were made by GPs on behalf of patients that had initially been denied treatment, 50% more than in 2013-14.

The results have sparked worry amongst healthcare professionals that the cutbacks are now stretching into patient care.

Amongst the requests submitted, mental health conditions were the sixth commonest. Although the NHS vowed to improve access to care, 1150 requests from health professionals still had to be submitted to get patients the care they needed.

Similarly, the number of Individual Funding Requests (IFRs) for hip and knee replacements across England rose from 49 to 899 last year:

“Hip and knee replacements are some of the most clinically effective and economical treatments available on the NHS. Unfortunately, patients needing hip and knee surgery have misguidedly become soft targets for NHS savings”, Stephen Cannon, Royal College of Surgeons (RCS).

Richard Vautrey, Deputy Chairman of the British Medical Association’s GP committee has said that “an open and honest” conversation is needed as different Clinical Commissioning Groups (CCGs) have different rules on treatments for patients:

“It’s clearly unfair for patients to be subjected to this postcode rationing, and it also adds further to GPs’ workloads as they are called on to provide more and more evidence to support each application.”

Some CCGs such as Stafford and Surrounds, receiving 2123, accept all requests, whereas some such as South Derbyshire, who received 14, accept none.

Jonathan Ashworth, Labour Shadow Health Secretary has said, “Underfunding and neglect of the health service is causing misery for patients and making it harder to access routine treatments on the NHS. Behind every one of these statistics is a patient and their family waiting longer in pain and suffering”.

Ruth Robertson from the Kings Fund states, “With financial pressures growing, we can only expect to see more of this. It is unrealistic to expect the NHS to maintain the current level of service, with the current budget, and so the government needs to either find more money for the NHS, or be honest with the public about what sort of healthcare is can expect in the future.”

So The Deal Is Done

As reported in the Guardian, this week finally saw a coalition deal drawn between the Democratic Unionist Party (DUP), and The Conservative Party. Unfortunately this deal came at a cost.

The DUP, well known for their controversial views surrounding abortion, have secured £1 billion for Northern Ireland’s economy in return for their support on the Conservative’s Queen’s Speech.

This allocation of funds begs the question why we are selling off and privatising huge NHS organisations, when we clearly have the money available to help fix some of the problem.

Theresa May’s strong and stable leadership is now a thing of the past as she removes much needed funds from our budget, and trades them for a majority vote.

Understandably, this has caused uproar with not only England itself, but Scotland and Wales too.

The deal, just three pages long, confirms the Conservative agreement to meet NATO and spend 2% of GDP on the armed forces, and both parties must adhere to the Armed Forces Covenant. This promises priority care for children of current and ex members of the Armed Forces.

According to the Guardian, Carwyn Jones, First Minister of Wales, named the agreement outrageous, stating it was “a straight bung to keep a weak Prime Minister and faltering government in office”.

Similarly, Nicola Sturgeon professed:

“In concluding this grubby, shameless deal, The Tories have shown that they will stop at nothing to hold on to power – even sacrificing the very basic principles of devolution”.

Earlier last week, Jeremy Hunt proclaimed he would consider reviewing the pay cap for healthcare staff, only for it to be forgotten in the Queen’s Speech.

Today, Tuesday 27th June, this was met with the start of the Nurse’s “Summer of Protest” that the Royal College of Nursing declared just last month.

On Thursday, Theresa May will be presenting her Queen’s Speech for vote in Parliament. She will require the alliance of all ten DUP MPs to even stand a chance of having it passed, and enabling her party to govern without majority.

Ironically, although ideal for the Conservatives short term, long term the deal may not be sufficient. It has been suggested that in just two years, the DUP will ask for further concessions from the Tories.

Instead of rejoicing for a secured government, many of us are mourning the loss of a nation that once was.

Leaked Document Suggests Havoc To London Healthcare

A 31 page internal NHS document has highlighted a cost saving exercise to help bridge the £183 million funding gap for a number of hospitals in north-central London.

As reported by the Guardian, this document suggests Doctors affected will have less money to spend on medicine, refer less patients to hospital, and slash the support offered to those with severe needs. They are also looking to close some A&E and maternity units.

Ultimately, this will increase time for treatments and operations as the strain will be added elsewhere to already struggling associations, resulting in poor care:

“We recognise that these choices may be difficult for a number of reasons .. Options that impact on quality of care and options that would be difficult to implement.” (The Guardian)

The affected boroughs are reported to be Camden, Islington, Haringey, Barnet, and Enfield, with University College London and Great Ormond Street Children’s Hospital amongst the hospitals affected.

The leaked document has sparked outrage amongst NHS providers, with Saffron Cordery, Director of policy and strategy emphasising, “Some of the proposals could challenge fundamental expectations shared by NHS staff and the public about what the health service is there to provide. We cannot do that without a full and proper debate.”

Following on from the General Election, Labour are now stating that the cuts are due to the government not allocating the funds needed to do the job effectively.

Although there has been no final decision, the discussions may result in:

Patients waiting longer than 18 weeks for planned operations.
Higher care rationing.
Hospital units being restricted, or shut altogether.
Cuts to financial support currently given to those with long term health problems.
Limitations to treatment for those with musculoskeletal conditions.
Less money being fed into the Better Care Fund (a scheme designed to reduce pressure on hospitals).
Job losses.

Is this really the end of the NHS as we know it?

 

 

 

Hung Parliament: So Where Do We Go From Here?

So, the country spoke. The 2017 General Election resulted in a hung Parliament. No majority vote.

With everyone on tenterhooks as the results rolled in, you couldn’t help but wonder why exactly the nation was going through this again.

Theresa May was secure. She had a majority. The Conservative Party were in power.

Now, Theresa May is in talks with Arlene Foster, leader of Northern Ireland’s Democratic Unionist Party to form what is being dubbed by many as the ‘coalition of chaos’.

This coalition means Theresa May remains in power, but must have the backing of the DUP party in order to push through laws and bills.

Although nothing is certain, Arlene Foster was reported in the Guardian as saying “talks are positive”. So a Conservative-DUP merge is looking likely.

And then there is Labour.

Jeremy Corbyn was hot on the heels of Theresa May, and although he didn’t secure a majority either, he pulled Labour into a position where they now sit only 56 seats behind the Conservatives.

Following his re-election as MP for Islington North, Mr Corbyn was quoted in the BBC News:

“The Prime Minister called this election because she wanted a mandate. Well the mandate she’s got is lost Conservative seats, lost votes, lost support and lost confidence. I would have thought that’s enough to go actually, and make way for a government that will be truly representative of all of the people of this country.”

Although Labour have been “preparing for government” (BBC News), with shadow chancellor John McDonnell telling BBC News they’ve “laid the foundations for a minority government, and then eventually a majority government”, Theresa May refused to succumb to Jeremy Corbyn’s calls for her to retire.

So what does she do now?

With Brexit negotiations looming, Mrs May has been keen to reinforce her determination to succeed and maintain “a deep and special partnership” with the EU.

Meeting on Tuesday with the French President, Emmanuel Macron, he was reported in the Guardian as saying that although he respected the decision of British people, “until negotiations come to an end, there is always a chance to reopen the door.”

Will the uncertainty of Britain, and effectively a Britain with no government bring a softer Brexit deal; one The Prime Minister may well welcome? Or is Mr Macron sending her a warning to retreat?

Although we cannot second guess what next weeks negotiations will begin to indicate, it’s imperative Theresa May organises a successful coalition, secures our government, and regains confidence, not only for Brexit, but for the people of the British Isles.

General Election 2017

49 days ago the Prime Minister, Theresa May, called a snap General Election she’d always insisted she would never call.

Tomorrow, Theresa May, leader of the Conservative Party, goes head to head with Jeremy Corbyn (Labour), Tim Farron (Liberal Democrats), Paul Nuttall (UKIP), Caroline Lucas and Jonathan Bartley (Green Party) and Nicola Sturgeon (SNP), whilst the UK votes for what could be the end of Britain as we know it.

Although originally calling the General Election to allow Britain the chance to choose who takes us through Brexit negotiations, Theresa May has found herself under serious pressure and scrutiny.

She has had to defend her decisions to not attend key conferences, and more recently has led the country through two terrorist attacks, one of which found Britain raising to a critical terror alert.

According to the Telegraph, the latest polls show Labour is still closing the gap behind the Conservatives, with YouGov stating a 4 point gap, and ICM stating 11 points. Despite the gap in the polls, when the election was called, the Tories lead by 17.8 points.

Far from the landslide victory the Conservatives expected, YouGov have predicted the gap will continue to close and suggested we are heading towards a hung Parliament. This occurs when no single party wins a majority vote.

If this was the case, Theresa May would remain in power, but begin discussions with the second party (most likely Labour), to decide whether they can form a coalition. This was the case in 2010 when David Cameron (the Conservatives) became Prime Minister, with Nick Clegg (Liberal Democrats) as his deputy.

Although each party promotes a very different manifesto, the common theme of each is the NHS. With 91% of nurses recently voting in favour of industrial action (ballot organised by RCN), the healthcare industry is definitely calling for change and crying for a lift on the pay cap nurses and doctors currently experience.

It has been no secret that the NHS is at crisis point struggling with money, staff, and with the Brexit vote, a potential nightmare regarding our nurses and doctors coming from the EU.

With Labour “over promising”, and the Conservatives planning to continue with seemingly little change, are there any parties that really have what it takes to put confidence back amongst the nation?

This Election is probably one of the most pivotal the country has ever held. With so much at stake for the nation, and with no party obliged to see their manifesto through, who will you have confidence in to lead the country out of crisis and into a bright future?