social care

  • 10 charts that show why the NHS is in trouble

    Nick Triggle, Health Correspondent - BBC News website 7th February 2017

    Although this article is now four months old, it is still a useful summary of the overall problems besetting the NHS and social care in the UK.

    What it does not address is (1) the impact of wasteful marketisation and (2) the massive reorganisation called "Sustainability and Transformation Plans" which the Conservative government and CEO Simon Stevens are currently promoting.

    The charts are:

     

    1. We spend more on the NHS than ever before

    2. A bigger proportion of public spending goes on health

    3. Key A&E targets are being missed

    4. The UK's population is ageing

    5. Care for older people costs much more

    6. Increases in NHS spending have slowed

    7. The UK spends a lower proportion on health than other EU countries

    8. Demand for A&E is rising

    9. Fewer older people are getting help with social care

    10. Much more is spent on front-line healthcare than social care

  • The view from the ‘burning platform’ - Medicine Balls, Private Eye Issue 1439 10th March 2017

     

     
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    Health secretary Jeremy Hunt has the gall to repeat the lie that the NHS is not for sale.

    ACCORDING to Professor Sir Mike Richards, chief inspector of hospitals, the NHS stands on a “burning platform” with 11 percent of trusts rated inadequate by the Care Quality Commission (CQC) and 70 percent requiring improvement. Understaffing and overcrowding put patients and staff at risk every day.

    Meanwhile, private providers lead by Virgin Care are busy “conquering the community care space”, says HealthInvestor magazine. “A market worth around £10bn has suddenly become a private affair.” Virgin has already hoovered up more than 400 health, social care and local authority services’ contracts, worth more than £1bn. It’s “quite the portfolio”, according to HealthInvestor, and other companies are lining up to conquer what’s left. “The chance to drink in a £9bn pool is tantalising.”

    There is a clear underfunding and privatising trend in NHS and local authority services. Between April 2013 and April 2016, 45 percent of the community health services that were put out to tender went to non-NHS providers.

  • Private Eye Medicine Balls "Bed Hunting" 27th Jan 2017

     

     

  • Julia Simon: "STPs and ACOs: solutions for a 'bankrupt' NHS and social care system"?

    Talk given at the Learie Constantine centre, Dudden Hill Lane, on 1st December 2016 at the invitation of Brent Patient Voice to an audience of 50 people.

    Dr Julia Simon was until Sept 2016 the head of NHS England's commissioning policy unit and its programme director of co-commissioning of primary care.

    She had worked at London and national NHS level since 2012 on CCG and commissioning issues.

     

    Dr Simon referred to a small number of presentation slides.

    "There has been a split between commissioning and provision for over 25 years. The 2012 Health and Social Care Act aims to create a truly clinically led system with GPs in the driving seat. But the outcome is actually a fragmented commissioning system with three main budget holders across CCGs, NHSE and local authorities (public health), and a bewildering number of other national organisations.

    In my view healthcare isn't a market: hospitals do not fail. They are always bailed out in order to give citizens care - which seems obvious. Andrew Lansley, the Secretary of State for Health responsible for the introduction of the HSCS Act, is married to a GP.

    CCGs:

    There were 212 in 2012 and there are 209 now. They are legally constituted by their members and all practising GPs must be members of one. CCGs have a statutory duty to (1) improve primary care and (2) to engage citizens.

    Fragmentation:

  • Social care services 'facing existential crisis', say council leaders

    Rising costs, ageing population, staff recruitment difficulties and years of cuts have left service in crisis, LGA report claims

    Councils will have to continue reducing at-home support for older people, according to the Local Government Association.

     

    Social care services that support elderly and disabled people are facing “an existential crisis” despite being as important to national well being as the NHS, council leaders will claim on Wednesday.

    Councils will have to continue reducing at-home support for older people and paying for beds in care homes because of Whitehall budget cuts, according to the Local Government Association.

    Rising costs, the ageing population, difficulties recruiting staff and years of central government reducing its grant have left the service in crisis, the cross-party body claims in a new report.

    Councils have had to provide less care at a time of growing need, leaving more vulnerable people isolated and at risk, it says.

    Philip Hammond, the chancellor, must recognise the “perilous” state social care is now in and ease the pressures on it when he delivers his autumn statement on 23 November, says the LGA, which represents 370 councils in England and Wales.

    “The situation is now critical and it is no exaggeration to say that our care and support system is in crisis,” said Izzi Seccombe, chair of the LGA’s community wellbeing board and the Conservative leader of Warwickshire county council.

    “For too long the service has too often been seen by decision-makers as an adjunct to the NHS, rather than a service of equal importance,” she added. Theresa May needed to deliver on her promise of building “a country that works for everyone” as prime minister to avoid the sector suffering even more damage, she said.

    The LGA’s intervention comes after a host of NHS leaders, including the NHS England chief executive, Simon Stevens, made clear that if Hammond does produce more money in the autumn statement for the health service, it should go instead to prop up social care.

    Richard Humphries, a social care expert at the King’s Fund, said: “It defies all sense and reason that social care spending will slip back to less than 1% of GDP by the end of the parliament when the number of older and disabled people is increasing and demand for services is rising. This is an unsustainable situation.”

    The Care Quality Commission said last month that social care was approaching “a tipping point” meaning even fewer people would get care they need and the NHS would become even busier, unless ministers came up with some solutions.

    “Bed blocking” stands at record levels and is costing hospitals £800m a year because mainly elderly patients who are fit to leave cannot be safely discharged because social care support is lacking.

    A Department of Health spokeswoman defended the government’s record on social care, saying: “This government is committed to ensuring older people throughout the country get affordable and dignified care. That is why we are significantly increasing the amount of money local authorities have access to for social care, by up to £3.5bn by 2020.”  [But only if the Local Authorities raise an additional precept of up to 2% through Council Tax - which many are reluctant to do].

     

  • Four in five UK councils struggle to provide older people's care – survey

    More than 6.4 million people aged 65 and over live in areas without enough care to meet demand – especially specialist dementia care, says research

    The north-east was the only area where more than half of the local authorities surveyed reported sufficient care.

    The Family and Childcare Trust surveyed councils across the country and found they are struggling to meet needs amid a background of growing demand, budget cuts and recruitment difficulties.

    The survey is published on the same day as an undercover investigation by BBC Panorama is to be broadcast, exposing shocking neglect at two Cornwall care homes   [Panorama: Nursing Homes Undercover broadcast on BBC1 on Monday 21 November at 8.30pm] including vulnerable people being left unattended and a nurse saying she will use morphine to “shut up” a resident.

    The deficit identified by the Family and Childcare Trust means more than 6.4 million people aged 65 and over are living in areas that do not have enough older people’s care to meet demand.

    Only one in five councils reported having enough older people’s care in their area to meet demand, the survey found.

    Just under half (48%) of the 182 councils (out of 211) that responded said they had sufficient availability of home care and a similar proportion (44%) reported having enough places in extra care homes, which allow people to live independently with 24-hour emergency or on-site support.

    Only a third of local authorities said they have enough nursing homes with specialist support for dementia, which is predicted to affect one million people in the UK by 2025.

    Claire Harding, head of research at the Family and Childcare Trust, which works closely with the government and local authorities, said: “It is inexcusable that vulnerable people are left unable to find the care that they need.

    “We urge government to make sure there is enough care for everyone who needs it. In order to do this, we need robust data on where there are gaps in care, a funding system that truly meets the cost of providing care, and clear information for families.

    “Without these steps, families will continue to struggle to find care and to meet the numerous care costs on their shoulders.”

    The survey also highlighted large regional variations, with just 7% of outer London councils reporting enough older people’s care to meet demand. The only area where more than half of local authorities reported sufficient care was the north-east, where 57% responded positively.

    The findings will add to the sense of crisis surrounding social care, with delayed transfers of care – when patients are medically fit to leave hospital but unable to be safely discharged – at record levels.

    Council and NHS leaders, as well as the Care Quality Commission, have called for urgent action, with the chancellor, Philip Hammond, facing pressure to increase social funding in Wednesday’s autumn statement.

    Inner London councils pay the highest rates for residential care for older people, at £649 a week per place, compared with the lowest rate of £464 in north-west England, according to the survey. The UK average for a residential place was revealed to be £27,113 a year.

    A Department of Health spokeswoman said: “This government is committed to making sure older people throughout the country get affordable and dignified care. That is why we are significantly increasing the amount of money local authorities have access to for social care, by up to £3.5bn by 2020.”

    Monday’s Panorama sees reporters go undercover at Clinton House in St Austell, and St Theresa’s, in Callington, near Plymouth, both owned by the Morleigh Group.

    Hidden camera footage captured one resident left on a bed pan for 40 minutes and an out-of-date prescription supplement relabelled for use by another resident.

    Clinton House is being closed as a result of safety concerns and St Theresa’s is under investigation by authorities along with two other Moreleigh Group homes.

    Moreleigh Group said it had already removed the staff involved and reviewed its systems and procedures, prior to receiving information from Panorma. Cornwall council apologised for the failings.

  • NHS hospitals suffer from chronic bed shortage, surgeons say

    Royal College of Surgeons calls for rethink after figures show 89% of beds are full overnight for fourth quarter in a row

    The Royal College of Surgeons has warned of a chronic shortage of NHS hospital beds in England, after occupancy rates for overnight stays topped 89% for a fourth successive quarter.

    The maximum occupancy rate for ensuring patients are well looked after and not exposed to health risks is considered to be 85%, a figure that has not been achieved since NHS England began publishing statistics in 2010.

    From July to September this year the percentage of beds occupied in wards open overnight was 89.1%, compared with 87% in the same period last year. That was the last time it was below 89%.

    The RCS said the figures, published on Thursday, made for alarming reading and indicated a failure to cope with the increasing number of older patients in hospital.

  • Rally for the NHS - Tuesday 10th March 2015 7pm Hammersmith Town Hall

     


     

     

  • Bed blocking is bringing NHS "to its knees"

     

    Thousands of patients are unnecessarily staying on NHS wards because they have nowhere else to go, doctor a Sky News investigation finds.

    18:56, search UK, Tuesday 18 November 2014

    Bed blocking in NHS hospitals has reached its highest level for four years, amid warnings that a lack of social care is bringing the health service "to its knees", a Sky News investigation has found.

  • Whitehall calls halt on £3.8bn NHS reforms

    £3.8bn NHS "Better Care Fund" policy delayed after damning Whitehall review

    A patient being taken to an operating theatre in a hospital
    The Better Care Fund was meant to reduce the growing pressures on hospitals and keep people healthier in their own homes. Photograph: Christopher Furlong/Getty Images

    A government policy intended to stop the NHS from becoming overwhelmed has been delayed after a confidential Whitehall review concluded it would not work as hoped. Neither would it help to balance the NHS budget or bring about an intended revolution in patient care.

    The £3.8bn-a-year Better Care Fund was supposed to have been launched last week, but its introduction has become mired in doubt after the Cabinet Office voiced deep disquiet about its viability and argued that there was little or no detail about how the expected savings would be delivered.