BGS blog: I have been a GP for 20 years and over this time I have witnessed the patient population becoming gradually older with increasingly complex problems. Also, GPs have become more and more involved in their patients’ chronic disease management. The standard 10 minute GP appointment just isn’t long enough anymore to deal with these older patients who have complex needs. For a long time I have been interested in exploring new ways of working and new models of care and so when I got the chance to join the Blackpool, Fylde & Wyre Extensive Care Service, I jumped at the chance. Read more on the BGS Blog
Guardian: The NHS would collapse without its 57,000 workers who are EU nationals and they must be offered free British citizenship so they don’t leave the country after Brexit, according to a leading thinktank.
The Institute of Public Policy Research (IPPR) says in a report released on Thursday the concessions to EU nationals living in Britain are needed to prevent a post-Brexit brain-drain of talent harming the economy.
Chris Murray, who compiled the report, said: “It is critical to public health that these workers do not seek jobs elsewhere. All EU nationals who work for the NHS, or as locums in the NHS system, should be eligible to apply for British citizenship. This offer should be organised by the regional NHS and mental health trusts, who would be responsible for writing to all NHS staff who are EU nationals to inform them of their eligibility.” In particular, according to Murray, the position of EU citizens working in the NHS needs to be safeguarded by making them a “generous citizenship offer”. He added: “There are currently around 57,000 EU nationals working in the English NHS, accounting for 5% of its workforce; one in 10 of the UK’s registered doctors is an EU national. Without them the NHS would collapse.”
RLB Law: One of the frustrating features of the CQC regulatory process has been that factual accuracy comments are submitted to, and considered by, the inspectors who made the judgments in the first place. The only internal review process thereafter was the quality review process, which CQC limited to a review of process, not facts. Accordingly, very few quality reviews succeeded, and the only remedy for providers whose factual accuracy comments had been wrongly decided was to seek judicial reviews.
In a landmark judgment, the High Court has found that to be unlawful. The case of R (SSP) v Care Quality Commission, concerned an inspection of a GP practice. CQC inspected and in accordance with its usual process, issued a draft inspection report inviting comment. The provider submitted corrections but only two minor changes were made. The Court went on to find that CQC had wrongly rejected a number of the provider’s factual corrections. The Court admonished CQC stating that it ‘cannot make adverse finds that something does not exist if the regulated body tells it that it does and it does nothing to test that assertion’. That itself will be welcome to providers who have been in similar circumstances.
Guardian: With results for A-levels and GCSEs now out, school leavers not planning to go to university will be weighing up their career options.
Apprenticeships are becoming increasingly popular, especially given rising higher education costs. An apprentice scheme allows you to find your feet in a new sector with constant guidance and supervision, with the security of a job at the end.
Lisa Hewitt, qualifications development coordinator for the Council for Awards in Care, Health and Education (Cache), says now is an ideal time to pursue an apprenticeship in social care – an ageing population and less reliance on informal care is increasing the demand for staff in the sector. Hewitt estimates the number of paid adult social care jobs in 2025 could increase from 1.52m to 2.34m.
“An apprenticeship is a great way in [to social care],” she says. “You learn through experience and are able to work alongside and learn from experienced practitioners. At the same time, you’re gaining a recognised qualification, developing your knowledge and skillset, and you’re getting paid while you learn. It can also lead to progression into a role in the sector once you’ve completed your apprenticeship.”
Commission on Care Blog: Dilnot’s main recommendations – the cap on individuals’ social care costs, the raising of the means tested asset threshold – are nowhere in sight. They appear buried so deep in the long grass that experts are asking whether they will “ever see the light of day”. The cap, due to be implemented this year in April, was postponed by the last government until 2020. The funding gap in social care meanwhile, which has direct consequences for pressures in health services too, has grown to £1 billion per year.
Perhaps the problem with the Dilnot recommendations was that there was never any solid plan, or political consensus, for how they were to be funded. The Commission’s remit was more focused on the balance between the individual’s and the state’s burden. It was assumed, without a great deal of evidence, that a market for insurance would appear to cover the cost of care up to the point at which the government took on the majority of costs. Funding the state’s contribution to adult social care, however, was an unsettled matter.
Dilnot himself suggested that pensioners could start paying national insurance to meet the £2bn a year costs to the state – the first policy to earn the title of “granny tax”. Liberal Democrat Paul Burstow, Minister of State for Care Services from 2010-2012, recommended in 2013 that the lifetime cap be raised to £60,000 and government costs be paid for by cuts to Winter Fuel Payments for wealthier pensioners and establishing a capital gains tax at death. Labour’s Andy Burnham repeatedly proposed an estates tax of 10-15%, which was branded a “death tax” each time it was considered. Interestingly, Conservative MP John Redwood argued that if the money could be found or the cap then it would instead be better spent improving the quality of care hocarerme services than protecting the inheritances of those able to afford care.
Surveys indicate that the public are fairly evenly split between favouring a social care system funded by government through taxation (48%) and individuals paying what they can (25%), or up to the new proposed threshold of £72,000 (22%) with the government picking up the remainder. It is questionable, though, whether or not the elusive cap as currently conceived would really provide a fair and sustainable policy anyway; it doesn’t include accommodation costs, so people could still be paying up to £140,000 before they even reach it, and it would only cover 8% of men and 15% of women entering care at the age of 85.
Guardian: RemindMeCare is the brainchild of Simon Hooper and Etienne Abrahams, who both had family members with dementia. When his mother got dementia, Hooper started to put her life story on to a tablet for her carers to use. “I realised that early memories were the key to communicating with those with dementia and to improving person-centred care, and that it needed tech to record them, so that the memories would not be lost and would be available to each carer in turn,” he says. On meeting Abrahams at a party and discovering that he was building software to store his grandmother’s memories, photos and favourite music, they both realised there was a gap in the market and decided to develop a business. After a year’s planning, they raised money from care experts and crowdfunding and RemindMeCare was born in November 2015.
Samir Patel, owner of Oaklands Rest Home in the New Forest, Hampshire, which has been using the system since May, says: “It’s had a huge impact on our residents. It’s a nice way to engage with your loved one. You can still contribute to their life in a really positive way.”
Not all dementia apps are designed for use in care settings. This month saw the launch of two new apps that people with dementia can use independently (as well as with a carer, if they choose).
The Times: People’s eyes, gait and blood could all offer early warning of dementia decades before symptoms appear, experts believe. Scientists said that finding clues to spot dementia early was likely to offer the best chance of defeating the condition, as they announced plans to shift the focus of their research to finding biological markers.
Even the magnetic fields generated by nerve cells in the brain will be investigated to see if they can offer clues in a Medical Research Council project involving intensive tests on 250 volunteers.
Professor Simon Lovestone, from the University of Oxford, who will lead the £7 million project, said: “Previous studies have shown changes to the brain as early as ten to 20 years before symptoms arise.”
See also: Hundreds of volunteers to help spot early Alzheimer's (BBC)
Telegraph: Hospitals are to cancel thousands of operations and appointments in a desperate bid to stop the NHS "buckling" this winter, under Government plans.
Health officials are drawing up contingency measures to attempt to safeguard emergency care by diverting senior doctors from operating theatres into wards and Accident & Emergency departments as winter sets in. The national plan, detailed in evidence to the Commons health select committee, comes amid concern that the NHS is already in the grip of the worst bed-blocking crisis on record.
The health service is already braced for rolling strikes from junior doctors throughout autumn, after the British Medical Association threatened to hold the “trade union dispute of the century” in protest at new contracts.
HSJ: Central to the on-going junior doctors’ dispute is if the deal that we have struck with them is reasonable, in terms of benefits to both them and the NHS. Wrapped up in that is whether they are treated fairly when things go wrong.
Healthcare bodies are at higher risk of corporate or gross negligence manslaughter than other organisations, due to the vulnerable people in their care. In the ever-increasing event that they come under scrutiny for deaths or harm, they need to prove their internal assurance processes are effective, and that they have done everything reasonably practicable to prevent harm. But will increased sanctions and the criminalisation of individual health and care professionals lead to better patient care?
The truth is that there is little understanding of the impact of potential criminal sanction on the behaviour of individual healthcare professionals. Professor Sir Liam Donaldson was very clear in his evidence to the Mid-Staffordshire Public Inquiry that it is generally undesirable to bring the criminal law into the clinical arena, as it inhibits openness and improvement. However, Robert Francis claimed there was a “serious danger that public confidence and trust in the health service will be undermined.” This seems at odds with other recommendations that advocated strongly for transparency and openness to prevent such insufficient care in the future. Read more in the HSJ
BBC: Researchers may have discovered a method of detecting changes in the eye which could identify Parkinson's disease before its symptoms develop. Scientists at University College London (UCL) say their early animal tests could lead to a cheap and non-invasive way to spot the disease.
Parkinson's affects 1 in 500 people and is the second most common neurodegenerative disease worldwide. The charity Parkinson's UK welcomed the research as a "significant step". The researchers examined rats and found that changes could be seen at the back of their eyes before visible symptoms occurred. Professor Francesca Cordeiro who led the research said it was a "potentially revolutionary breakthrough in the early diagnosis and treatment of one of the world's most debilitating diseases".
One solution to loneliness in old age? Sixty, female and all living under one roof (just don't call it a commune)
Telegraph: In 1998, Shirley Meredeen was in her late 60s and had recently retired from her job as a student counsellor. But she had no plans for a quiet life.
Meredeen was keen to change the world, or at least the way the world saw older women. In the summer of that year, she attended a workshop on co-housing at the National Council for Voluntary Organisations (NCVO) in north London. Co-housing is a fundamentally different way of life in which people live close to, but not with, each other. The workshop was life-changing. ‘Madeleine and I went to the pub afterwards and decided to create something similar,’ Meredeen says. Next month, 26 women aged from 50 to 86 will move into a unique community that they've had built in High Barnet, north London.
Nursing Times: Society needs to challenge ageism more, according to a nursing academic, who has spoken out following the launch of a national “dementia atlas” that reveals a postcode lottery in care.
The comments by Julienne Meyer, professor of nursing at City University London and an expert the care of older people, followed yesterday’s launch of the government’s new dementia atlas. Speaking about the care variations revealed by the map, Professor Meyer, said: “It is interesting that more people are not up in arms about the ‘postcode lottery’ for dementia care.
“With the aging population and growing numbers of people with dementia, we are all likely to experience first-hand dementia in ourselves or our loved ones,” she said. “However, we tend to avoid the issue until it personally affects us. By this late this stage, we are often lack capacity to take action.”
She added: “I just don’t understand why society does not challenge ageism more in the same way that it seeks to challenge sexism or racism. “Older people, including those with dementia, are the largest client group for health and social care,” she said. “We should take care not to tuck this fact away as a minority issue.”
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