Care Management Matters (25 July 2017): New analysis from Skills for Care shows the adult social care workforce continues to grow, with 1.45m people now offering care and support in communities and services across England.
Skills for Care’s Size and structure of the adult social care sector and workforce in England 2017 report reveals that workforce numbers have grown by 19% to approximately 1.58m job roles since 2009. The rate of increase for adult social care jobs has slowed, however. There was an increase of 30,000 jobs between 2014 and 2016, compared with an increase of 70,000 between 2012 and 2014.
There are now around 20,300 organisations involved in offering social care across England, and around 70,000 adults, older people and carers who receive direct payments employ their own staff.
The report contains a new projection that if the workforce grows proportionally to the projected number of people in the population aged 65 and over then 500,000 new jobs will be needed by 2030 to meet demand.
Skills for Care CEO, Sharon Allen said, 'This report is now firmly established as the gold standard for workforce data on the existing workforce and is also projecting significant potential growth to meet demand over the coming years.
Reported in The Guardian (24 July 2017): A comprehensive settlement for funding social care remains elusive. Successive governments have placed it in the “too difficult” pile and, given the role that social care played in the election campaign and its outcome, it is difficult to envisage the government being able to solve it anytime soon.
Now, as a result of repeated failures to address this fundamental issue, we have a growing dispute between health and local government about how new money announced in the budget earlier this year should be allocated. While there may be those who wish to cast aspersions on either side, the reality is that this dispute reflects the fact that both parts of the system are under intolerable pressure. Yet it is in no one’s interest, least of all those who rely on our services, for the NHS and local government to be at loggerheads about how funding is allocated.
For the last few years, the NHS Confederation has worked alongside the Association of Directors of Adult Social Services, the Care & Support Alliance and Care Providers Alliance to put forward the strongest possible case for increased funding for social care in England. Through successive spending reviews and budgets we have together demonstrated the impact of prolonged under-investment in social care provision, on the NHS and specifically on those rely on social care to maintain their independence. The spring budget brought some relief. The announcement of £2bn over the three years went some way to providing a short-term fix for the immediate crisis, although in reality it can do little more than forestall the worst excesses.
Reported in Care Industry News (20 July 2017): In response to updated life expectancy figures from Professor Sir Michael Marmot at UCL Institute of Health Equity, Jeremy Hughes, Chief Executive of Alzheimer’s Society, said “Every day through our helpline we hear how the chronic lack of funding to the social care system over the last decade is devastating people with dementia. This latest analysis suggests just how The have been for the most vulnerable in our society.
“Too often we hear the consequences of inadequate, underfunded care – our investigation last year revealed people with dementia left in soiled sheets, becoming ill after eating out of date food, and ending up in costly hospital or care home admissions unnecessarily.
“The Government has to act before the care system collapses entirely. The promised consultation on social care reform can’t be a platitude or a way to buy more time. We need a long-term solution for social care, and – crucially – enough funding to implement it.”
Reported in The Sunday Times (23 July 2017): Complaints over who should foot the care bill for people with complex needs have hit a record high, Money can reveal. Individuals usually have to pay for care if they have assets worth more than £23,250, including their home. However, the state will pay if NHS assessors deem a person’s needs and condition serious enough. All costs will be covered, regardless of their wealth, under what is known as NHS continuing healthcare (CHC). There were 628 complaints about CHC funding in the 12 months to the end of April, according to figures obtained by Money from the Parliamentary and Health Service Ombudsman. This is almost double the 319 received five years ago. The figures highlight the struggle some families endure to convince the NHS of a relative’s needs. Those people who are approved for funding have to undergo regular reassessment to show they are still in need.
Disputes over CHC funding are expected to rise as pressure grows on the NHS budget. The average weekly cost of a private nursing home has doubled over 20 years to £841, according to the analyst Laing Buisson.
Deadline Friday 17th November 2017
The BGS Trainees Council needs new representatives. Prospective candidates who want to join the BGS Trainees Council are welcome to self-nominate and invited to submit expressions of interest to for one of the four available voting positions.
- Education, training & development representative
- Less than full time representative
Applicants must be ST3+ and a member of the BGS
If elected, posts are for 2 years in duration (2016-2018 session). The deadline for applications is 5pm on 17th November 2017.
Should there be more than one nomination per position, a ballot will be held. Online voting will open in the week preceding the BGS Autumn conference and close during the trainees' meeting (24th November) where the results will be announced.
If you are keen to know what the roles involve please check out the BGS Trainee Council page or contact the current representatives individually.
All expressions of interest must be emailed to the chair of the trainees council at . Expressions of interest should be no longer than 1-2 paragraphs and outlining why you wish to take on the role.
Published by the King's Fund (20 July 2017): A growing number of mental health providers (in the UK and beyond) are beginning to embed quality improvement across their organisations, with some encouraging results. The approach is based on the concept that sustained improvement is best achieved by empowering frontline teams, service users and carers to design, implement and test changes to services.
This report describes the quality improvement journey of three mental health organisations (two in England and one in Singapore). It provides key insights and lessons for others considering embarking on a similar journey.
- Embracing quality improvement requires a change in the traditional approach to leadership at all levels of an organisation, so that those closest to problems (staff and patients) can devise the best solutions and implement them.
- Doing quality improvement at scale requires an appropriate organisational infrastructure, both to support frontline teams and to ensure that learning spreads and is taken up across the organisation.
- Tools and approaches used in the acute hospital sector can be adapted for use in mental health care, including in community settings.
- Success is most likely when there is fidelity to the chosen improvement method, and a sustained commitment over time.
- The strong emphasis on co-production and service user involvement in mental health can be harnessed as a powerful asset in quality improvement work.
Download the report from the KF website
Reported in the Independent (18 July 2017): Sir Michael Marmot has collected data which suggest that life expectancy growth rates are slowing rapidly
For several years now, we’ve been drowning in ominous forecasts showing an exploding old-age dependency ratio, and projections of much higher structural spending on health care for the elderly – spending which will need to be paid for by higher taxation or lower spending on almost everything else.
Ageing featured prominently in last week’s Fiscal Risks report from the Office for Budget Responsibility.
Between 2000 and 2015, life expectancy at birth increased by one year every five years for women and by one year every 3.5 years for men. But since 2015, that life expectancy growth rate has fallen to one year every 10 years for women and one for every six years for men.
Fiscal austerity from the Government since 2010 might be a contributory factor in the slowdown. In truth, there’s not much empirical support for this link. Official data on excess winter deaths did show a spike in 2014/15, at a time when the NHS and social care were under serious strain. But they fell back in the most recent figures.
Until we have more evidence, the best argument against the underfunding of social care and the NHS is that it creates a great deal of discomfort and misery for the elderly while they are alive – something for which we have an abundance of evidence – rather than jumping to the conclusion that it is driving them to an earlier grave as well.
Reported by Inside Housing (requires subscription) (19 July 2017): We’ve known for some time that sheltered housing is a precious resource. Now we know just how precious. Research by Demos, commissioned by Anchor, Hanover and Housing & Care 21, demonstrates the enormous social value of sheltered housing – which is worth £486m a year. According to Demos, supported housing saves the NHS, emergency services and social care services at least:
- £300m per year from reduced length of in-patient hospital stays
- £12.7m per year from preventing falls by residents of sheltered housing
- £156.3m per year from prevention of falls which result in hip fractures
- £17.8m per year from reduced loneliness
According to Demos, each year 600,000 older people attend A&E following a fall, and around a third of them are admitted to hospital. Every year 300,000 people aged over 65 are hospitalised for a hip fracture. In light of these statistics, Demos highlights how sheltered housing presents a very effective resource to tackle the primary drivers of health and care costs among older people – namely poorly insulated houses, falls and loneliness. Such findings should feature in government thinking as they consider the report of the joint select committee inquiry into funding reform for supported housing.
On 14 July 2017, Public Health England published a new consensus statement supporting commissioning for prevention of falls and fractures and its resource pack. The guidance was produced by the National Falls Prevention Coordination Group (NFPCG). The NFPCG is made up of organisations involved in the prevention of falls, care for falls-related injuries and the promotion of healthy ageing. The resource pack identifies resources to support delivery.
The guidance is aimed at local commissioning and strategic leads in England with a remit for falls, bone health and healthy ageing.
Reported in Care Management Matters (17 July 2017): The latest statistics on dementia prevalence in England have been published by NHS Digital. The annual report brings together GP-level data on recorded dementia diagnoses.
The Department of Health, on behalf of the Secretary of State for Health and NHS England, directed NHS Digital to establish this data collection in order to receive specific dementia diagnosis data. These data support the Prime Minister's challenge on dementia 2020, which aims to improve the national diagnosis rate of dementia.
For each general practice included in this data collection, NHS Digital receives a count of the number of patients with a dementia diagnosis in their clinical record, as well as a count of the total number of registered patients at the practice.
In 2016-17, it reports that:
- 422,000 people aged 65 and over in England have a recorded dementia diagnosis. This represents 1 in 23 people aged 65+ registered with a GP.
- 1 in 5 women aged 90 or over have a recorded dementia diagnosis, the highest prevalence for any group.
- There were 207,797 unique patients aged 65 and over admitted to hospital in an emergency with a diagnosis of dementia (provisional data).
Other key facts in this report include:
- Recorded dementia prevalence at 30th June 2017 is 0.770% (1 person in 130).
- When considered alongside monthly data previously collected, this indicates a progressive increase in recorded prevalence from June 2016 (0.763) to June 2017 (0.770).