Reported by the Chartered Society of Physiotherapy (20 June 2017): NHS England has announced eight areas which will lead action to provide joined-up care, breaking down barriers between GPs and hospitals, physical and mental healthcare, social care and the NHS.
Simon Stevens, NHS England’s chief executive, said: ‘We are now embarked on the biggest national move to integrating care of any major western country.
‘For patients this means better joined-up services in place of what has often been a fragmented system that passes people from pillar to post.’
The eight ‘accountable care systems’ (ACSs) are:
- Frimley Health including Slough, Surrey Heath and Aldershot
- South Yorkshire and Bassetlaw, covering Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield
- Nottinghamshire, with an early focus on Greater Nottingham and Rushcliffe
- Blackpool and Fylde Coast, with the potential to spread to other parts of the Lancashire and South Cumbria at a later stage
- Luton, with Milton Keynes and Bedfordshire
- Berkshire West, covering Reading, Newbury and Wokingham
NHS England expects west, north and east Cumbria and Northumberland to join the group of ACSs later in the year.
Reported in The Guardian (20 June 2017): Prisons are now the largest providers of residential care for frail and elderly men in England and Wales and are increasingly turning into hospices, providing end-of-life care for older prisoners and even managing their deaths.
In the first report on older prisoners by the prisons and probation ombudsman, published on Tuesday, Nigel Newcomen reveals that the number of prisoners over 60 has tripled in 15 years. He also says there will be 14,000 prisoners aged over 50 by 2020, amounting to 17% of the total prison population, up from 13% in 2014.
The situation is so serious that Peter Clarke, the chief inspector of prisons in England and Wales, has told the Guardian that he believes the time has come to introduce purpose-built “older prisoner” jails: essentially, residential care homes surrounded by a wall.
Older prisoners frequently have significant health needs that prisons struggle to cope with. As well as increasing numbers of prisoners requiring palliative care, there are several hundred older prisoners suffering dementia. Numbers are expected to rise sharply. While there are pockets of good practice, Newcomen criticises the prison service for widespread “inhumane” treatment of these older prisoners.
Reported by the Guardian (20 June 17): The election campaign led the public to the misconception that the “dementia tax” is a new issue. The reality is that decades of squeezed government funding have left people with dementia and their families enduring inadequate care, crippling costs and impossible choices. The Queen’s speech on Wednesday will hopefully promise to create a long-term, sustainable system for funding dementia care that doesn’t leave the burden of cost on individuals.
But fixing the system goes beyond funding. The government needs to adopt a more cost-effective approach that starts with preventing or slowing the rate that people need to access services. Investing money in ways to improve quality of life – and the quality of support people affected by dementia receive from the start of the care pathway – will alleviate the demand and reduce the costs incurred at a later stage.
We know most people with dementia want to remain in their own home for as long as possible and that better post-diagnostic support and care at home can empower people to remain independent for longer, minimise unnecessary hospital admissions and help avoid early entry to care homes.
To tackle this challenge, Alzheimer’s Society is funding three care research centres of excellence with £2m each over the next five years. Focusing on ways to measure and improve quality of life, access to post-diagnostic support and homecare, the interventions developed by each of these programmes could have life-altering implications for people affected by dementia.
Reported in Public Finance (19 Jun 17): The government must not use the inconclusive general election result to kick social care reform into the long grass, an umbrella-group has said.
The County Council Network has today urged the government to be bold in addressing the crisis in social care funding, ahead of a meeting between county leaders and health experts tomorrow.
Colin Noble, health and social care spokesman for CCN and leader of Suffolk County Council, said: “We should not look to kick the social care green paper into the long grass.”
It was important for county authorities to play an active role in all future discussions about long-term social care reform, he added.
The organisation has called on the prime minister to “start a national conversation on social care and launch a green paper on the future sustainability of social care”.
Reported in The Times (18 June 2017) - requires subscription: As the Conservative Party is forced to negotiate to form a new government, some of its manifesto pledges will undoubtedly fall by the wayside. But it must not be an excuse for more delay in tackling Britain’s looming social care crisis. If the issue is absent from the Queen’s speech this week, it will be a huge mistake. The Tory election manifesto promised the “first ever proper plan to pay for — and provide — social care”, giving families some hope of certainty about paying for the care of older people. This assurance seems increasingly in doubt, however. The economist Sir Andrew Dilnot was asked to come up with a way to cover the rising care costs of an ageing population. In 2011, he suggested a cap on how much an individual would have to pay before the state stepped in. Politicians have repeatedly delayed the implementation of his plan. The Tory manifesto omitted any mention of a cap, but when questioned about it last month, Theresa May made one of her fastest U-turns yet, saying she had always intended to have one. On-the-hoof policy making about such an important and sensitive subject is not good enough. Growing old and needing care can be stressful enough for individuals and families without the addition of money worries. How much will my care cost? What care am I entitled to? How much can I leave to my loved ones? How does it all work?
Reported in Pharmatimes (16 June 2017): The Head of the NHS in England has pledged to give local leaders and communities more control over how they improve health and social care to help seal up current fractures in the system that leave too many patients “passed from pillar to post”.
Stevens has announced nine areas in England covering some seven million people that are to lead nationwide action to provide joined up, better coordinated care by breaking down some of the barriers between GPs and hospitals, physical and mental healthcare, social care and the NHS.
Eight ‘accountable care systems’ (ACSs) will bring together local NHS organisations, often in partnership with social care services and the voluntary sector, building on early results of NHS England’s new care model ‘vanguards’, which the organisation claims are slowing emergency hospitalisations growth by up to two thirds compared with other less integrated parts of the country.
The first ACS’ have been tasked with delivering “fast track improvements” set out in Next Steps on the Five Year Forward View, including alleviating the pressures on A&E, and improving access to GPs as well as high quality cancer and mental health services.
Reported by the National Health Executive (14 June 2017): A project to review the way that quality of life is measured across health and social care is being undertaken by NICE research project, called ‘Extending the QALY’, is being led by the School of Health and Related Research (ScHARR) at the University of Sheffield, and also involves collaborators from the University of Kent, the Office of Health Economics and the EuroQol Research Foundation. It began in May and will last two and a half years. When NICE looks at the cost-effectiveness of a healthcare intervention like a new drug or diagnostic, the benefit of an intervention is measured by how many quality-adjusted life years (QALYs) it provides. This measurement is based on a number of different factors, which the research will review to determine how best to measure quality of life. NICE said that the research is also a response to criticisms that the current measures do not capture the important benefits of treatments beyond health-related quality of life, such as independence or improved relationships with family, friends and carers. “NICE relies on an accurate assessment of quality of life when making decisions about interventions across health and social care,” said Nick Crabb, programme director of scientific affairs at the organisation. “Research is needed to develop new tools to assess quality of life that are equally relevant across these sectors and capture the key things – not just health – that are important to people.”
Blogged by the King's Fund (14 June 2017): The Conservative Party’s manifesto proposals for social care – promptly labelled a ‘dementia tax’ by its critics – was one of the turning points of the election campaign. The question now is whether, as a result of that debacle, all proposals for reforming social care are, in practice, a dead letter for this parliament, given the government’s lack of a majority. The answer is they should not be. The problems in social care, which include the trauma it is causing for the NHS, are not going to go away. It would, however, be foolish to pretend that solving these problems will be easy – as illustrated by the fact that over two decades at least four serious independent reviews of social care and its funding, including a Royal Commission and the Dilnot review, plus at least a dozen Green and White Papers, have failed to produce a settled answer for England.
See also: Piecemeal workforce policymaking is failing the NHS (National Health Executive, 13 June 2017)
Reported in Care Home (14 June 2017): Since the referendum on Brexit last year, the number of nurses from the EU registering to practise in the UK has dropped by 96 per cent.
The Health Foundation obtained figures from a Freedom of Information request to the Nursing and Midwifery Council (NMC). It found that 1,100 EU nurses came to work in the UK last April, but this fell to just 46 EU nurse registrants in April this year.
Anita Charlesworth, director of research and economics at the Health Foundation, said: "The recruitment and retention of nurses is one of the biggest challenges facing health and social care, with a shortage of 30,000 nurses in England alone.
"The drop in EU nurses registering to work in the UK could not be more stark – just 46 registered to work in the UK in April. Without EU nurses it will be even harder for the NHS and other employers to find the staff they need to provide safe patient care. The findings should be a wake-up call to politicians and health service leaders.
The British Geriatrics Society's vision is for a society where all older people receive high quality, patient-centred care when and where they need it.
In its 70th anniversary year the BGS has seven calls for action. We call on the incoming Government to take action to ensure:
Sufficient investment in the NHS and social care
Full integration of services
A lasting solution to the current crisis in social care
Greater capacity in intermediate care
Access to comprehensive geriatric assessment (CGA) and personalised care plans for all older people with frailty, dementia and complex and multiple long-term conditions
All who care for older people have the right skills
The commitment and expertise of the current workforce is better recognised