BGS policy review - A pre-election call from the BGS to the incoming Government
Health is already a hot topic in the lead-up to the General Election on May 7th. In the early weeks of 2015, problems in hospital Accident and Emergency departments have alarmed the public and been the subject of heated political and media debate.
Healthcare and support services are struggling to cope with flat funding to the NHS, reduced social care funding and increased demand for services, much of it driven by the ageing of the population. Performance on NHS efficiency targets, including the 4 hour target for treatment in A&E departments continues to dip, often because the health and care system is not geared to meet the needs of its core user group – older people with multiple long-term conditions. This is the backdrop against which the BGS has prepared its General Election 2015 Position Statement, launched earlier this month.
The BGS has issued a call to the incoming Government to take six decisions to promote excellent healthcare and support for older people. Excellent care and support is person-centred, effective, efficient, safe, equitable and timely. Older people deserve no less.
Decision 1: End the Divide between Health and Social Care
The Barker Commission has recommended that those whose needs are currently defined as ‘critical’ should receive free social care, ending the current distinction between free NHS Continuing Healthcare and means-tested social care at the highest level of need. The BGS supports this recommendation and is calling on the incoming Government to end the divide between health and social care for people with ‘critical’ care needs and to provide clarity at national level about people’s entitlements to health and social care.
Decision 2: Build capacity in Intermediate Care
Currently there is a 50 per cent deficit in the capacity of intermediate care i.e. community services forming a link between home and acute hospitals and enabling older people to receive rehabilitation, re-ablement or sub-acute treatment in more appropriate settings. The NHS National Clinical Director for Integration and Frail Elderly has said that the annual spend on intermediate care should be doubled from £2 million to £4 million per 100,000 population. The BGS supports this recommendation and calls on the incoming Government to build the capacity of intermediate care to meet the needs of an ageing population.
Decision 3: Invest adequately in healthcare and social support
The BGS calls on the incoming Government to provide sufficient funding to the NHS to achieve the goals of the Five Year Forward View, to reverse the trend of cuts to social care funding, to reduce the imbalance in funding between NHS and social services, and to provide adequate funding to local authorities to meet their social care obligations, including those to older people.
Decision 4: Provide national strategic direction on older people living with frailty, dementia, complex needs and multiple long-term conditions
Older people living with frailty, dementia, complex needs and multiple long-term conditions need expert, multi-disciplinary and co-ordinated care. The incoming Government should provide strategic direction and highlight those needs in future Mandates to the NHS. Specifically, future Mandates should set out expectations of the NHS with regard to older people’s access to comprehensive geriatric assessment, personalised care plans for treatment and long-term follow-up.
Decision 5: Support the development of staff competencies in the management of older people
One of the keys to the equitable and safe care of older people is the assurance that staff caring for them – doctors, nurses, allied health professionals, care attendants and others – have the right knowledge, training, skills, values to deliver care to them; combined with the flexibility to do so in multiple settings. The BGS calls on the incoming Government to require the regulatory and advisory bodies to incorporate competencies in the management of older people in their curricula, guidance, professional and quality standards.
Decision 6: Measure the dimensions of care that matter to older people and their families
Outcome measures should incentivise commissioners and providers to focus on services and dimensions of care that matter to older people and their carers; and that make a difference to their quality of care and its outcomes for them, not alone the service they have used. The BGS calls on the incoming Government to ensure that future reviews of the NHS Outcomes Framework address current deficits in the measurement of older people’s experience of care pathways, their access to a continuum of care and care outcomes; and to direct that new outcome measures are developed to close existing gaps.
What happens next?
In the months leading up to the General Election and to the formation of a new Government, officers and staff of the BGS will be working together to bring the BGS’s pre-election messages to the attention of political and other audiences. Watch out for a progress report on the responses we receive from the different political parties in the next issue of the newsletter.
A call for advice
Finally, I’d like to ask for your help. As members of the BGS, through your clinical practice, you will have direct experience of the healthcare and support issues discussed in this column. Your insights and direct experiences, anonymised of course, would be an invaluable resource in our political meetings. If there are experiences you can share for this purpose, please get in touch with me. I would really like to hear from you.
BGS Policy Manager
Tel. 0203 747 6940