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Survey finds little focus on using telecare to promote social contact and alleviate loneliness

Reported by Community Care (16 February 2018): What new research tells us about telecare use in English local authorities

Telecare doesn’t produce better outcomes for people who use it. This stark message was the finding of a large, Department of Health funded clinical trial, known as the ‘Whole System Demonstrator’ project (WSD), which concluded several years ago. But, despite this finding, and the adult social care spending cuts which continue to this day, local authorities have not scaled back investment in telecare.

The UTOPIA (Using Telecare for Older People In Adult social care) project, led by staff from the Social Care Workforce Research Unit at King’s College London, has produced new findings about why and how telecare is used for older people. They raise the possibility that it might not have been telecare itself but the ways it was used that led to the WSD findings. The study also suggests that given the strategic importance many councils now place on telecare, the infrastructure needed to implement it effectively may not be as robust as needed. The study involved a survey of all 152 English local authorities with social care responsibilities between November 2016 and January 2017 with a response rate of 75%. Key findings found that only a minority of local authorities said their telecare strategies had been produced collaboratively with local NHS or other partners and in most, telecare did not seem to be referenced within their carers’ strategy.

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King's Fund: Approaches to social care funding

It is widely accepted that the system for funding social care is in urgent need of reform. Faced with shrinking budgets, local authorities are struggling to meet the growing demand for care, linked to increasing complexity in need and an ageing population. As a result, the number of older people receiving publicly funded social care has declined. While in practice, much of this shortfall has been met by private spending and informal care; it is also likely that many people’s care needs are going unmet.

There is little sign of a long-term solution on the horizon. For those who have watched the progress of the social care system over the years, this is a familiar disappointment. Since 1998, there have been 12 green papers, white papers and other consultations, as well as five independent commissions, all attempting to grapple with the problem of securing a sustainable social care system. It has been called ‘one of the greatest unresolved public policy issues of our time’.

Against this background, the Health Foundation and The King’s Fund are undertaking work exploring options for the future funding of social care. This paper considers the following approaches to funding social care for older people in England:

  • Improving the current system
  • The Conservative Party’s proposals at the time of the 2017 general election (a revised means test and a cap on care costs)
  • A single budget for health and social care
  • Free personal care
  • A hypothecated tax for social care

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Falls prevention: cost-effective commissioning

The return on investment tool, to which Dr Vicki Goodwin contributed, has now been published by Public Health England and pulls together evidence on the effectiveness and associated costs for interventions aimed at preventing falls in older people living in the community. The flexible Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user. All interventions are aimed at those aged 65 and over.

The tool comes with an accompanying report, which details how the tool was constructed and presents the main results.

The second report summarises the findings from a literature review carried out to identify cost-effective interventions.

Local authorities and Clinical Commissioning Groups (CCGs) can use results from the tool to protect and improve the health of their local populations when making commissioning decisions.

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Safe care for adults with complex health needs - survey

Imperial College London have set up a Priority Setting Partnership (PSP) with the James Lind Alliance to prioritise research into safe care for adults with complex health needs. They define adults with complex health needs as those who have more than one illness/disease/condition/disability or those who need care in more than one setting. For example, these people might have both diabetes and depression and/or need care from some of these different services: primary care (e.g. GPs), secondary care (e.g. hospitals), community health services, mental health services, or social care (e.g. care at home or in a care/nursing home).

Using a survey, ICL are asking patients, carers, the public and healthcare staff for their concerns and questions they would like to see answered about safe care for adults with complex health needs.

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New Alzheimer's drug offers hope for end to 'terrifying' psychosis affecting half of all patients

Reported in The Telegraph (13 February 2018): A new drug promises to spare hundreds of thousands of Alzheimer’s sufferers from “terrifying” hallucinations and paranoia, researchers have announced.

Scientists have successfully tested the first medicine capable of treating psychosis, which affects around half of patients with the disease, without the devastating side-effects caused by current drugs. Published in the Lancet Neurology, the trial of pimavanserin offers particular hope to those with advanced psychosis, which doctors often describe as the most distressing symptom of Alzheimer’s.

Currently people with dementia rely on mainstream antipsychotics, however these can double the speed at which brain function deteriorates, increase the risk of falls and lead to sedation. Figures indicate they also cause 1,660 unnecessary strokes and 1,800 unnecessary deaths in the UK every year. By contrast, pimavanserin, which targets a specific nerve receptor in the brain, was shown to significantly improve psychosis symptoms without the normal side-effects. 

Researchers at the University of Exeter Medical School tested the drug on 90 patients with Alzheimer’s disease, giving a placebo to a further 90.

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