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Will you still need me? Of course we do
The Beatles once sang “will you still need me when I’m 64”. The lyrics would need some very necessary upward revision nowadays. Yesterday’s Office for National Statistics (ONS) figures of population trends suggests that we are all expected to live longer than previously projected. Until now the projected age for a female was 83 and for a male 79. The ONS has looked at recent deaths trends and arrived at revised figures of 89 and 85 respectively. And this news should be a cause of celebration.
Last Friday’s debate on the Place and Contribution of older People in Society was led by the Archbishop of Canterbury in his last ever appearance in the Lords. His sense that society was becoming dangerously used to speaking and thinking of an ageing population as a problem, a burden on public purse and private resources alike. He was in no doubt that the dignity of older people in the UK should be recognised as they make a significant contribution with more than half the over-60 population are involved in some sort of formal and structured voluntary work. He asked what can be done by government and other agencies to harness most effectively this resource, not just as a way of solving problems that require such resources, but as an affirmation of positive models of living for older citizens.
Many other Peers referred to the Gold Age Pensioners report published by WRVS in 2011 which estimated that in 2010, over 65s, through taxes, spending power, provision of social care and the value of their volunteering, made an astonishing net contribution of £40 billion to the UK economy. Furthermore it was estimated that in 2030 the positive net contribution of over 65s will grow to £77 billion by 2030.
Aviva published its Recent Retirement report for Winter 2012 last week. This showed that 10.4 million over-65s typically give up 10 hours each week to volunteer and support their families. The combined efforts of this 'volunteer army' add up to 104 million hours of free support: worth £643.8 million per week at the national minimum wage. Some 8% of those over the age of 75 look after other older people.
During the debate Lord Wei highlighted in particular the opportunity to develop national service-type programmes, delivered by charities and social enterprises and targeted at people undergoing major transitions in life as a means of connecting them with each other to create social capital, providing useful information in a safe way, and of building resilience. He saw the biggest opportunity in retirement. He found that baby boomers nearing, or who had entered, retirement experienced a fundamental challenge. Retirement can often be a traumatic experience for some and bewildering for others and more could be done to develop ways led by retirees for retirees to help smooth this transition. Many, if encouraged in the first year or so of retirement, before long-term habits are formed, could be encouraged to enjoy a well earned rest but also be given the opportunity to work out how to make the best of the remaining decades of their lives in non-traditional ways.
Undoubtedly, older people do make a significant contribution both in economic and social terms to their communities. And with financial pressures on spending likely to continue for many years to come, the support this army of volunteers provides will only become more essential. But with a large group approaching retirement, society needs to think more creatively about how it can best ensure that these people remain a useful part of communities for as long as possible in a way that is mutually beneficial for all, but most of all to themselves.
Posted by Steve Smith Public Affairs Manager (England) at 00:00
Tuesday, 18 December 2012.
Families, loneliness and digital inclusion
A couple of weeks ago, there was a meeting at the Welsh Assembly of the Cross-Party Group on Older People & Ageing, where we spent a very interesting hour talking about older people’s access to technology, and the ways in which older people in Wales are increasingly using the internet to stay in touch with their families.
Some of the news is very good indeed – there are some great examples of older people being helped to learn new IT skills, and of software like Skype transforming older people’s ability to speak with – and see – their children and grandchildren on a regular basis. Meanwhile, at a Welsh Government level, support for the Communities 2.0 project has widened access exponentially.
All of this is very encouraging, but as new research launched today by WRVS reveals, the bigger picture is somewhat bleaker. For all the technological advances of the past 20 years, older people in Wales remain incredibly lonely, with nearly three-quarters of over 75s who live by themselves feeling isolated; worryingly, older people who live alone are actually LESS likely to be in contact with their children than older people who live with their husband or wife. This comes on top of previous findings which showed that older men in Wales are the loneliest group of people in the UK.
Moreover, the WRVS research found that older people in Wales are less likely to speak to their children every day than is the case for the UK as a whole, and that for 11% of Wales’ older people, their nearest child lives more than an hour’s drive away. Part of this can be explained by Wales’ rural geography, but economics and the harsh financial climate has also played a part; 82% of children who have moved away from their older parents have done so for work reasons.
The clear message from all of this is that more needs to be done to help older people to be connected with their families. With the Winter Break just round the corner, many of us will take the time to visit our families – but what about the 8,666 older people in Wales who WRVS estimate will spend Christmas Day alone this year?
Technology offers some hope for the future; the WRVS research showed that 85% of older people who use Skype say that it helps them feel more connected. However, this is simply not an option for some older people, with figures showing that 308,000 over-70s in Wales have never surfed the internet. Even those who do can often face confusing and conflicting messages – such as the list of websites blocked by local authorities to users of their computers in libraries (which includes a disproportionately high number of older people). Skype is a really good example, with many local authorities banning access to Skype over their computers because of a misguided ‘safety first’ attitude, which only serves to reinforce people’s concerns and prejudices about technology rather than challenging them. If we’re to help unfamiliar audiences to overcome their suspicion of technology, we need to start by getting public bodies to do the same.
We are at an interesting junction of age relations. We have a growing cohort of older people, and have a huge divide between the “digital haves” and the “digital have-nots”. For those older people who are able to exploit technology, there are huge opportunities to stay better-connected with friends and families, despite society becoming more disparate as people move further afield to find work. But we also have to cater for the large cohort who cannot (through lack of access or lack of expertise) use the technological corridors open to them. It is surely a sad state of affairs when half of our older people cite the television as their main source of company, particularly when more ‘active’ technologies could be transforming their lives by ensuring they can do the thing they value most – being able to see and hear their loved ones.
Posted by Dr Ed Bridges, Public Affairs Manager (Wales) at 00:00
Tuesday, 11 December 2012.
Autumn budget statement: difficult decisions lie ahead
Yesterday’s Autumn Budget Statement was quiet on the future financing of social care. I doubt whether anyone expected anything different. NHS funding remains ring fenced, although there was a reported dispute between UK Statistics Agency chair Andrew Dilnot who is seeking clarification from Jeremy Hunt on claims that NHS spending has increased. An investigation from the watchdog concluded that in real terms it was lower in 2011-12 than it was in 2009-10.
There is little doubt that local services are under immense strain. We know from the figures released by the Health and Social Care Information Centre just last week that real-terms spending by councils on adult social care fell by between 2% and 7% from 2010-11 and 2011-12. There are fewer older people receiving social care now then there were in 2001-2 despite the growth in their numbers.
The voluntary sector is, therefore, in a position to bridge this gap and provide help and support at times when it is most needed. However, earlier in the day Compact Voice published its report which investigated funding and engagement between Government and the voluntary sector. It rather worryingly found that around half of local authorities are continuing to see the voluntary sector as a soft target for spending cuts, with disproportionate cuts common and a worrying lack of impact assessment and engagement. It reported that 56% local authorities reported reducing the amount of grant funding between 2011-12 and 2012-13.
It is therefore something of a conciliation that local government is not having to make a further 1% cut next year in line with the majority of Whitehall departments. Less welcome is the fact that local government funding will be cut the year after - 2014 - by 2%, in line with Whitehall departments.
On the benefits side, carers will receive an increase in line with inflation which is better than the freeze or 1% increase for most other benefits recipients.
The Chancellor did announce that in the first half of next year there will be a Comprehensive Spending Review (CSR). This will budget government spending through 2015-16. This is necessary as, with fixed term parliaments now in situ, an election won’t take place until May 2015, a month into the 2015-16 financial year. Ministers have repeatedly said that they agree with the principles of the Dilnot recommendations and intend to base a new funding model on these principles if a way to pay for it can be found. They have added that given the size of the structural deficit and the economic situation the UK faces it is right that the final decision is considered alongside other priorities at the Spending Review. This CSR then provides the opportunity to take a detailed look at the future funding of adult social care, not just for the CSR period but for the long term. This means getting to grips with the recommendations contained within the Dilnot report. More difficult decisions lie ahead.
Measuring Loneliness: The start of a journey not the end
Yesterday saw the Department of Health issue it’s Adult Social Care Outcomes Framework (ASCOF) for 2013/14. Normally this would not be a newsworthy feature in itself. But yesterday was different. For the first time local authorities will measure levels of isolation and loneliness for users of care and support and carers. This is in response to the key White Paper commitment to address loneliness and social isolation.
It doesn’t sound much in itself. The ASCOF was only first published in March 2011 and has been evolving since then. The inclusion of measuring loneliness, albeit to only a section of society, is a culmination of a great deal of effort by a number of bodies including the Campaign to End Loneliness of which WRVS is a Board member. The previous social care Minister Paul Burstow should also take credit for his role in this achievement.
But it’s not just users of social care users and carers who can feel lonely and isolated. The Department of Health in its Public Health Outcomes Framework (PHOF) 2013-16 recognises that “social connectedness” is a public health issue and is working on a wider population measure of loneliness. In January the PHOF included social connectedness as an indicator to improving the wider detriments of public health. At that stage major work was required across all of the indicators (age, location, gender, socioeconomic group etc). The inference was that this work could take in excess of a year. A revised PHOF was issued earlier this week showed that social connectedness is still included as an indicator, but remains requiring major development work which suggests that this could take some time. This is where our efforts should now be directed.
But the inclusion of isolation and loneliness in the ASCOF is a good start. We should not take our eye off the ball. There is a growing impetus around tackling loneliness and isolation. We have overcome that important first step of getting it acknowledged as having a serious negative impact on an individual’s health and wellbeing. The online toolkit issued by the Campaign in May is also designed to support health and wellbeing boards to better understand, measure and commission to address loneliness and social isolation. We are now on the way to measuring it so that a strong evidence base will help ensure that the right support including that provided by organisations, like WRVS, is available to those that need it.
Read WRVS' response to the Adult Social Care Outcomes Framework announcement
Westminster Eye: An insight into the week of politics 15-19 October 2012
Monday 15 October saw the return of Parliament following the Party Conference season. Jim Cunningham MP received a reply to his question to the Secretary of State for Health on what assessment had been made of the findings of the report by the British Geriatrics Society on rehabilitation services for the elderly. Norman Lamb said that on 12 September 2012, the National Audit of Intermediate Care was published. This audit made a valuable contribution to understanding developments in intermediate care services. It would support local social care services, clinical commissioning groups and health and well-being boards in preventing unnecessary hospital admissions and supporting timely and safe discharge from hospital.
Tuesday saw the laying of an Early Day Motion that drew the House’s attention to the fact that over the last 10 years there has been an average of nearly 30,000 excess winter deaths
each year in the UK, the vast majority of which are older people. The cost of this has been estimated by the Chief Medical Officer at £890 million per year in England alone. The Motion concluded that MPs had a role to play in helping prevent excess winter deaths and associated ill-health problems by encouraging local authorities and other organisations in their constituencies to both prioritise this issue as a public health concern and put plans in place to deal with it.
Meanwhile in the Lords a motion of regret was tabled, aimed at defeating the government's NHS (Clinical Commissioning Groups) Regulations 2012. Labour health spokesman Lord Hunt of Kings Heath said that Clinical Commissioning Groups faced a "formidable" challenge and would be "at the heart" of the NHS reforms. The regulations concerned the establishment and governance of CCGs, which included a provision that members of the CCG board should include "a registered nurse, a secondary care specialist and two lay people". Lord Hunt called the "limited" representation of lay people "very disappointing" and warned that it could be a "vital error" to provide such a minority of lay people who could challenge decisions.
On Wednesday Steve McCabe MP
received a reply to his question over the number of care homes in each region which did not meet national minimum standards of care. The Minister referred to the CQC's most recent Market Report, published in June 2012. It showed that the proportion of adult social care services inspected that were meeting all the standards was 72%. A further 27% were not meeting at least one standard. In these cases, the CQC was satisfied with an action plan from the provider setting out how it was going to improve. In 1% of cases, the CQC's concerns were serious enough to cause it to take enforcement action.
Lord Hunt of Kings Heath tabled a Lords oral question relating to the numbers of vulnerable elderly people obliged to rely on care workers with criminal records. He said that recent CQC inspections showed that more than 220 care agencies working for older people in England had failed to show that they were employing properly qualified and vetted staff. He called for the statutory regulation of care-home workers. Earl Howe responded saying that it was the responsibility of the employing organisation to carry out appropriate checks on the people they intend to employ. They should take decisions in the context of their responsibility for the well-being of the people who use the service. That position had not changed, and indeed it must be at the core of the safeguarding agenda. If someone had a criminal conviction, the employer should consider how old and relevant that conviction is in the context of the activities that the person would be undertaking and the characteristics of the people they would be looking after. It continued to be an offence for a provider to employ a person barred by the Independent Safeguarding Authority.
Brandon Lewis MP responded to Helen Jones’s question to Communities and Local Government Ministers on what proportion of council budgets would need to be spent on adult social care in each of the next 10 years and what assumptions had been made of the growth in numbers of elderly people and increases in the cost of social care in reaching that estimate. Lewis said that on 28 September the Office for National Statistics had published projections of the population for the next 10 years which included the projected number of elderly people. The 'Technical Consultation on Business Rates Retention', which closed on 24 September, set out Government's proposals on local authority financing. He also referred to the Governments update to the Dilnot proposals.
The Department of Health
announced that resources are now available for Self Care Week 2012
, to help NHS, social care and voluntary sector organisations run local initiatives. Self Care Week will run from 12-18 November and is an annual national awareness week that focuses on embedding support for self care across communities, families and generations. This year's theme is 'Self Care for Life - growing older healthily', which builds on the European Active and Healthy Ageing initiative on improving the health knowledge of patients and the public as they get older. For Self Care Week 2012, the Department is extending this approach through all the life stages - from pre-birth to older years - to ensure healthy and happy living at every age.
Do older people have a voice in today's society?
On the opening day of the Conservative Party Conference at the ICC in Birmingham, WRVS hosted its “fringe” event entitled “Do older people have a voice in today’s society?”. With a packed room, Esther Rantzen started the debate with an unequivocal “no they don’t!” Esther strongly argued that older people are a massive resource and asked “where would the voluntary sector be without the older generation giving up their time?”.
Esther spoke passionately about the issue of loneliness amongst older people and drew on her own personal experience of downsizing to a flat in “little old lady land” recently and the experience of coming home to a dark flat with no one to talk through about your day or discuss what’s in the papers with. Esther touched on the stigma attached to admitting that you are lonely and succinctly summarized what loneliness feels like - “plenty of people to do something with but nobody to do nothing with”.
When it comes to public policy, Esther felt that older people’s concerns are not properly represented in Government, in a holistic rounded way: there may be someone in the Department of Health dealing with older people in hospital, then there could be someone in the Department for Work and Pensions with responsibility for pensions issues, but there is no one looking out for older people more generally, Esther argued. And that’s why she would like to see a Minister for Older People appointed. Names were bandied about with Esther proposing Ken Clarke – who is currently a Minister “without portfolio”, meanwhile an audience member suggested Boris Johnson.
Whilst Esther spoke evocatively about the social aspects of growing old, Ruth Porter, director of communications at the Institute of Economic Affairs focussed on the economic impacts of ageing in her response. Ruth argued that older people do indeed have a very strong voice, but the debate has become polarized, with older people pigeon-holed.
Ruth thinks that this is divisive and unhelpful and pitches older generations against the younger. She strongly believes that the issues to do with our ageing population should be tackled by all of us working together. Ruth quoted the startling fact that by 2020 more than half of voters will be over the age of 55 and therefore it follows that politicians are very much listening to what older people say. Ruth said that as a country we must face up to the fact that the sums don’t add up and that the retirement age hasn’t kept up with life expectancy. She said that we’ve been lied to by politicians, as, although many people should rightly expect a decent pension after paying into the system for 40 years, there isn’t enough money in the pot. Ruth’s comments that wealth has transferred from the younger generations to the older ones in recent years and that they are passing the bill for old age to the younger generations sparked plenty of comments from the (mostly older) audience.
There was plenty of food for thought for the Conservative politicians and activists who attended as they continued on at the rest of the conference, including (just a few):
- Should each TV/radio channel be required to have older presenters/reporters?
- Should the state pension be scrapped altogether and people be forced into compulsory savings schemes?
- Should universal benefits, such as free TV licences and the winter fuel payment be means tested?
Join the debate on Twitter using #oldervoice
Westminster Eye: Liberal Democrats party conference
Keeping Social care reform at the top of the agenda was the subject of a Fringe meeting at the Liberal Democrats Party Conference this week.
Introducing the debate, health and social care correspondent for Channel 4 News Victoria McDonald said social care had been on a "rollercoaster" since the publication of the Dilnot report. However, there had been concerns that the Government's response was too muted, and that the white paper did not include funding.
Social Care Minister Norman Lamb praised the contribution made by Lib Dem colleague Paul Burstow in his time as Minister. Burstow was keeping the pressure on through his comments made to the media.
Lamb wanted social care to a Government legacy. He acknowledged the Dilnot proposals but said this was not the whole answer but gave some consensus for parties to work together for a settlement. He argued that a mechanism needed to be created to deliver a solution within short timescales.
Lamb was clear that social care reform was a top priority for the Deputy prime Minister. He suggested that the term “social care” was not sexy and there needed to be a shift of language towards care and support to gain a better understanding and draw more attention to the issues.
The Minister stated that he was aware that the system could be a complex jungle and that he was a huge fan of integration. He said that the Health and Social Care Act reforms offered a basis for a more joined-up approach, putting individuals centre stage. But that there needed to be a better understanding of what integration was.
Finally, the Minister reminded the audience that he was new in post and that he would be better placed to judge the points of resistance to reform once Parliament resumed. However, he was clear that he did not want to see the reforms delayed or allowed to fall by the wayside.
At a separate fringe meeting on how today’s decisions will shape tomorrow’s services, Lamb said that he was keen to combat “institutionalised fragmentation” and help sustain the NHS in the face of an increasing elderly population.
Another topic impacting on the lives of older people that was discussed at Conference was the future of universal benefits for the elderly. Communities Minister Don Foster and Lord Oakeshott called for the benefits to be removed from wealthy pensioners. Leader Nick Clegg said that they should be reconsidered after 2015 as it would be difficult to explain why the benefits were not up for consideration in a time of austerity. Business Secretary Vince Cable said there was "no question" of the benefits being cut within this Parliament.
Westminster Eye: An insight into the week of politics 3 - 7 September 2012
The House of Commons returned from its Summer break on Monday with a great deal of speculation about a substantial Ministerial reshuffle. There wasn’t long to wait with the first announcements being made on Tuesday and continuing into the next day. The reshuffle resulted in all the existing health Ministers being moved. Jeremy Hunt takes the place of Andrew Lansley as Secretary of State, and on Social Care Norman Lamb picks up that portfolio from Paul Burstow, meaning that Social Care remains in the hands of a Lib Dem coalition partner. Norman Lamb has some background in healthcare, being the Lib Dem health spokesperson from 2006-2010, before joining Vince Cable’s Business Department. The two other new Health Ministers are Anna Soubry and Dr Daniel Poulter. Earl Howe remains the spokesperson in the Lords.
On Tuesday Alison McGovern MP asked the Secretary of State for Health what steps he expected HealthWatch to take to measure the quality of care provided in the recipient's own home. Anne Milton responded saying that HealthWatch was being established to represent the collective voice of all people. It would provide scrutiny of all public-funded health and social care services wherever they are delivered. She added that it was up to each local HealthWatch to decide how it carried out its functions and which issues it prioritised based on feedback from the local community.
The government's Small Charitable Donations Bill, which would enable charities to claim gift aid-style payments on small cash donations up to £20, received its second reading in the Commons on Tuesday.
The Bill would introduce the gift aid small donations scheme (GASDS) announced in the 2011 budget, and aimed to help charities and community amateur sports clubs (CASCs) to claim top-up payments on up to £5,000 small donations each year, which were often difficult to obtain gift aid declarations for.
On Wednesday Oliver Colvile MP asked Health Ministers what discussions his Department had with (a) industry and (b) other Government departments and agencies to ensure that they have put in place dementia-friendly policies since the Prime Minister's challenge on dementia. In his reply Norman Lamb said that as part of the Prime Minister's challenge on dementia, the Dementia-friendly communities Champion Group was taking forward work with a range of organisations including industry to deliver key commitments relating to dementia-friendly communities. By 2015, the Government wanted to see up to 20 cities, towns and villages signed up to become more dementia-friendly and we want to see support from leading businesses for the Challenge. This work was being supported by the Dementia Action Alliance, which is a group of over 100 organisations including charities, businesses and industry who have signed up to the National Dementia Declaration and are working together to improve quality of life for people with Dementia and their carers.
Labour MP Barbara Keeley introduced a debate on her private member's Bill on Friday - Social Care (Local Sufficiency) and Identification of Carers Bill. Keeley explained that her Bill would "introduce a strategic duty on local authorities in England to ensure that sufficient social care services exist in their local area to meet the care needs of disabled people and carers".
Sir Tony Baldry joint chairman of the all-party group on carers, welcomed the aims of the legislation but noted that the Bill had been introduced shortly before the government published its "much-awaited" social care white paper. He expressed hope that, while the government was likely to oppose Keeley's Bill, care minister Norman Lamb would "give a clear undertaking that, between now and the eventual second reading and debate of the government's Bill on social care, he would be willing to have meetings with the relevant all-party groups to discuss how provisions relating to carers could be further enhanced". Norman Lamb responded that he was "happy to give, straight away, the undertaking that the MP seeks". The minister continued: "It is important that we get this right and that we do not let down those people with caring responsibilities. I am very happy to give a firm commitment to engage fully between now and when the government's Bill is presented to this place."
Indeed the Bill was talked out after new care minister Norman Lamb said he was "keen to engage" with Keeley on the issue but was opposed to introducing new legislation in advance of the codifying legislation in the upcoming Care and Support Bill.
The House of Lords is still in Recess.
The Health Lottery
We're very pleased with the High Court’s ruling on The Health Lottery. It is important, in order for the third sector to flourish, that there is a variety of sources of funding available to charities.
Money raised through The Health Lottery provides invaluable funding to many health charities delivering vital services. The grants given from People’s Health Trust together with 51 community interest companies have enabled WRVS to support older people across the UK through schemes such as Good Neighbours befriending services and community transport, which help combat loneliness and keep isolated older people connected to their communities.
Getting back on your feet
Last year, 15,281 over-75s in Wales were readmitted to hospital within 30 days of discharge. It’s a figure which has been growing steadily since 2007. Clearly we need to be smarter about how we help older people if we’re to end the cycle of people yo-yoing to and from hospital.
With that in mind, WRVS set out to examine the state of so-called ‘reablement’ services in Wales, to see what help was given to older people by health boards and local authorities so they could adapt back to life at home after a prolonged stay in hospital. Services coming under the banner of reablement might include physical rehabilitation, home adaptations or social support such as befriending schemes.
In the research report, Getting back on your feet: reablement in Wales, WRVS found some encouraging signs but also some challenges in the responses we received from health boards and local authorities to our Freedom of Information requests.
First, the good news. Although health board budgets for reablement varied significantly across Wales, funding was moving in a positive direction. All health boards were either maintaining or increasing reablement budgets, despite the challenging financial climate. Furthermore, there was evidence of good local authority partnership working (particularly in north Wales), and evidence of common aspirations to increase referrals, and for interventions to be targeted towards those who needed them most. These are significant steps in the right direction.
Less encouraging was the very fundamental problem that health boards and local authorities are still operating to different understandings of what is meant by the term ‘reablement’. There is no standard Welsh definition, and this is leading to confusion and different interpretations. So when we asked councils about their reablement budgets, it appeared that Torfaen was spending ten times as much on reablement as Conwy – but in reality, this was because of different readings of the term ‘reablement’. Until a standard definition is developed for Wales, we cannot hope to have a level playing field where we can compare like with like.
Elsewhere, there was also a disproportionate focus on physical support. Reablement necessarily involves a whole-person approach – so physical rehabilitation must be matched by social and emotional support to help a person regain confidence. Recent research from America has shown an inextricable link between social isolation and increased risk of mortality, so stopping people becoming lonely really does save lives. This is particularly important after what might be a debilitating illness which could leave someone housebound for a period.
It’s clear that reablement works. Agencies delivering front line reablement services in Wales have seen the benefits it brings to service users; the Social Services Improvement Agency have shown that it delivers better outcomes; and research from Demos has pointed to the significant savings it delivers to the public purse. It really is a win-win for Wales.
Our hope in releasing today’s report is to help highlight the areas which the Welsh Government will need to prioritise if we are to have a first-class reablement service in Wales. Specifically, we are recommending the following:
- The development of a reablement framework for Wales, outlining what exactly is meant by reablement and what features public bodies should seek to include in services.
- The establishment of a mechanism to measure wellbeing which looks at not only physical health, but also emotional and social wellbeing, both crucial to a person’s quality of life.
- The creation of a central source of funding for reablement services, to pump-prime investment into first-class reablement and share best practice.
- The involvement of the voluntary sector to ensure a multi-sector approach to providing social support services.
If we can start to pick up on some of these areas, then we really can help older people in Wales to get back on their feet.
Join in the conversation, leave a comment below or on Twitter using #backonyourfeet
Dr Ed Bridges
Public Affairs Manager, WRVS