Find out about the people behind Royal Voluntary Service in our series of guest stories from our volunteers, staff and partners.
It’s easy to get caught up in the commercial side of Christmas, with the shops piled high with gifts and presents and the TV constantly bombarding us with adverts for the latest perfumes and electrical gadgets. But it’s worth remembering that all some people want for Christmas is a little care and attention.
The best gift you can give this year is your own time and effort to help out a good cause in your local area. You don’t need any special skills or experience, and it won’t cost you anything, but the rewards it gives are priceless.
Volunteers are the lifeblood of many charity organisations, and without them many simply wouldn’t be able to deliver the services that are so vital in your local community. No amount of money can replace a willing pair of hands when it comes to the sharp end of charity services, and volunteers can make a real difference.
You don’t have to make a huge commitment, most organisations, such as WRVS will welcome any time that you can spare to help. Just a couple of hours per week can really change the lives of older people in your community.
A couple of hours delivering Meals on Wheels, for example, not only ensures that the elderly and infirm get a hot, healthy meal once a day, but also gives them a welcome visitor to check on their well-being and stop for a chat. Support at home is another great way to help people to live independently, while making sure that they get all the services and support that they need.
So this Christmas, give something that really counts, give a little of your time to your local community by volunteering.
The beginning of the week began with oral questions to the Communities and Local Government Ministers. Margot James MP asked what discussions they had held with the Secretary of State for Health on funding for adult social care. In responding the Communities and Local Government Minister Bob Neill said that the Secretary of State had held a number of discussions with the Secretary of State for Health. In recognition of the need to reform the system the Government has said that we will bring together proposals in a White Paper in the spring. An extra £7.2 billion was being provided over the next four years to protect access to services that support vulnerable people.
In her supplementary question Margot James said that the recent report by the Equality and Human Rights Commission exposed the poor quality of care of some home care providers. She had received complaints from constituents that reinforce the report's findings. Funding has been a problem for a long time and would the Minister discuss further with the Secretary of State for Health the diversion of more money from health to social care, on top of the £648 million already announced?
In his reply Bob Neill said that it is appropriate that Government consider the matter in the context of the White Paper that is to come out in April. The report is valuable, and the Government as a whole will want to consider its recommendations carefully. He pointed to the £648 million in this year that will be followed by another £622 million in the next. That £1 billion coming from the Department of Health is matched by £1 billion coming from the Department for Communities and Local Government.
Helen Jones MP asked why the Minister did not admit that the Secretary of State's ambition to be the biggest axe man in Whitehall has been achieved on the backs of elderly and vulnerable people. She said that 70% of councils had to cut social care, leaving old people to make difficult choices. The cost in wasted lives was high, and the cost to the NHS through more delayed discharges and more emergency admissions will run into millions of pounds. She asked why the Government did not now admit that the Government's policy is not only uncaring and out of touch but economic madness.
Robert Neill said that Ms Jones had failed to recognise the fact that the Government have assisted local councils in the greatest need by increasing the weighting given within the settlement to the needs allowance and by introducing a transition grant to assist those that are most dependent on public money. She had failed to recognise that the Government is trying to rectify the economic mess that left by the previous administration. She had also failed to recognise the observation of the head of the No10 policy unit when she was in government that the "long-term funding of social care was the largest piece of unfinished social reform under Labour."
Jim Cunningham MP received an answer to his question posed the previous week on how much the Department of Health has spent on research on the (a) causes and (b) treatment of dementia since 2010. Social Care Minister Paul Burstow reported that Dementia is a research priority for the Government. Through the National Institute for Health Research (NIHR) and the Policy Research Programme, the Department funds a wide range of research on dementia including research on causes, diagnosis, treatment, and organisation and delivery of health and social care services. The Department's expenditure on dementia research increased from £12.7 million in 2009-10 to £18.6 million in 2010-11.
The NIHR has issued a themed call on dementia. This call extends across the translational pathway, covering the fields of cause, cure and care, including prevention. In addition, four new NIHR biomedical research units in dementia will receive a total of £18 million over five years from April 2012.
Several MPs asked the Communities Minister what assessment had been made of the effect on the third sector of reductions in funding for local authorities. Ministers responded by saying that they are working closely with the third sector to assess capacity and provide support, for example through the Transition Fund and Big Society Capital and we are looking together at opportunities for the Voluntary and Community Sector from increased local authority commissioning. Andrew Stunell MP agreed that local spending decisions are a matter for local councils but there was no excuse to target the voluntary sector disproportionately.
Jim Cunningham MP received a reply to his question on what steps the Government is taking to ensure house building schemes take into account the needs of older people.
Minister Bob Neill said that Part M (access to and use of buildings) of the building regulations already includes a number of provisions including level thresholds, downstairs toilets and accessible switches and sockets that help to make all new homes more accessible and age friendly. In addition, the Housing Strategy published on 21 November sets out Government's view that new housing developments need to make further suitable provision for the ageing population by ensuring a mix of property types, including Lifetime Homes, which help to provide the diversity and choice needed to support longer term independent living. Future needs will vary considerably at a local level and the Government believe that decisions on the number of Lifetime Homes within each development should be made at a local level, in proportion to local need and aligned with other local housing support and information services. They are exploring how research undertaken by DCLG can be used to support local authorities in developing proportionate and effective policy at a local level.
The draft national planning policy framework asks local councils to plan for a mix of housing based on current and future demographic trends and the needs of different groups in the community, including older and disabled people. The draft framework makes clear that councils should have a robust understanding of housing requirements in their area, and that they should produce local plans, in consultation with people in the local area.
Helen Jones MP followed up her recent question with two more relating to communications between the Departments of Health and Communities and Local Government. She asked what recent discussions had been held with Ministers in the Department of Health and Communities on the possible extra costs for the NHS of local authorities introducing changes to the criteria governing eligibility for social care. Her other question asked what estimate had been made of the possible extra costs which will be incurred by the NHS as a result of local authorities introducing changes to the criteria for eligibility for social care.
Paul Burstow responded by saying that in the spending review, Government recognised the pressures on the adult social care system within a challenging settlement for local government, and took the decision to prioritise adult social care by allocating an additional £7.2 billion to the system over the four years to 2014-15 to support local authorities in delivering social care. When combined with a rigorous local authority focus on efficiency, this additional £7.2 billion means that there is funding available to protect people's access to care and deliver new approaches to improve quality and outcomes.
Jim Cunningham MP asked the Secretary of State for Health what steps he is taking to ensure consistent levels of provision of social care support across the country.
Paul Burstow replied that local authorities are responsible for providing or arranging care services for their populations. Their funds are derived from local taxation and funding from central Government. The great majority of this funding is provided without condition. It is for local authorities to decide how best to manage their resources, according to local priorities.
In the spending review, the Government recognised the pressures on the adult social care system within a challenging settlement for local government. It took the decision to prioritise adult social care by allocating an additional £7.2 billion to local authorities over the four years to 2014-15 to support them in meeting their social care commitments. When combined with a rigorous local focus on efficiency, this additional money will mean that there is funding available to protect people's access to care and deliver new approaches to improve quality and outcomes.
The Health Select Committee interviewed Andrew Dilnot, Lord Warner and Dame Jo Williams as part of its inquiry into social care. Dilnot himself said that not enough was currently being spent on social care, something that was of extreme importance to the nation. He added that it was absolutely vital to look at the funding for social care for those that were most in need. He said there was no doubt that not all of this funding had made its way through. He said local authorities were over spending on care, it was not the case that social care was an unpopular thing. He said the commission argued strongly that local and central government needed to come together to create a national eligibility criteria. Dame Jo said that portability of an assessed need to other local authorities "could be addressed quite urgently", along with national eligibility criteria. She said a universal assessment system would be more clear and transparent. Lord Warner said that as local authorities tightened eligibility criteria as more elderly people ended up in hospital and the NHS "takes up the slack". He said the Department of Health should examine how spare capacity in the NHS could be created and money could be released from the NHS to social care. Lord Warner suggested that spare NHS beds could appear if money was quickly put into the adult social care system, but that spare capacity was currently poorly understood. He said serious work must be done on how this transfer could take place.
The NHS Outcomes Framework 2012-13 was published.This refreshes the first NHS Outcomes Framework published for England in December 2010 and includes updated definitions for some of the indicators in the framework.
The framework has three main purposes, which remain the same in this updated version:
- to provide a national level overview of how the NHS is performing against certain outcome measures
- to act as a mechanism for the Secretary of State to hold the NHS Commissioning Board to account for delivering improvements in outcomes, from April 2013
- to act as a catalyst for driving improvement and a focus on outcomes throughout the NHS.
In the Lords, Dilnot Commissioner, Lord Warner, received a reply to his question on what would be the cost to the Government of the cap on lifetime care costs proposed in the report of the Commission on Funding of Care and Support if that cap was increased from £35,000 to (1) £50,000, (2) £60,000, (3) £70,000, (4) £80,000, (5) £90,000, and (6) £100,000.
The Parliamentary Under-Secretary of State, Department of Health Earl Howe said that the Commission on the Funding of Care and Support set out detailed costings in its evidence and analysis report, and these included costs for different levels of the cap. This information is available in the Analysis and Evidence Supporting the Recommendations on the Commission on Funding of Care and Support and The Government is considering the recommendations of the Commission and will publish their response in a White Paper and progress report on funding in the spring.
Towards the end of the week during the Health and Social Care Bill reading debate, Lord Warner moved an amendment regarding the health secretary's annual report. He acknowledged the need for reform in the social care and health systems, but argued that they were not on a level playing field; and the reduction in access to state-funded care services had seen an increasing burden on informal carers. "At the heart of this problem is that social care simply does not have the standing of the NHS," he said. He called for a clear duty upon the health secretary to promote a comprehensive social care system; and the amendment would require an annual report on the health service's integration with the care sector. Earl Howe agreed on the importance of integration between the health and social care sectors. However, he argued that the amendment was unnecessary because the Bill already contained duties to promote and encourage the commissioning and provision of integrated services.
On Thursday John Hemming MP received a reply from the Health Minister to the question on when the Government would publish a response to the Dilnot Commission's report Fairer Funding for All. Paul Burstow said that the Government had set out its initial response on 4 July. The Government welcomed this report, which is an immensely valuable contribution to meeting the long-term challenge of an ageing population. Government had spent the last few months engaging with stakeholders from across the care and support community to ensure that we get funding reform-and social care reform more broadly-right. The Government plan to publish a social care White Paper and a progress report on funding reform in the spring.
Robert Buckland MP asked what steps the Minister has taken to meet each of the six shared objectives contained in his Department's mental health outcomes strategy and what meetings he has had with Ministerial colleagues on cross-Government steps to achieve each of the six shared objectives contained in his Department's mental health outcomes strategy. Andrew Gwynne MP quizzed the Minister on his assessment of the likely take-up of telehealth schemes. Richard Burden MP asked what recent meetings Ministers have had with representatives of the Care and Support Alliance and whether there were plans to bring forward proposals to reform the care system. Replies to these questions are awaited.
Posted by Steve Smith, Public Affairs Officer at 00:00
Friday, 16 December 2011.
On Monday Simon Kirby MP received an answer from the Minister to his question on what assessment the Department of Health has made on the findings of the Shaping our Age report by WRVS on loneliness. Minister Anne Milton said that the Department of Health welcomes the Shaping our Age report and has noted its findings. She added that the engagement exercise, Caring for Our Future: Shared ambitions for care and support, was launched on 15 September 2011, and will last until early December. This engagement exercise will cover among its six themes prevention, integration, quality, personalisation, shaping local services, and financial services. After the engagement exercise, the Government will set out its response to the Dilnot Commission in the spring, with full proposals for reform of adult social care in a White Paper and progress report on funding reform.
Helen Jones MP asked what discussions had taken place with Ministerial colleagues on the likely effect of the Local Government Resource Review on social care. Bob Neil MP replied that the Secretary of State for Communities had regular discussions with ministerial colleagues on a range of issues.
Tuesday saw the Chancellor George Osborne deliver the Autumn Statement. The statement contained a commitment to raise the basic state pension by £5.30 and the pension credit by £5.35. He also announced that the pension age was being raised from 66 to 67 in 2026. Finally total managed expenditure in real terms was to fall by 0.9% for the years 2015-16 and 2016-17 following the current spending round.
The previous week Jim Dobbin MP had asked how much of the extra £70 million funding announced for re-ablement has been (a) spent by and (b) allocated to each Primary Care Trust and on what services this money has been spent. Paul Burstow provided a response on Tuesday. He said that the Department of Health had announced on 5 October 2010 that £70 million of extra funding would be allocated to Primary Care Trusts (PCTs) to be spent across the health and social care system to enable the NHS to support people back into their homes after a spell in hospital through re-ablement. Allocations to PCTs were made on 4 November 2010, and details on this are available here
Following the extra £70 million re-ablement monies the Government allocated to PCTs in 2010-11, on 4 January 2011 the Department announced a further allocation of £162 million to PCTs for winter pressures funding on social care services that also, benefit the NHS.
Examples of the kinds of services PCTs could invest in included further investment in re-ablement services, to help people regain their independence and reduce the need for ongoing care.
He continued by saying that the spending review and 2011-12 NHS operating framework announced further funding to PCTs in financial years 2011-12 and 2012-13 to develop local reablement services in the context of the post-discharge support plans submitted to strategic health authorities last December. This funding totals £150 million in 2011-12 and £300 million in 2012-13, and is contained within recurrent PCT baseline allocations. Details on this are also available here and here
It is for PCTs in partnership with local agencies to commission services to meet the healthcare needs of their local populations, taking account of local and national priorities.
Chris Skidmore MP wanted to know how many people over the age of (a) 65, (b) 75 and (c) 85 years were admitted to accident and emergency centres in each of the last 10 years for which figures are available. Replies are awaited. Minister Simon Burns MP replied saying that patients are not admitted to accident and emergency (A&E) centres; though they may be admitted to other hospital departments following an attendance at an A&E department. Statistics for admissions to A&E are therefore not available. Statistics are available for attendances at A&E departments though not for the exact age ranges requested, and have only been published since 2007-08. The 2009-10 admissions for ages 60-69 were 1,186,933; for ages 70-79 114,954; for ages 80-89 991,054 and for ages 90-99 256,618.
Several MPs asked what the Communities Minister what assessment had been made of the effect on the third sector of reductions in funding for local authorities. Jim Cunningham MP asked what steps the Government is taking to ensure house building schemes take into account the needs of older people. Replies are awaited.
Helen Jones MP followed up her recent question with two more relating to communications between the Departments of Health and Communities and Local Government. She asked what recent discussions had been held with Ministers in the Department of Health and Communities on the possible extra costs for the NHS of local authorities introducing changes to the criteria governing eligibility for social care. Her other question asked what estimate had been made of the possible extra costs which will be incurred by the NHS as a result of local authorities introducing changes to the criteria for eligibility for social care, broken down by region. Replies are awaited
Dilnot Commission member Lord Warner asked the Government what would be the cost to the Government of the cap on lifetime care costs proposed in the report of the Commission on Funding of Care and Support if that cap was increased from £35,000 to (1) £50,000, (2) £60,000, (3) £70,000, (4) £80,000, (5) £90,000, and (6) £100,000. A reply is awaited.
Baroness Greengross received a reply on Thursday to her question about the Government ‘s assessment of the impact of (a) hospital admissions, and (b) emergency hospital admissions, on health outcomes for people with a diagnosis of dementia. In replying Earl Howe said that they know that people with dementia stay longer in hospital and that there is room for improvement in the quality of their care. He said that was why improving the quality of care in general hospitals is one of the Government's four key priorities for improving dementia care services. The Government want to see people with dementia only admitted to hospital when absolutely necessary and, when they are in hospital, to receive high-quality care from staff trained to care for people with dementia.
On 21 September 2011, following a year-long project funded by the department, the Royal College of Nursing launched a new commitment to the care of people with dementia in general hospitals. The commitment is a guide to promote a positive experience and support the delivery of dignified care for people living with dementia and their families, in hospital.
During the ninth day of the Committee stage of the Health and Social Care Bill in the Lords, Baroness Bakewell moved an amendment regarding how well NHS services met the needs of older people. This would require the board's annual report to be measured by how effectively it met the needs of older people; and were intended to test views on the creation of a commissioner for older people.
Baroness Jolly highlighted the forthcoming consultation on social care in the New Year, and asked if an older person's commissioner was likely to be included in the next Bill. Responding, Earl Howe, the Minister, said he was sympathetic to the amendments, and completely understood their motivation. However, he said that the government already received advice from the UK Advisory Forum on Ageing on steps to improve well-being and independence in later life. The national clinical director for older people, Professor David Oliver, also held regular meetings with organisations such as Age UK and WRVS, he added. In terms of a future health Bill, he said that the government "certainly do not have a closed mind" on the issue of an older people's commissioner.
Jim Dobbin MP followed up on his question of last week to ask the Secretary of State for Health what assessment he has made of the reasons for delayed hospital discharge. Paul Burstow MP said that based on the latest information, about 61% of delayed transfers in October are attributable to the NHS and 32% to social care, with the remaining 7% being attributable to both in October 2011.
He continued that no one should be made to stay in hospital longer than necessary. The NHS and social care must work together to ensure people have the support they need on leaving hospital. The new Clinical Commissioning Groups will bring together general practitioners, specialist doctors and nurses to shape the best joined-up local care for patients, helping to avoid unnecessary delays. The Department has allocated additional funding to help people return to their homes after a spell in hospital-by 2012-13 this will be £300 million per year. This money will help people to leave hospital more quickly and get settled back at home with the support they need.
Jim Dobbin MP quizzed the Minister over how many delayed hospital discharges there have been of (a) under and (b) over 75 years old in each region since May 2010. Paul Burstow MP produced a table providing this information. Most recent figures showed that the Department collects data only on people over 75 years for acute delayed transfer of care and that the figure for the final quarter of 2011 was 1,806, the highest for the year.
Jim Dobbin MP also asked the Minister what assessment he has made of the costs to the NHS of delayed hospital discharge. Paul Burstow MP replied saying that the Department of Health does not collect data on the cost of delayed transfers of care. Data on the number of delays are published each month by the Department.
He added that significant sums of money had been made available in this spending review period to reduce the level of delayed discharges to a minimum. In the last financial year, an extra £162 million was made available to local health and care services to spend on front-line services, and an additional £70 million of funding was available for spend on helping people to return to their homes after a spell in hospital. This money was aimed at helping people to leave hospital more quickly, get settled back at home with the support they need, and to prevent unnecessary admissions to hospital. This year, there is £150 million available for re-ablement and £648 million for social care spend that also benefits the NHS.
Also on Thursday John Hemming MP asked the Health Minister when he expects to publish the Government's response to the Dilnot Commission's report Fairer Funding for All. A reply is expected shortly.
Posted by Steve Smith, Public Affairs Officer at 17:00
Tuesday, 06 December 2011.
Shaping our Age,
Caring for Our Future: Shared ambitions for care and support,
reform of adult social care white paper,
commission on funding of care and support,