What we're saying
Find out what we're saying - where we share our thoughts and opinions and make comments on issues facing older people, volunteering and preventative care.
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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.
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
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
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
Posted by Dr Ed Bridges, Public Affairs Manager, Wales at 00:00
Monday, 13 August 2012.
The Social Care White Paper
On Wednesday the Health Secretary Andrew Lansley announced the Government’s measures to reform social care in England. In fact a number of documents were published simultaneously; the White Paper, the draft Care and Support Bill, a progress report on the future funding of social care (Dilnot), a response to the Law Commission recommendations and finally a response to the Health Select Committee, not to mention plethora of equality and impact assessments.
Most of the news headlines are about funding. However, there is much to welcome in the body of the text on the document. The new system will:
- focus on people’s well-being and support them to stay independent for as long as possible
- introduce greater national consistency in access to care and support
- provide better information to help people make choices about their care
- give people more control over their care
- improve support for carers
- improve the quality of care and support
- improve integration of different services
The Caring for Our Future engagement exercise has led to the Government taking on board a number of the problems highlighted by stakeholders, including WRVS. For example, too often the system only reacts to a crisis, people do not have access to good information and advice and society does not make the most of the assets embedded in communities. In addition access to care varies from authority to authority. All of these problems are magnified as the population ages and lives longer in the absence of no new thinking.
The Government now fully recognises that not enough is done to intervene early to support people to remain independent and healthy. Failure to support people at an early stage means that many people are needlessly admitted to hospital because they have an accident or crisis and lose their independence. This is wasteful in so many ways.
The White Paper states that loneliness and social isolation remains a huge problem that society has failed to tackle. Up to 16 per cent of older people in the United Kingdom are said to be lonely, potentially leading to poor physical and mental health, including depression. The White Paper also cites that more than a million people over the age of 65 report feeling lonely often or always, and a similar number report feeling trapped at home.
The Government concedes that social isolation is not something that they or services can tackle on their own, but that action can be initiated to recognise and identify the most isolated people. The work led by the Campaign to End Loneliness, of which WRVS is a founder member, has important contribution to make in this area. The 2013/14 Public Health and Adult Social Care Outcome Frameworks, will set out how the Government will measure the effects on well-being of social isolation, and will work with the care and support sector to establish measures of loneliness that help to identify isolation.
Another key policy to retain an older person’s independence is making prevention and early intervention a core local authority role. The White Paper includes a duty on local authorities to commission and provide preventive services in the draft Care and Support Bill. Local authorities will work with their communities to commission support that helps to keep people well and independent. This means that local stakeholder will need to engage with the local commissioners. How this will work in practice and what controls will be in place remains to be seen, but the sentiment is right.
Over recent years eligibility criteria has been tightened, with now over 82% funding substantial or critical needs only. It’s become a post code lottery with a widespread feeling that the system is confusing and unfair. From 2015, the Government will introduce a national minimum eligibility threshold. Once implemented, local authorities will be free to set their eligibility threshold at a more generous level, but will not be able to tighten beyond the new national minimum threshold. Entitlements to care and support will be much clearer and fairer, reducing the variations in access that currently exist between local authorities. The introduction of a national minimum eligibility threshold will help to overcome some of the barriers that people face when they wish to move home.
Many older people are carers too, often to their spouse or a relative. The White Paper sets out plans to identify and support carers by legislating to extend the right to a carer’s assessment, and provide an entitlement to public support for the first time. This will remove many of the limitations in current law and means that carers and people who use services will have equal access to an assessment, with greater consistency in the way that carers are treated.
There will be a ban on age discrimination in health and social care services from October 2012 and dignity and respect will be at the heart of training for care providers.
There is a further desire to give people more control over their care. This means providing them with the correct levels of advice and information in a clear and accessible way. The White Paper makes further commitments to better integration and coordination between health and social care services. A further £300million is being transferred from the NHS to social care by 2014/15 over and above the £2.4billion announced in the 2010 Spending Review to help ease the implementation of the new reforms .
The White Paper is clear that it is not intended to set out a funding settlement for care and support in future years. It believes that the outlined reforms will ensure that resources – from both individuals and the taxpayer – are used in the best possible way to promote people’s well-being and independence. Future decisions on the overall funding in the system will be taken alongside other funding decisions at Spending Reviews.
The Accompanying impact assessment estimates that the costs of all of the measures in the White Paper taken over a 10 year time frame (2012/13-2021/22) amount to £2.112billion. The savings over the same period amount to £178million. This would seem to suggest that a substantial amount of the transfers will be eaten up by the policies in the White Paper unless further tranches of money are made available in future years to ease the transition as local finances remain squeezed and demographic changes continue take hold.
Posted by Steve Smith Public Affairs Officer (England) at 00:00
Friday, 13 July 2012.
David McCullough: "Social care White Paper is a step in the right direction"
Introducing a requirement for councils to invest in preventative practices and early intervention is a step in the right direction. But it is merely a step. As local authorities cut back on non essential services, the White Paper has failed to address the estimated £1billion shortfall that is leading councils to cut these vital services and leave older people vulnerable in their own homes. To turn the rhetoric into reality, the Government must put measures in place to ensure local authorities act on the White Paper advice and commission services that offer a standard of care to older people in their community that will enable them to live life instead of merely exist.
Some councils are already finding cost effective ways to implement support services without damaging the long term health of their communities but others seem to be making knee jerk decisions based on the pounds they will save in the short term without thought for the huge increases in costs they are storing up for the future.
The services WRVS’ 40,000 volunteers provide – a helping hand, a warm meal, a lift to hospital or a chat over a cup of tea – help older people stay independent in their own homes for longer and ensure they remain connected to their communities. Delivered by volunteers, they are cost effective and save lives as well as money for the taxpayer.
WRVS awarded IiV status
We were all delighted to learn recently that WRVS has been awarded Investing in Volunteers (IiV) status. It’s particularly satisfying as we are the largest and most complex organisation to gain the award both in terms of number of volunteers and geographical spread.
The award means that we are recognised as an organisation that appreciates and values its volunteers and is committed to ensuring that we offer meaningful volunteering roles. And of course that people have fun when they are working with us.
We are working towards growing our services so that we can help even more older people live the life they want to and that means we are going to need more volunteers, lots more. So having this award will send a message that WRVS is good at volunteering and it’s a great way to contribute to local communities by getting involved.
Of course IiV status does not mean we are perfect. We don’t always get it right. But there is a commitment across the organisation to be fair and open and to deal with issues that crop up quickly and effectively.
We have spent the last two years producing practical guides for managers on all aspects of volunteering and then working alongside them to make sure they feel confident. This was reflected in the IiV report when assessors visited many of our services to meet with volunteers and staff. Their feedback was brilliant; it’s clear that our people did us proud.
But this is just the start. It’s great to be recognised in this way but we will be continuing to look for ways to improve our volunteering offer and we are already thinking ahead to three years’ time when we will be going for reaccreditation. We have taken on board the points in the final report on areas where we could improve and have put plans in place to address these.
We want to be known as experts in the field of volunteering so that our stakeholders and partners have confidence in what we do. Volunteers are at the heart of what we do and so we will always strive to cherish them and encourage new people to get involved.
Why not volunteer for WRVS?!