The Public Accounts Committee chaired by Margaret Hodge MP recently reported that there had been an 8% real terms cut in spending on adult social care between 2010/11 and 2012/13. This was despite the growing numbers of elderly and disabled people, who are most likely to be reliant on care. As a result care and support is focused on those with the most severe needs.
In addition the Care Act will introduce new duties on local authorities, including a duty to assess carers’ needs and provide support and obligations in respect of those that fund their own care. These new duties are being introduced as local authority budgets become increasingly constrained.
And it’s not just social care that is under strain. Hospitals are under growing pressure too. NHS hospitals ended the last financial year in the red for the first time in eight years, according to official figures, with 26 loss-making trusts reporting a combined deficit of £456.8m.
The number of NHS trusts referred to the health secretary over financial concerns increased almost fourfold in a year, a report reveals. Nineteen were flagged in the financial year 2013-14, compared with five in 2012-13, according to the Audit Commission. Twenty-four clinical commissioning groups (CCGs) were also referred.
Clearly this situation is not sustainable in the long term. Recently the Government announced changes to the allocation of funds through the Better Care Fund. The key change is that £1billion will be paid locally and be linked to reducing hospital admissions. In 2012-13, there were 5.3 million emergency admissions to hospitals, representing around 67 per cent of hospital bed days in England, and costing approximately £12.5 billion.
This change places more pressure on local authorities to draw up plans that do more to tackle the level of hospital admissions. For that reason it is essential that local authorities engage more fully with the voluntary sector in coming up with practical, low cost support that could help achieve this aim. For example, figures published by the HSCIC last month show that older people are the largest group who attend A&E or are admitted into hospital as an emergency following a missed outpatients appointment. A missed appointment can increase the likelihood of a hospital visit or stay by 2-3 times.
Similarly older people who are discharged from hospital after a stay have a 15 per cent chance of being readmitted within a month. This amounts to over 200,000 readmissions a year for the over 75 age group and far exceeds readmissions for the rest of the adult population.
However, we know that Royal Voluntary Service volunteers through our Community Transport services can provide support for older people who are housebound, isolated and have difficulties getting out. Royal Voluntary Service volunteers undertake some 90,000 journeys on behalf of older people. These may be trips to and from hospital or to a GP appointment. Equally, these may be trips to the shops or into town, journeys that enrich lives and really add to the pleasure of day-to-day living.
Likewise we know that that having a volunteer on hand to provide practical support for an older person on returning home from a hospital stay can significantly reduce the numbers of older people being readmitted within a short period of time.
The voluntary sector doesn’t have all of the answers but it can help take some of the strain and relieve some of the pressures that both the NHS and local authorities face.
In response to the Nuffield Trust’s report which asserts that initiatives in place to reduce emergency readmissions aren’t effective in the short and medium term, and that emergency readmissions are rising rather than falling, David McCullough, Chief Executive of Royal Voluntary Service, said:
It is essential at a time of increased pressure on local authority funding and scarce NHS resources that the money available is used in the best possible way, to achieve the guideline reduction in unplanned admissions of at least 3.5 per cent in line with the Better Care Fund. There is a cost-effective solution available in the support that can be offered by the voluntary sector that is very successful in reducing emergency readmissions. Volunteers can provide personalised, practical support which addresses the needs of individuals. We know from our own research that this kind of help has a hugely positive impact on older people’s wellbeing and results in fewer emergency readmissions; readmission rates among people aged 55 and over who use our Home from Hospital scheme in Leicestershire is 50% lower than the national average for older people.
Posted by David McCullough, Royal Voluntary Service chief executive at 11:14
Thursday, 10 July 2014.
In response to today’s survey of adult social services chiefs highlighting concerns that council-run care systems are unsustainable due to lack of funding, David McCullough, Royal Voluntary Service chief executive, said:
We know that increasing pressures on funding, combined with an ageing population, means that councils are being forced to provide more social care with less money but the ADASS survey reveals just how dramatic the cuts have been. However, lack of funding doesn’t have to equate to lack of quality care; there is a cost-effective solution available in the support that can be offered by the voluntary sector and it is vital that more councils utilise the services available to them through the third sector in times of austerity. Volunteers can provide personalised, tailored support which addresses the needs of individuals. This kind of help has a huge impact on older people’s wellbeing and results in them needing less support from social services.
Posted by David McCullough, Royal Voluntary Service chief executive at 00:00
Thursday, 03 July 2014.
Two different things. Many of us will have experience of being alone during various points in our lives and for most some of us perhaps during part of each day but, when I thought about it, I realised that I have never really experienced being lonely. I am fortunate enough to have a partner, close family and friends. I have work colleagues, I attend a yoga class, and I have a two and a half year old grandchild. I simply cannot imagine being lonely.
So I decided to close my eyes and focus hard on trying to see how it might feel for me to be lonely. My first thoughts were; well, I have two cats for company, I can talk to them (actually I do talk to my cats on a daily basis but obviously it is a one way conversation). After I had exhausted the one way conversation with the cats, I could fill in the time with the radio and then perhaps the television.
Then I pictured myself watching TV; perhaps a documentary, a wildlife programme or a gardening programme and I realised that I would want to share that with someone. I would want to turn to another person to discuss what I was watching. That is something of great importance to me, to share my experiences with another.
OK, so I do not have anyone to share this with, what would I do? Well, I would research local activities, groups, clubs etc but how would I go about that without a computer? What if I was also housebound? And then I immediately began to feel isolated and very frightened, deeply saddened and desperately lonely.
Contact is something each and everyone of us has for the majority of our lives; from when we are first born we have contact with our parents, followed throughout our lives by contact through friendships, school years, working life, intimate relationships. We have contact and we also have touch; touch is experienced from birth, being held & maybe breast fed, hugs, kisses. Being dried in a big fluffy towel by my mother is a fond memory for me. Other forms of touching - a pat on the back, a stroke of the hand, shaking of hands - physical contact, are important to most of us.
To be in this world without contact and touch for me would be loneliness.
So how can we ensure that no-one is ever lonely? The fact is we can’t. What we can do in a community is work together, in close partnership, which is something I feel we have here in Dorset.
My role as a Befriending Service Manager for Royal Voluntary Service in Dorset enables me to build good strong working relationships with other local organisations. We currently have 14 befriending schemes across Dorset, over 140 volunteers supporting over 150 older people.
Posted by Tina Damon, Befriending Service Manager, Dorset at 10:05
Tuesday, 01 July 2014.