What we're saying

Royal Voluntary Service blog
Find out about the people behind Royal Voluntary Service in our series of guest stories from our volunteers, staff and partners.

Showing 1-6 results

National Audit Office reports on planning stage of Better Care Fund

healthcareTuesday’s report from the National Audit Office on Planning for the Better Care Fund painted a disappointing picture of plans containing misplaced assumptions not backed up with evidence through a lack of engagement with important stakeholders.

As a result, during the summer the process was placed on hold and targets and incentives were redesigned. Plans were not put to Ministers in April as intended because the financial risk to the NHS was regarded as far too great.

Plans have been reworked and last month we learned that 146 of the plans, the vast majority, have been approved, including those requiring further support (91) and some with certain conditions attached (49).

The Better Care Fund now contains some £5.3 billion in funding and exceeds the minimum contribution by £1.5 billion. The amount of credible savings has been adjusted down from £1billion to £532 million made up of reduced emergency admissions (£283 million), reduced delayed transfers of care (£31 million) and increased effectiveness of reablement (£30 million). The vast majority of savings appear to accrue to the NHS.

The main change was to the framework for the £1 billion payment-for-performance part of the Fund. The proportion of the £1 billion linked to performance now depends on the level of the local target for reducing total emergency admissions to hospitals.

We know all too well that there are far too many people being admitted and readmitted into hospital unnecessarily. Over 200,000 older people are readmitted into hospital within a month of discharge. Together the plans aim to deliver over one year an overall reduction in non-elective activity (general and acute) of 163,162 stays. In addition over 2 years the Fund aims to deliver 100,962 fewer unnecessary days spent in hospital, 11,860 older people remaining at home 3 months after discharge and 1,948 more people supported to live independently.

This process has been tough on local authorities. In the past few months local areas would have been preparing to implement the Fund. Instead they were reviewing and resubmitting their plans. This may impact on their performance and therefore ability to hit targets in the early stages of the Better Care Fund which may have a knock on effect on resources.

Joined up health and social care is a laudable and necessary ambition given tight funding and an increasingly ageing population. With the emphasis so strong on reducing hospital admissions, local government believes that the resources to support wider local initiatives to promote integration and prevention will be reduced. Reducing admissions by over 3% when they have risen by 47% over the past 15 years is a very ambitious target.

Providing a degree of focus and direction is a good thing and is an improvement on a vague call to pool budgets. But we must not lose the good initiatives that already exist. The dust is now settling and it is hoped that lessons have been learned and that that the Fund can deliver on its core undertaking “to give elderly and vulnerable an improved health and social system and to join up health and care services around the needs of patients, so that people can stay at home more and be in hospital less”.

Posted by Steve Smith at 11:47 Thursday, 13 November 2014.

Labels: Healthcare, social care, nhs, better care fund, nation audit office, older people, older people health, home care

Conservatives: NHS budget continues to be ring fenced. But is it enough?

David Cameron, Prime MinisterOn Older People’s Day when there are a record level of more than 1 million people aged 65 or over in work, the Prime Minister announced that a future Conservative Government will raise the tax-free personal allowance from £10,500 to £12,500. Furthermore the threshold at which people pay the 40p rate, currently £41,900 will rise to £50,000.

In yesterday’s closing speech the Prime Minister announced his commitment to balance the books by 2018.  To achieve this the Conservatives will need to find £25 billion worth of savings in the first two years of the next Parliament. £25 billion is actually just three per cent of what government spends each year.

On Tuesday Health Secretary Jeremy Hunt announced that the NHS budget would not be cut like those health services in Greece, Portugal or Italy but would continue to be protected and rise in real terms in the coming years.

Political commentators have yet to analyse the content of the speech in detail. However ,it’s become clear that a commitment to £25 billion more in Government savings, whilst maintaining NHS expenditure and giving billions of pounds back in tax cuts is not going to be easy. It will mean some savage cuts to other Government budgets. Local authority budgets have come under a lot of pressure in recent years and this looks set to continue for some time. Many council based services that frail and older people rely on could be put at risk. This will make the work of the voluntary sector all the more important.

The Government argues that the only way to continue to increase spending in the NHS was to have a strong economy. Hunt was keen to stress that the two building blocks to improving the NHS were personal care and personal choice.

The first step towards this is integration of the health and social care system. Hunt pointed to the 150 local authorities working with local NHS partners on Better Care Fund to pool commissioning to reduce emergency admissions.

He added that personal care means more than integration, it needs a response from GPs too and he announced the training and retaining of an extra 5,000 GPs. Key to this personal care was providing better access to GPs. Improved out of ours access to GPs is to be rolled out to 25% of the population and then to all by the end of the next parliament. In time the whole population would have access to GPs between 8am and 8pm and during weekends.

Last year the Government announced that over 75s should have a GP named on their medical record responsible for their care. In the new GP contract for 2015 this is to be expanded so that every single person in England will have a family doctor named on their record and responsible for their care. In addition everyone will have access to their own medical records by April 2015.

There was some good news for older people with pension pots. On Monday Chancellor George Osborne unveiled a new tax cut for pensioners. In a bid for the grey vote, he announced that the Government would abolish the "punitive" 55% tax that is levied when people pass on a pension pot. The change will apply to all payments made from April 2015, and means that people will be able to pass on their pension pot effectively tax-free.

Next up the Liberal Democrats.

Posted by Steve Smith at 00:00 Thursday, 02 October 2014.

Labels: David Cameron, Prime Minister, Conservative Party, Tax Cuts, NHS

Historic chances to health and social care begin this week

The delivery of health and social care has undergone major change to its core structures. Many of the changes have already taken place, but most took effect on 1 April 2013. These changes will have an impact on who makes decisions about NHS services, how these services are commissioned, and the way money is spent.

Primary care trusts and strategic health authorities have been abolished, and other new organisations such as clinical commissioning groups (CCGs) have taken their place. As of this week a total of 211 CCGs are responsible for £65 billion of the £95 billion NHS commissioning budget. All 8,000-plus GP practices in England are members of a CCG, putting the majority of the NHS budget in the control of frontline clinicians for the first time. The groups will include other health professionals, such as nurses.

CCGs will commission most services, including, planned hospital care, rehabilitative care, urgent and emergency care, most community health services and mental health and learning disability services. CCGs can commission any service provider that meets NHS standards and costs. These can be NHS hospitals, social enterprises, charities, or private sector providers.

To add to the mix are health and wellbeing boards; a new forum where leaders from the health and care system work together to improve the health and wellbeing of their local population and reduce health inequalities. Each top tier and unitary authority has its own health and wellbeing board. Board members will work together to understand their local community’s needs, agree priorities and encourage commissioners to work in an integrated way. The intention is that as a result, patients and the public should experience more joined-up services from the NHS and local councils in the future. Local boards are free to expand their membership to include a wide range of perspectives and expertise, such as representatives from the charity or voluntary sectors.

In addition each local authority will have a local Healthwatch organisation in their area. The aim of local Healthwatch will be to give citizens and communities a stronger voice to influence and challenge how health and social care services are provided within their locality. Local Healthwatch will also provide or signpost people to information to help them make choices about health and care services.

Add to this other bodies such as the NHS Commissioning Board, Public Health England and Healthwatch England to name but a few, and it becomes a complex maze to work oneself through. The intention is the make health and social care more integrated and responsive to the needs of the local community. Support for older people such as that provided by organisations like WRVS has never been more necessary given the constraints on central and local Government spending. It is in everyone’s interest to work towards making sure this new system delivers. Time will tell whether the changes bring about the transformation that is urgently required.

Posted by Steve Smith Public Affairs Manager (England) at 00:00 Thursday, 04 April 2013.

Labels: older people, Social Care, Health Care, NHS, welfare, wellbeing, healthwatch

Westminster Eye: An insight into the week of politics 21-25 May

Steve_Smith_Public_Affairs_Manager_EnglandIn the House of Lords during Oral Questions the Earl of Clancarty asked the Government whether they would reconsider their decision to cap income tax reliefs on charitable donations to the arts, universities and other areas. A reply is expected on 14 June.

Minister for Civil Society, Nick Hurd announced a raft of measures designed to encourage more people to volunteer and to make it easier for people to run charities. The steps taken to make it easier for people to volunteer include:

  • a "Volunteer Code of Good Practice" stating that volunteering is not a generally risky activity and setting out simple guidelines that will reduce any risk there might be;
  • guidance from the Association of British Insurers on 'How to run an event' giving volunteers advice on how to arrange appropriate insurance;
  • ABI's "Volunteer Driving - The Motor Insurance Commitment" which has encouraged insurers not to charge additional premiums for volunteer drivers. 66 insurance companies have already signed up, covering over 90% of all drivers. WRVS has over 10,000 volunteer drivers alone; and
  • new legislation the Protection of Freedoms Act 2012 will radically improve the "portability" of CRB certificates so that people can volunteer using the same certificate as they do for employment. This change will lead to a big reduction in the need for repeat checks on the same individual reducing the time and costs incurred.

Monday 21 May

Nick Smith MP received a reply from Paul Burstow MP relating to his question on what systems are in place to minimise the impact of provider failure on users of care and nursing homes. He also asked who is responsible for oversight of the financial viability of private companies that provide care and nursing home services. Paul Burstow said that the responsibility for providing or arranging residential care rests with local authorities, which have specific duties of care to their populations under the National Assistance Act 1948 and the National Health Service and Community Care Act 1990.

He added that the NHS and Community Care Act 1990 gives local authorities the powers to provide or arrange care services for anyone in urgent need. Were a care home to fail, no resident-whether publicly or self-funded-would be left homeless or without care. As commissioners and providers of care services, local authorities have a responsibility to manage the care sector in their areas in order to ensure there is a suitable range of provision available to meet local need.

He reminded Mr Smith that social care is a devolved matter; different oversight and regulatory mechanisms are in place across the United Kingdom. The Care Quality Commission (CQC) has responsibility for the regulation of adult social care in England. As such, it contributes to ensuring the safety and wellbeing of people who use social care services. All providers of regulated activities in England must be registered with the CQC and meet the registration requirements, which are set out in regulations made under the Health and Social Care Act 2008.

He concluded that the regulations included a requirement to take all reasonable steps to carry on the regulated activity in such a manner as to ensure the financial viability of the carrying on of that activity. This requirement does not apply to local authorities or NHS bodies. The CQC can take enforcement action, including cancellation of registration, if the registration requirements are not met. In October 2011, the Department published a discussion paper, "Oversight of the Social Care Market", which outlined the issues facing the social care market and possible options for strengthening oversight of the largest and most complex providers. The Government had considered the responses to the consultation paper and intend to address the issue of market oversight in the forthcoming White Paper on Care and Support.

Hazel Blears MP received a reply from the Minister to her question on what assessment had been made of the effect of not increasing the means test capital limit for residential care on (a) businesses, (b) charities and (c) voluntary bodies in the sector. She had also asked what savings have accrued from maintaining the means test capital limit for residential care at the same level since 2010. Paul Burstow said that the Department had not made an assessment of the effect of not increasing the means test capital limit for residential care on businesses, charities and voluntary bodies in the sector. The decision in the spending review 2010 not to increase capital limits was taken in order to help local authorities, at a time of financial stringency, to maintain the level of services they provide. The spending review 2010 covers Government spending up to April 2015. However, the capital limits were being kept under review in order to monitor the impact of them.

Helen Goodman MP quizzed the Cabinet office seeking information on the estimate that had been made of the change in income of the voluntary and charitable sector in each region of (a) decisions in Budget 2012 and (b) spending cuts in (i) 2010, (ii) 2011 and (iii) 2012. A reply is expected after recess.

Tuesday 22 May

Business and Enterprise Minister Mark Prisk MP urged volunteers from all over the country to speak out against uncaring officialdom - but also to give credit where credit is due if someone has been really helpful. The Government is urging anyone involved in volunteering - from a jumble sale, to organising a Jubilee party, to a three-peaks challenge - can feed in their experiences, good and bad, of dealing with local authorities and other regulators as part of the Focus on Enforcement campaign.

"Volunteers are the unsung heroes of communities in this country. But dealing with the way rules are enforced can sometimes be more of a problem than the red tape itself - no one volunteers to be a bureaucrat. So, whether it's an inspection by someone who won't listen or having to fill in the same form twice - we want to hear about it. I urge you to go to the Focus on Enforcement website and let us know your views so that we can take action. We know there are good regulators out there, so we also want you to tell us on the website about the heroes - people who give really good guidance and help your event to happen well and safely."

Mark Prisk MP
Caroline Nokes MP had asked Health Ministers who will (a) fund and (b) have responsibility for commissioning (i) local and (ii) national enhanced services following the implementation of NHS reforms. Simon Burns MP replied saying that the NHS Commissioning Board will be responsible for funding and commissioning all future primary medical services, including any nationally specified enhanced services under the general practitioner contract arrangements.

He added that the Government also proposes to transfer the funding attached to current local enhanced services to clinical commissioning groups. Clinical commissioning groups will be able to use their commissioning budgets to fund commissioning of community-based services, for which the provider might be a general practice where the service is outside the scope of the general practitioner contract and where the award of such contracts have been undertaken in line with safeguards to protect against any potential conflicts of interests.

Meanwhile in the House of Lords Baroness Finlay of Llandaff tabled an Oral Questions to ask the Government how they plan to implement the recommendations in the report Delivering Dignity A reply in expected on 18 June.

Lord Patel of Bradford had asked the Government whether clinical commissioning groups will be subject to specific duties under the Equality Act 2010. Earl Howe in replying confirmed that Clinical commissioning groups, as public sector organisations, will be subject to the specific duties of the public sector equality duty under the Equality Act 2010.

Baroness Greengross has asked the Government what assessment they have made of spending on adult social care services by local authorities in the last year. A reply is due on 7 June.

Wednesday 23 May

Simon Burns MP replied to MP David Evennett’s question over how many people over the age of 60 received a free eye test. The published table showed the number of NHS sight tests for persons aged 60 and over in England in 1999/2000 was 3.3m and had risen to 5.3m in 2010/11.

Dr Phillip Lee asked what steps the Government is taking to reduce the administrative burdens of volunteering. An answer is due on11 June.

Thursday 24 May

The Prime Minister as part of Dementia Awareness Week, called on up to 30,000 National Citizen Service young volunteers to help people with dementia by giving their time in care homes around the UK. The scheme forms part of a national challenge aimed at raising awareness and understanding of dementia, improving the lives and experiences of people living with dementia and helping make communities more inclusive.

Anne McIntosh MP asked what representations the Government had received on delivering health and social care in the community. Mark Spencer MP asked what steps the Government was taking to reduce the administrative and regulatory burdens that affect the number of people who volunteer. Both questions are due for answer during Oral questions on 13th June.

Jim Cunningham MP received an answer from Health Ministers about the assessment their Department had made of the effect of changes to local government budgets on the cost of placing each patient into care provided by an independent care provider. Paul Burstow responded by saying that the commissioning of adult social care services is devolved to local authorities, and it is for each local authority to negotiate and agree the fees paid to individual providers, reflecting local circumstances. In setting these fee levels, local authorities should have due regard to the actual costs of providing care. He added that the Department does not set or recommend rates at which local authorities contract with providers of care, and has therefore made no assessment of the cost of placing individual care users with independent providers.

In the most recent spending review, the Government had 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.

Chris Skidmore MP asked the Secretary of State for Health how many patients received treatment from the NHS for dementia in each year since 1997. Paul Burstow responded saying that data on out-patient activity for dementia are not routinely collected. However, in September 2011, the NHS Information Centre published the results of an audit of memory services for dementia which showed that 951 people per primary care trust on average accessed memory services in 2010-11, compared to 605 in 2008-09. In-patient admissions for dementia were 29,925 in 1997/98 but had fallen to 17,275 in 2010/11.

Jon Trickett MP asked the Cabinet Office what guidance had been issued to local authorities on how to support voluntary and charitable organisations applying for local authority funding. An answer is due on 11 June.

A number of debates were announced as part of upcoming business and these will be covered in future blogs.

In the Commons on 11 June Ben Bradshaw MP will lead an Adjournment debate on Dementia services in the South West.

Also on 11 June in the Lords Baroness Wheeler will ask the Government what is the timetable for the draft bill to modernise adult care and support in England announced in the Queen’s Speech and to what extent the proposals in the bill follow the recommendations of the Dilnot Commission.

On 21 June Baroness Scott of Needham Market will move that the House takes note of the role of the voluntary sector and social enterprise.

Westminster Eye: An Insight into the week of politics 23 April – 2 May 2012

Last week Michael Meacher MP had asked how much was spent on social care for the elderly, in each of the last 10 years. On 23rd he received his answer from Social Care Minister Paul Burstow. He said that the requested figures collected annually by the NHS Information Centre showed that social care expenditure on older people had risen from £6.17 billion in 2001/2 to £9.44 billion in 2010/11.

Caroline Lucas MP had asked the Health Minister what his timetable is for making regulations and orders under the Health and Social Care Act 2012. Simon Burns MP responded saying that many of the regulations and orders to be made under the Health and Social Care Act 2012 will come into force on 1 April 2013. This is the intended date for the NHS Commissioning Board to take on its full statutory functions; local authorities to take on new public health responsibilities; local Healthwatch organisations to come into being; and strategic health authorities and primary care trusts to be abolished. He added that other changes are planned for different dates; Healthwatch England will come into existence in October 2012, and the health special administration regime for organisations providing NHS services will come into force in April 2014.

Helen Jones MP asked Health Ministers whether they had made an estimate of potential costs to the NHS arising from ill health as a result of (a) falls by and (b) deterioration in existing conditions of adults who will not receive social care because councils have introduced restrictions on the eligibility criteria for such care. In his response Paul Burstow said that the Department had not made an estimate of the potential cost to the NHS arising from ill health as a result of falls. However, it estimated that the annual cost of health and social care for the care of all the hip fracture patients in the United Kingdom amounts to approximately £2 billion.

On the eligibility criteria question he added that the Department did not formally monitor changes to local authority social care eligibility criteria and therefore does not hold information on potential costs to the NHS arising from ill health as a result of existing conditions of adults who will not receive social care because councils have introduced restrictions on the eligibility criteria for such care. Allocations of resources at a local level was the responsibility of local authorities who are best placed to understand the needs of their community. Councils should use the framework set out in the guidance ‘Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care’, to draw up local eligibility criteria. This is graded into four bands:

  • critical;
  • substantial;
  • moderate; and
  • low.

He went on the say that on 11 May 2011, the Association of Directors of Adult Social Services published a survey that indicated that 13% (19) councils had changed their eligibility criteria between 2010-11 and 2011-12, of whom 15 councils moved from moderate to substantial. According to the survey, there are now 78% (116) councils at substantial, 15% (22) at moderate, 3% (4) at low and 4% (6) at critical.

In addition, the Audit Commission's 2008 report: ‘The Effect of Fair Access to Care Services Bands on Expenditure and Service Provision’ found there is no directly observable link between the council's eligibility criteria policy and emergency admissions to hospital.

Nick Smith MP had asked what assessment the Treasury had made of the effect on pensioners of the proposed changes to age-related income tax allowances. Treasury Minister David Gauke MP replied on 24th saying that no on wouldl pay more tax in 2013-14 than they do today as a result of the changes. There were no cash losers. He said that the Government remained absolutely committed to supporting pensioners. He added that the Government had introduced a triple guarantee for the basic state pension, ensuring that it will increase each and every year by the highest of earnings, prices or 2.5%. The Government had also protected other benefits that make a real difference to the lives of millions of pensioners.

In his follow up question Nick Smith wanted to know what the Minister had to say to those who are turning 65 in just under a year's time as they were set to be more than £25 a month worse off than they thought they would be, but they had no time to plan for that change. David Gauke said that those who turn 65 next year would benefit from the biggest increase in the personal allowance that has ever been seen.

Stephen Williams MP said that he was sure that many MPs had received letters from constituents over the years saying that they did not want their taxes spent on one thing and preferred them to be spent on something else. He believed it was right in principle, therefore, that the Government cap the ability of the super-rich to allocate taxes to charities of their choice. He asked the Chancellor to acknowledge, however, that universities and medical research charities have always depended on philanthropic support and in reviewing the cap on tax relief, will he ensure that those institutions' interests are safeguarded. David Gauke was grateful for the support and explained that Government was looking to explore with charities dependent on large donations how this can be implemented without it having a major impact on them.

Tim Farron MP had asked what recent steps the Department of Health had taken to implement the recommendations of the Dilnot Report. In his response Paul Burstow said that Government would publish a White Paper on social care and a progress report on funding reform in spring 2012. The progress report will set out the Government's response to the Commission's recommendations.

Ian Lucas MP asked Business Ministers what discussions they had held with Royal Mail on its concessionary scheme for pensioners to purchase stamps at Christmas. In his reply Norman Lamb MP said that Ministers in the Department for Business held regular meetings with Royal Mail to discuss a broad range of issues, including the scheme to offer discounted stamps to some low income households at Christmas. The pricing of stamps, including proposals for discounts, is an operational matter for the company. However, Ministers were informed of the plans and kept updated on progress.

On 25th Ian Austin MP asked the Work and Pensions Minister what the average value per year will be for a new pensioner no longer entitled to Savings Credit once it is abolished for new pensioners. A reply is awaited.

On 26th Margaret Ritchie MP asked the Chancellor of the Exchequer what estimate his Department has made of the financial effect on charities of his proposal to introduce a cap on tax relief for charitable donations. David Gauke explained that at the Budget 2012 the Government had announced it would introduce a cap on unlimited income tax reliefs to ensure that those on higher incomes cannot use them excessively. He added that the Government will explore with charities and philanthropists ways to ensure this new limit on uncapped reliefs will not impact significantly on charities that depend on large donations to carry out their charitable activities. A consultation document on the detail of the policy, including the implications for philanthropic giving, will be published in the summer.

On 30th the Department of Health published the monthly delayed transfers from hospital figures. The data showed that whilst the actual number of delays was static at just over 4,000 the number of days had increased by around 10,000 to 119,416. A similar jump was seen last year in the same month. Of the delayed days over 76,000 were due to the NHS.

Shadow Health Spokesperson Liz Kendall MP asked what information the Department of Health held on the number of people in (a) England and (b) each local authority who sold their homes to pay for residential care in each of the last five years. On 30th Paul Bustow responded saying that there was no such information. Information about the sale of property to pay for residential care by service users supported by councils is not collected centrally. Local councils may also not know if properties are sold by those who arrange their own care, for example, where a person sells a property and contracts with a care provider privately without the involvement of social services.

During Commons Oral Answers to the Communities and Local Government Ministers on 30th, Grahame Morris MP said that in the national press there had been reports of dramatic increases in bed-blocking. Bed-blocking occurs when patients cannot be discharged from hospital because social care packages have not been put in place by hard-pressed local authorities. He believed that this was now costing the taxpayer about £600,000 every day. He asked if this was not this more evidence of the Government's failed policies on social care in local government. In responding Eric Pickles said that the Government had invested an extra £7.2 million. But he acknowledged that the MP had made a reasoned point. He felt that the reforms in the NHS and giving local authorities more responsibility for health should bring about a much better and much more closely co-ordinated and integrated process. The movement from hospital into care or into a person's home needs to be better organised. The Government would certainly produce a White Paper soon to deal with this. He hoped that it will meet some of the problems that Mr Morris had mentioned.

Adam Afriyie MP had asked the Secretary of State for Health if he will take steps to ensure that primary care trusts consult independent nursing homes when making changes to their payment terms for funded nursing care payments and whether he has recently had discussions with Buckinghamshire Primary Care Trust (PCT) about changes to its payment terms for funded nursing care payments; and whether he has made an assessment of the subsequent effects on cash-flow for independent nursing homes receiving payments from Buckinghamshire PCT. Paul Burstow replied saying that the annual level of the national health service contribution towards the cost of a place in a care home with nursing for those people assessed as requiring the help of a registered nurse is set at a national level. Once the need for NHS Funded Nursing Care is determined, primary care trusts (PCTs) have a responsibility to pay a flat rate contribution towards registered nursing care costs. He added that the Department would not hold discussions with individual primary care trusts about the level of the NHS Funded Nursing Care contribution or local arrangements for administering such payments. Eligibility for NHS Funded Nursing care may be considered when an individual is not eligible for NHS continuing health care and where it is considered that a place in a nursing home is the best option for meeting their needs.NHS continuing health care is a package of health and social care funded by the NHS where the individual is assessed as having a primary health need. NHS continuing health care can be provided in a range of settings including care homes.

Meanwhile in the House of Lords Baroness Greengross quizzed the Government on what action they would take to tackle the risk of malnutrition for disabled and older people who live in the community. In his reply of 2 May, the Parliamentary Under-Secretary of State, Department of Health, Earl Howe, said that there were a number of initiatives in place to help local healthcare organisations develop their nutritional policies. These included the National Institute for Health and Clinical Excellence clinical guideline to help the N HS identify patients who are malnourished or at risk of malnutrition and the "essence of care" benchmarking system, which includes food and drink, and covers health and social care settings.

He added that Government buying standards for food and catering services (GBSF), launched in June 2011, covered nutrition and sustainability aspects of food provision. GBSF is mandatory for central government departments and their agencies. However, local authorities were encouraged to adopt GBSF and, as such, if local authorities are responsible for provision of food in residential/community care settings, they could require them to implement GBSF.

He concluded by saying that the department has published practical guidance to help caterers provide food that meets the nutritional needs of adults working in or in the care of the public sector and is currently developing plans to update previous guidance on food served to older people. While the department can produce best practice initiatives for care, it is ultimately up to local nursing leadership to both ensure and assure the patients, organisational board and commissioners that good care is delivered.

Both Houses are not sitting at present. Prorogation took place on Tuesday. It is the formal name given to the period between the end of a session of Parliament and the State Opening of Parliament. The House will return to hear the Queens Speech on 9th May when the Government’s legislative programme for the next session will be set out.

Posted by Steve Smith Public Affairs Manager (England) at 00:00 Wednesday, 02 May 2012.

Labels: Social care, NHS, healthwatch, nutrition, charity, charitable donations, primary care trust (PCT), philanthropy, older people, health

Westminster Eye: An Insight into the week of politics 20-24 June

A week in WestminsterThe week began on Monday with the Equality Commission on Human Rights publishing emerging findings indicating that older people’s basic human rights are being overlooked in the provision of care at home. In gathering its evidence the EHRC found numerous cases that give cause for great concern.

WRVS issued a swift statement saying that dignity and respect are vitally important in terms of older people’s well-being. The right support can enable individuals to stay independent in their own homes for longer or to return home safely and in a way that gives them the chance to regain their confidence.

Also on Monday the Government set out more detail of its plans to reform the NHS. The response argued that simply doing the same things in the same way will no longer be affordable in future, given the pressures. More of us are living longer and the number of people in the UK aged over 85 has almost trebled over the past 25 years. It is set to double again over the next 20. By 2034, one in 20 of us will be aged over 85.

The Government recognised that better commissioning can improve quality and save money at the same time, for example by helping people to manage their conditions at home and reducing the need to go to hospital.

The Government described a powerful new role for local councils in helping join up the NHS with social care, public health and other local services. Too often, organisational boundaries get in the way of providing seamless care. We want local authorities to be able to work far more closely with the NHS to shape services around the needs of individuals. A new duty would be created for clinical commissioning groups to promote integrated services for patients, both within the NHS and between health, social care and other local services; and we will strengthen the Bill’s existing duty on the NHS Commissioning Board to mirror this.

Meanwhile in the House of Lords, Baroness Turner of Camden tabled a written question asking what steps are being taken to ensure that when local authorities close day centres alternative arrangements are in place to provide services for elderly and vulnerable people and their carers.

In response Earl Howe referred to an answer he had given to an earlier question. He said that the responsibility for addressing the social care needs of their local community rests with local authorities. The Government recognised the importance of social care services and have taken steps to ensure that local authorities have sufficient funds to provide them. In recognition of the pressures on the social care system in a challenging fiscal climate, the Government has allocated an additional £2 billion by 2014-15 to support the delivery of social care. With an ambitious programme of efficiency, there will be enough funding available both to protect people's access to services and deliver new approaches to improve quality and outcomes.

On Tuesday evening during an Adjournment Debate on Volunteering, Andrew George MP praised WRVS volunteers for the wonderful job that they undertake across the country as a whole and particularly in Southend through the trolley services at Southend Hospital and Southend Meals on Wheels. He also admitted to having volunteered with WRVS which coincided with the late Queen Mother's centenary.

Friday saw the monthly situation report from the Department of Health on Delayed Transfers of Care by NHS Provider and Local Authority showing an increase for the month of May. WRVS was quick to react saying “Many independent commentators warned Health Ministers that increases in patient admissions were inevitable as cuts in social care begin to bite. WRVS feels that May’s increase in delays in transferring patients is a critical indicator that Ministers now have to watch.

It is essential that Ministers are ready and prepared to review social care funding once we see the longer term trend emerge and more data becomes available.”

Posted by Steve Smith, Public Affairs Officer at 17:00 Monday, 27 June 2011.

Labels: Westminster, older people issues, human rights, Hospital services, Meals on Wheels, Department of Health, NHS