What we're saying
Find out about the people behind Royal Voluntary Service in our series of guest stories from our volunteers, staff and partners.
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The new ONS statistics on loneliness in older people, published today, paint a stark picture of growing old in Britain today, with almost half of those over the age of 80 feeling lonely. These feelings of loneliness are exacerbated by poor health and living alone, both of which we know increase as the nation ages. Those that feel lonely do fewer day to day activities creating a vicious circle of isolation with older people feeling trapped in their own homes. WRVS comes into contact with older people day in day out whose main company is the TV, and without our volunteers may not see another person from day to day. It doesn't have to be like this. Simple and cost effective solutions, such as befriending, can help tackle loneliness, help older people to stay connected to their communities and prevent unnecessary hospital stays.
The ONS have also today release a report on older people's wellbeing, leisure time and volunteering. With WRVS’ army of 40,000 volunteers, we know well the benefit of volunteering, as do the older people that our volunteers provide a lifeline for. The new ONS data shows that one in five of the over 50s volunteer and links volunteering with higher satisfaction in life. We know through our own research that older volunteers live happier and healthier lives and we see this every day, as over half of our volunteers are in this age group with some still volunteering into their 90s and over the age of 100. However, with an ageing population, this country needs more people to step up and volunteer to make life better for others. So we would encourage anyone thinking of volunteering to take the plunge and get involved!
Yesterday’s confirmation by the Health Secretary revealed that the cap on social care will be set at £75,000 in England. This headline has received a cautious welcome from most quarters. However, the cap cannot be looked at in isolation and at the moment it is still difficult to see how many older people and those entering old age in the coming years will be affected as there are still a number of unknown factors. In addition, boarding and food costs are not included in the cap. The objective is to try and ensure that people living in their own home are not penalised unfairly as they are still responsible for paying their housing costs. These so called “hotel” costs will be capped at £12,000 a year.
The cap won’t take effect until April 2017 and the Government has stated that £75,000 in 2017 is in effect worth the equivalent of £61,000 in today’s prices. The current threshold over which support is not provided is rising from £23,250 to £123,000, a rise of nearly £100,000. This means that more people will be entitled to receive some support for their care albeit on a sliding scale.
The big element missing in all of this is at what level the national “eligibility criteria” will be established. At the moment councils are free to set the criteria at low, moderate, substantial or critical. This perpetuates something of a postcode lottery. As funding has become tighter, an increasing number of local authorities have set their criteria at substantial. At the last count well cover 82% of England’s local authorities were at a substantial level or higher. The level at which this is set will be important calculating how many people will be supported. The higher the eligibility criteria bar is set means that those with lower needs which may prevent or delay more intensive and expensive interventions may miss out.
But the response to Dilnot is not the full answer. Implementation of these changes and those proposed in the Care and Support Bill won’t take effect for over 5 year’s and there is already a shortfall in the funding of adult social care that will increase during this time as local authorities make further savings.
All of this goes to demonstrate that volunteers working within organisations such as WRVS are key in delivering the practical support that older people want, but without the huge bills attached, not just for now, but for the long term.
Paying for care in old age is a significant worry for many people. However, for a large number of people going into a care home is the last resort and most older people would rather live independently in their own homes for as long as possible. Supporting them to do this doesn’t have to have a large bill attached. Practical support provided by volunteers at crucial times, such as settling people back into their homes after a major operation, will be central to us managing demand for health services in lean times. WRVS volunteers bridge that gap through a whole range of practical services, such as supporting older people to continue do food shopping; making sure their houses are warm and cupboards well stocked when they are discharged from hospital or just a friendly face popping in to see them regularly. This support is relatively inexpensive but the rewards are considerable.
Understanding and getting to grips with the opportunities and challenges of an increasing ageing population is one of the key conundrums that the Government and wider society has to currently face.
The pre Christmas House of Lords debate on the place of older people in society highlighted the net financial contribution that older people make to the UK economy, citing the WRVS figure of £40billion benefit in 2010. But it’s not just about finances. Earlier this week in a response to a tabled question, Baroness Warsi said that the Government recognised the importance of the issues facing people in later life and the contribution they make to society, but did not have all the answers. She added that the Age Action Alliance was created in recognition of the need for a radical shift in approach and its vision was informed and driven by older people themselves.
The Lords Committee on Public Service and Demographic Change took oral evidence from Ministers Hunt, Lamb and Webb on Wednesday. In response to questions around what the Cabinet had done collectively to address issues arising from an ageing population, Hunt said that it had taken some good first steps but agreed that there was much more that it could do. He agreed that the ageing population was a nettle that had to be grasped. He saw the 2 biggest issues being the sustainability of the NHS and pension provision. The Committee Chair appeared sceptical; saying that the Committee had not seen much in the way of a coherent long term strategy to look at the scale of the challenges around ageing and that most work undertaken was fiscal and short term in nature.
Early in the week, the Coalition’s mid-term review re-confirmed the Government’s support for the principles set out in the Andrew Dilnot report. But any detail as to how the future costs of adult social care would be met was disappointingly absent. Just a couple of days later to emphasise the urgency, analysis by London Councils estimated that the funding gap for providing adult social care in London will amount to £907m within five years. Councils in London currently spend a third (£2.8 billion) of their total budgets on adult social care and this is set to rise dramatically as the number of Londoners aged over 65 increases by some 50,000 during the next five years.
So in a week when detail was thin on the ground about long term thinking on the future funding of care and for older people more generally, it is clear that there is a major role for the third sector to step up to the plate and take on an enhanced role. But this week there was criticism of the Government from the Chief Executive of AVECO that the potential for charities to transform public services remains largely untapped, with reforms in too many areas either glacially slow, as demonstrated by social care funding reform.
In his response, the Civic Society Minister said that harnessing the spirit of common purpose witnessed in 2012 so that together big social problems could be tackled was a cultural change that won’t happen overnight, especially in challenging economic times. He acknowledged that Britain is blessed to have some of the most generous people and the most innovative charities in the world.
He is right - the spirit is there, in spades. It is estimated that in the UK about 20 million people volunteer in some form. In WRVS alone over 50% of its 40,000 volunteers are over the age of 65. Not only are the volunteers helping older people in a more cost-effective way than through expensive state mechanisms like the NHS, but they are helping themselves to enjoy better mental and physical health outcomes. This is essential as the Government plans its strategies for the future. And WRVS, in celebrating in 2013 its 75th year of civic service, is keen for this message of volunteering to amplify and grow.
As we enter 2013, the many issues that come with an ageing population have never been more centre stage. Keeping with the theatrical theme, even the film industry is getting in on the act with Dustin Hoffman making his directorial debut at the age of 75 with “Quartet”, a film about four friends who reside at home for retired opera singers.
The draft Care and Support Bill published in July 2012 proposes a single, modern law for adult care and support that replaces existing outdated and complex legislation. Comments were requested by the Government by 19 October and a summary of responses was published just before Christmas. The Joint Committee on the Draft Care and Support Bill has already begun to take evidence from experts and has invited written submissions by 11 January as part of this work.
In yesterday’s report by think-tank Centre Forum, Paul Burstow sets out some ideas of how the funding of future care could be achieved by linking winter fuel payments with Pension Credit, reducing the number of recipients from over 12 million to around 3 million, saving £1.5 billion annually. The idea is welcomed by some, but criticised by others and is likely to be controversial. But it does set down an early marker for the ensuing comprehensive spending review that will begin shortly.
In December local clinicians were given the green light to take control of the NHS budget in 34 areas of England shaping the way in which care is delivered for millions of older people in the coming months and years.
The House of Lords Select Committee on Public Service and Demographic Change hold their final evidence session on 9 January, where they will put the questions that have emerged over the course of their inquiry to Ministers Jeremy Hunt MP, Norman Lamb MP and Steve Webb MP. WRVS has been one of a number of organisations that have given oral evidence at hearings over the past few months. The inquiry is the first by Parliament to assess if our society, policies and public services are really ready for the ageing population. The evidence that the Committee has received so far suggests that we are worryingly underprepared.
The outgoing Archbishop of Canterbury Rowan Williams in his final New Year Message centred on the crucial role of volunteers. He said that anyone who had seen the London Games “will have been made aware of the army of volunteers who cheerfully gave up their free time and worked away, without complaint, all hours of the day and night to make these great events happen. They were the key people who translated the Olympic vision into reality for the rest of us.” He recognised that similar acts are happening in many other communities around the country in far less glamorous circumstances. But he also asked the tougher question: what can we all do to join this silent conspiracy of generous dedication?
It is clear that urgent action is required by Government to put in place the adult social care framework that older people deserve and that will be necessary to meet the demands of the 21st century. It has also become clear that Government cannot do this alone.
Earlier this week building on the comments made by Williams, social care minister Norman Lamb said that friends, family and neighbours should all do more to prevent older people going into care unnecessarily. Just before Christmas it was announced that volunteers will soon benefit from a free service which will allow them to re-use criminal records checks time and time again. The move to cut red-tape and reduce the burden on those who give up their time to work with older people is a welcome step. The many tens of thousands that give up their time on a regular basis with WRVS and other organisations to help in their local communities are an essential part of the solution. So not only do we need a new legal framework, but also to devise new and innovative ways to encourage more people, especially those reaching retirement, to continue to contribute. At the same time movement to ensure cooperation and coordination between organisations and authorities is necessary, if we are to be in better shape at the end of 2013.
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
Taking off my Scots bunnet just for now and putting on my English... er... Bowler hat? Top hat? What do folk wear on their heads down south these days? Well, anyway, whatever you wear to declare your Englishness imagine that I’m wearing that because I’m blogging today to talk about social care in England and what the UK’s coalition government are going to do about it, once they have got over the trauma of David Laws departure. If ever there was a story that could use the word ‘rocked’ without sounding wildly inappropriate, this was it. But I don’t have time to go there today. If his replacement, Danny Alexander, MP for Inverness, Nairn, Badenoch & Strathspey (that’s basically the Highlands for you guys) the here-today-gone-today ex- Scottish Secretary, now Chief Secretary to the Treasury, does anything exciting maybe I’ll use his Scottishness as an excuse to blog about him. But moving swiftly on...
OK: there’s a quartet of big headlines under the social care policy heading. There’ll be a Commission on long term care to report within a year, barriers between health and social care will be broken down, theree'll be more use of personal budgets and more use of direct payments. This is set in the context of the rest of the coalition agreement which includes a bigger role for the third sector in public service delivery, help for older people to live at home longer through adaptations and community support programmes (though it doesn’t specify what this will look like in practice), more spending on the NHS, more opportunities for public sector staff (presumably including NHS staff?) to run services themselves using the cooperative model, pensions re-linked to earnings, retirement age up to 66 by 2016 for men and 2020 for women and so on.
So what? Well, anyone with an interest in social care should, while keeping an eye out for the development of all these policies, get off the blocks as soon as there’s an announcement of the Commission chair and get on the blower to him/her to have their say (and if they’re really influential they should be calling the Health Secretary, Andrew Lansley and Paul Burstow MP, Minister of State for Care Services and making some suggestions about who the chair should be). It seems that, while, according to the coalition agreement, the Commission will have to consider both a voluntary insurance scheme and the Wanless recommendations, all other bets are off. The Commission was a Lib Dem policy, the Tories already had theirs worked up, so I guess we can take it that they couldn’t jointly agree on a social care policy or on any of the numerous proposals that have come out in recent years. We know this because if they had, well, they would have said so wouldn’t they?
Commissions are traditionally a way of ‘kicking something into the long grass’, as they say in political circles (i.e. if we talk about it for long enough everyone will forget about it and we won’t have to do anything) but this time the issue is too immediate and important for that, as well as there being a huge question mark over how its paid for. With an ageing population there has to be some sort of change to the English system to make it work for people, which may or may not contribute to solving the country’s economic woes, meaning it will cost the state less, although it really will have to will have to be economically viable if it stands any chance of going ahead. It seems certain that, whatever proposals emerge or are accepted, it will involve greater cost to individuals who need care. Why? Well, Liam Byrne’s (Labour ex-Chief Secretary to the Treasury) note to David Laws (you know who he is) saying "Dear chief secretary, I'm afraid there is no money. Kind regards – and good luck!" might have been flippant but it was basically true. Just how this ends up being squared with the social care budget remains to be seen but squared it will have to be.
But here’s a thought for you: WRVS runs on volunteers and the impact they can have in the social care arena has been made clear in a recent report. We may not run what you’d think of as ‘social care services’ but our services occupy a space very close to them and it’s obvious that if people can stay independent, healthy and happy in their own homes for longer and therefore don’t require NHS or social care services as soon as they otherwise would, pressure on health and social care budgets is eased.
WRVS – and thousands of other voluntary organisations – arose from an initial spark, an upsurge of energy and effort, a passion and a readiness in people to tackle social problems for themselves, to look after each other as opposed to waiting for the government to do it. And in many, if not all cases, such organisations started out without a brass bean in the bank. But they still got on and did things, thanks to voluntary effort.
Now, neither I nor WRVS are suggesting that the state should be let off the hook, to be allowed to do less and less while making us do everything for nothing yet still ratcheting our taxes up (Prime Minister Dave will tell you that’s a fundamental misunderstanding of his ‘Big Society’). No. What I’m suggesting is that if we can recognise that there is a tremendous energy out there for mutual support it needs to be developed in tandem with good state services – whoever delivers those, either the state directly or someone on behalf of the state – to make sure people get what they need and so we can make the best use of our money. If we face massive service cuts because the state hasn’t got the money - and, regardless of the rights and wrongs of how we ended up in this mess and who is really to blame and who will suffer as a result, let’s be clear: the state hasn’t got the money - shouldn’t we be thinking creatively about how the shoulder of voluntary action can best be turned to the wheel rather than ending up being exploited or mistaken for a substitute for paid jobs or, possibly even worse, just being discounted because of a lack of understanding about the potential role volunteers and the voluntary (third, charitable, social enterprise, whatever) sector could, can (must?) play.
I’m not suggesting we can run things like specialist cancer care on wide eyed enthusiasm and people who can manage to be around on alternate Tuesdays and Fridays and, God knows, sometimes even the most straightforward tasks involve hacking through reels of red tape and someone might have to be paid to do that, but there are many services and activities, social care being a good example, which could benefit from much more extensive volunteer involvement. And that energy and willingness is out there.
Look at it this way; if the alternative is saying goodbye to these activities forever or ending up with second rate services, hobbling along with only pennies in their pockets, what have we got to lose?
I have no idea what the form is for bloggers in general but I am aware that some of the most successful (ie widely read and influential) political bloggers are successful because their blogs are constantly current. These folk appear to have either hours of spare time every day or are so mentally – and possibly physically - hyperactive that they can toss off the daily blog as quick as a wink and get on with doing whatever else it is that they do.
The reason I haven’t blogged for so long - fun as it is, and it really is - is because I’ve been struggling to come up for air from under the current stormy sea of work in the actual world. Up in Scotland WRVS is experiencing a mini-flood of visits by Scottish politicians to WRVS services or by WRVS to various public events and it all takes organisation, preparation and of course, some performance on the day/night.
In this last fortnight (that is the last half of March) alone, we have seen:
- The First Minister of Scotland, Alex Salmond MSP, MP, welcome WRVS Chief Executive Lynne Berry – with a supporting cast of Angela Geer, Head of Older People’s Services UK, Margaret Paterson, Head of Older People’s Services Scotland and... er... who else was there, oh yes, me! – to his official residence in Edinburgh, Bute House, to talk about WRVS’ work.
- A visit to visit our Auchinairn lunch club by the Labour leader in the Scottish Parliament, Iain Gray MSP, plus his Scottish Parliamentary colleague, deputy spokesperson on finance and skills David Whitton MSP (don’t let that junior shadow post fool you; Whitton’s one of Labour’s policy-brains and ex-right hand man to two previous Scottish Parliamentary leaders). Hats off to the patient older people who are members of the club and all credit to the volunteers, particularly Eleanor Swann, and to Local Service Manager Jackie Gallagher and Service Delivery Manager Alison Love (I promised I'd include a thanks on the Blog so there it is!).
- WRVS talking about the future of older people’s care on BBC Reporting Scotland TV news and BBC Radio Good Morning Scotland, which for those unfamiliar with the UK’s northern nation is much more like being on the 6 o’clock news and Radio 4’s Today than it is being on ‘North West Tonight’. (Scotland isn’t a region after all, he said, waving his Saltire!
- WRVS at the British Irish Council Ministerial dinner in Edinburgh (that’s representatives of every administration in the British Isles) delivering a speech about volunteering, voluntarism and handing back power to people and communities to better support older people.
- Our tireless Scottish staff continue to help plan what is now approaching a dozen visits by MSPs to our Scottish services to make sure MSPs understand what WRVS is all about in their constituencies and how much our volunteers matter to the places they live.
And since I last blogged we had a phenomenally successful reception in the Scottish Parliament on 10 February that saw around 50 WRVS volunteers, various WRVS staff, including Lynne Berry, Angela Geer, Margaret Paterson and the Scottish Service Delivery Managers, meet and talk to 45 MSPs (making it one of the most highly attended Parliamentary events I have experienced in my eight years working in this field) and a host of public and third sector luminaries about what WRVS does. I measure success here by the number of people who turned up and the fact that they were buzzing about what they’d learned about WRVS.
So while I love blogging, I am not enough of a desk jockey to be able to do it as much as I’d like. After all, if anyone inside or outside WRVS is going to be interested in what we’re up to, we have to be up to something! But blogs are about opinion as well as fact, so next time I'll try to get worked up about something and let rip, right here, with some entertaining invective!