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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.

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Our biggest commitment yet to supporting those living with dementia

Dr Allison Smith Dementia is becoming increasingly prevalent in our society, with more and more people affected each year. As an organisation that supports older people to stay healthy and happy, and which helps the NHS, Royal Voluntary Service has a duty to provide the best possible support to enable all older adults to live well whatever their condition.

That’s why this year - our 80th anniversary year - we are making our biggest commitment yet to supporting those living with dementia. We’re doing this by launching a series of new dementia training videos for our staff and 20,000 volunteers who deliver a range of services and social activities in hospital, at home and in the community.

Royal Voluntary Service staff and volunteers already receive thorough and rigorous training, but to deepen our knowledge and critical understanding of dementia, we’ve joined forces with an award-winning and truly inspirational charity, Dementia Adventure. Dementia Adventure is a forward-thinking, innovative organisation that helps people live well with dementia by thinking differently about the condition and connecting them to the outdoors and their community.

Thanks to support from players of People’s Postcode Lottery, we’ve worked together to develop a set of inspirational video tutorials that will equip our staff and volunteers with practical, specialist skills to help those with dementia to live well and get the most out of our services and activities. The videos uniquely include the voices and experiences of those living with dementia.

We know that anxiety and fear of stigma mean that people with dementia sometimes disengage from social activities and their local community. By equipping our staff and volunteers with rich knowledge about ‘what dementia is’, ‘what it is like to live with dementia’ and ‘how we can better communicate with those living with dementia to improve their wellbeing’, we hope that more people with dementia will feel confident and comfortable interacting with Royal Voluntary Service – for instance, by coming along to a local social event or club or to return to an activity or hobby that they enjoyed prior to diagnosis. At the same time, commissioners of hospital, social care or community services can be assured that we have an effective combination of practical and communication skills to support those living with dementia to live well.

There are many misperceptions and myths about dementia, the greatest being that people with dementia are unable to participate fully in life, including enjoying an active social life. We don’t subscribe to that and our highly trained staff and volunteers will be working hard to break down those barriers.

Posted by Dr Allison Smith, Head of Strategy and Development at 13:00 Wednesday, 27 June 2018.

Labels: Dementia

How making health changes could help people avoid Dementia and ill health

As we grow older, many of us become concerned about developing dementia. Especially if we have cared for a parent, relative or friend with dementia, we want to feel like we have the power to change our own fate.

Recent guidance published by National Institute for Health and Care Excellence suggests that there are ways in which dementia might be prevented or delayed by choices we make in our mid-life (40-70’s).

There is no question that leading a healthy lifestyle in your mid-life will have a positive impact on your later years, but the ageing process is not fixed. Some people will experience dementia in their 50’s and others won’t be affected until their 90’s. It’s vital to maintain moderate physical activity and cognitive stimulation on a regular basis to delay frailty, whatever your age.

Volunteering is a great way of staying physically and mentally active post retirement. Many of our volunteers tell us that they have been given a new lease of life, as well as a sense of purpose at time when their social roles are changing.

Social and mental stimulation not only has positive impact on our volunteers but also for the older people they are caring for. Conversation or social stimulation for an older person, who maybe only has one visitor a week, can have a huge impact on their morale and mental wellbeing. And for those living with dementia, our volunteers can provide a break to their partner or family member so they can have some time to themselves for a short while.

As dementia remains high on the health agenda, Royal Voluntary Service is looking at ways in which we can better support those living with dementia and their carers. Alongside our work providing on-ward support for patients with dementia and home support services, we are going to be trialing a new dementia service in Oxfordshire and elsewhere which offer activities that are focused on cognitive and physical stimulation. Together we want to improve the well-being of those living with dementia and their carers.

Volunteering is a great place to start. To find out more about opportunities in your area visit our volunteering section.

Posted by Dr Allison Smith, Head of Strategy and Development, Royal Voluntary Service at 00:00 Monday, 30 November 2015.

Labels: Dementia

Westminster Eye: An insight into the week of politics 26 - 30 March

26 March

On Monday the Secretary of State for Health Andrew Lansley launched the Prime Minister’s challenge on dementia to tackle one of the most important issues the UK faces arising from an ageing population. The challenge sets out the Government's ambition to increase diagnosis rates, raise awareness and understanding and to strengthen substantially the UK’s research efforts. He added that the Government was determined to transform the quality of dementia care for patients and their families. In England today there are an estimated 670,000 people are living with dementia, a number that is increasing with one in three people set to develop dementia in the future. The three key areas where the Government wants to go further and faster and build on the progress made through the National Dementia Strategy. The three areas are:

  • driving improvements in health and care
  • creating dementia-friendly communities that understand how to help
  • better research.

Meanwhile in the House of Lords, Lord Kennedy of Southwark asked the Government what assessment they have made of the Campaign to End Loneliness (CEL) and what action they are taking to support the aims of the campaign. The Parliamentary Under-Secretary of State, Department of Health, Earl Howe, replied saying that the Government is working with the CEL to raise awareness of the problem of loneliness and tackle the factors that cause loneliness and isolation in older people. The department recently co-hosted a social isolation and loneliness summit with CEL to gain a commitment to tackle loneliness and isolation through health and well-being boards, commissioners, local communities, businesses, statutory and voluntary sector organisations. It has also commissioned CEL to produce a digital toolkit for health and care commissioners to combat loneliness and isolation.

He added that the CEL and the Ageing Well programme, funded by the Department for Work and Pensions, have produced a guide for councils on combating loneliness. Representatives from CEL play a key role in the Age Action Alliance. This is a partnership of private, voluntary and public sector organisations jointly led by the Department for Work and Pensions and Age UK.

27 March

On Tuesday The Health and Social Care Bill gained Royal Assent to become the Health and Social Care Act 2012. The core principles of the Act mean that doctors and nurses will be able to tailor services for their patients, more choice will be given to patients over how they are treated, and bureaucracy in the NHS will be reduced.

The Act will:

  • Devolve power to front-line doctors and nurses: Health professionals will be free to design and tailor local health services for their patients.
  • Drive up quality: Patients will benefit from a renewed focus on improving quality and outcomes.
  • Ensure a focus on integration: There will be strong duties on the health service to promote integration of services.
  • Strengthen public health: Giving responsibility for local public health services to local authorities will ensure that they are able to pull together the work done by the NHS, social care, housing, environmental health, leisure and transport services.
  • Give patients more information and choice: Patients will have greater information on how the NHS is performing and the range of providers they can choose for their healthcare. And they will have a stronger voice through Healthwatch England and local Healthwatch.
  • Strengthen local democratic involvement: Power will shift from Whitehall to town hall - there will be at least one locally elected councillor and a representative of Healthwatch on every Health and Wellbeing Board, to influence and challenge commissioning decisions and promote integrated health and care.
  • Reduce bureaucracy: Two layers of management - Primary Care Trusts and Strategic Health Authorities - will be removed through the Act, saving £4.5 billion over the lifetime of this Parliament, with every penny being reinvested in patient care.

Helen Jones MP asked the Communities Minister what estimate he has made of likely changes to the number of pensioners who will take up council tax benefit if localisation of the benefit is introduced. A reply is expected after recess.

Health Oral Questions took place on Tuesday.  Meg Munn MP asked what steps the Health Minister is taking to ensure that people receiving care at home funded by the NHS are involved in making the arrangements for that care. In responding the Social care Minister, Paul Burstow said that the Government’s ambition is to enable shared decision making for all NHS patients. He expected people who are eligible for NHS continuing care funding to be fully involved in discussions about their care. Subject to the results of the current personal health budget pilots, everyone eligible for NHS continuing health care, including many people receiving care at home, will have the right to ask for a personal health budget, including a direct payment, from April 2014.

In her supplementary question Meg Munn MP said that she had received a letter from one of her constituents who has had direct payments for 15 years under social services. Following a stay in hospital, she was moved on to health funding, and her life has changed dramatically for the worse. She says that she no longer has any choice in who cares for her and finds it hard to find the right people with whom she feels comfortable. She asked if the Minister will bring forward measures more quickly, so that people who have been directing their own care under social services can have the same quality of life and the same choices that they have become used to. Paul Burstow agreed and said that the Government needs to ensure that, as soon as possible, the benefits and the control that direct payments give to individuals in social care are available to people in regard to their long-term health care and particularly to continuing health care. It is realistic to say that Government can roll this out nationwide by 2014. He encouraged her to carry on those conversations with the authorities in Sheffield, and with him about the way in which people can use the current arrangements to access those facilities.

Stephen Dorrell MP intervened and asked whether the constituency case raised by Meg Munn did not highlight the increasingly urgent need to achieve much more integration between health and social services, and indeed between different parts of the NHS, in order to provide joined-up care that focuses on patients' needs and delivers better value for money to the taxpayer. Paul Burstow said that Mr Dorrell was right. He added that it is not just a question of delivering more integration within health care-which is often still too fragmented, or between health and social care; it is also a question of recognising that issues such as housing and leisure are critical to the delivery of greater well-being, and to an improvement in the health of the nation. The Health and Social Care Bill gives people in every part of the system a clear duty to collaborate, integrate, and deliver better care for all.

Ian Swales MP intervened saying that his constituent Joyce Benbow was discharged from Redcar Hospital last November, but is still there, owing to a failure to agree on her care package. He asked when would those managing health and social care budgets be more joined up so that people receive the right provision at the right time. In his reply Paul Burstow said that this demonstrated the importance of joining up hospital care, community care and social care, which has often been overlooked. He added that the Government had invested more than £300 million this year in developing more re-ablement services, and in January the Government invested an extra £150 million in support for them. The Government was also extending its plans for more tariff reform to ensure that local hospitals have the means to drive the development of such services in their communities.

Nick Smith MP asked what recent assessment the Minister had made of the performance of services for older people. Paul Burstow saying that a number of inspections, reports, independent audits, and investigations have revealed long-standing and unacceptable variations in the standard of care that older people receive in the NHS, and in social care. The Government is determined to root out poor-quality care wherever it is found. The national Nursing and Care Quality Forum had been established to work with patients, carers and professionals to spread best practice.

Nick Smith’s supplementary focused on the British Geriatrics Society's Quest for Quality report which identified that too many people in care homes were without access to NHS services, including psychiatric, physiotherapy and continence services. He asked what action the Government is taking to ensure that care home residents get the high-quality NHS care that they deserve. Paul Burstow responded by saying that in England, one of the things that the Government is doing is making sure that a programme of special inspections of care homes, conducted by the Care Quality Commission, looks at those issues to ensure that Government provides the right range of support services for people in care homes. In addition, the National Institute for Health and Clinical Excellence has produced quality standards; in particular, it has been working on quality standards relating to issues affecting older people-incontinence, nutrition support for adults, patient experience, delirium, dementia, and many others.

In her question Margot James MP said that Russells Hall hospital, which serves her constituency, has reviewed recent reports, and done its own research, on dignity and care for older patients. It has elevated the qualities of care and compassion to the top of its criteria for recruiting health care assistants. Paul Burstow said that it is important that that is applied to all who have direct responsibility for delivering care, and hands-on care in particular. The work that Russells Hall Hospital is doing on care and respect, and in its responsibility programme, is a good example of that. On issues such as dementia, the Government is clear that it needs to ensure good advice, training and support for all nursing staff. He was working with the Royal College of Nursing on this so that they treat people who have dementia with dignity.

In her intervention Liz Kendall MP stated that the Government is rightly building on Labour's national dementia strategy, and the Minister should know that the dementia crisis cannot be addressed without tackling the crisis in care. She added that the Government had cut more than £1 billion from local council budgets for older people's care, services are being withdrawn and care charges for dementia sufferers are soaring. The Alzheimer's Society and Age UK say that these cuts have pushed the system to breaking point. She asked if the Minister agreed with them. Paul Burstow responded by saying that the Government identified £7.2 billion of additional investment to go into social care over the life of this Parliament, and those resources are being used creatively by some local authorities to protect front-line services. He urged her to applaud the authorities that are doing that and join in condemning those that are cutting services despite being given the resources.

Further on dementia care, Mark Menzies MP welcomed the announcement on support for dementia care. He asked what assurances the Secretary of State could give that this will be an aggressive strategy, looking at matters such as new access to drugs, early diagnosis and support for carers of those with dementia. Andrew Lansley replied saying that not only were there the recent announcements, but as part of that there was the establishment of three sets of champions, including Angela Rippon and Jeremy Hughes from the Alzheimer's Society, working together as champions to raise awareness and understanding, Ian Carruthers and Sarah Pickup as champions on improving treatment and care, and Dame Sally Davies, the chief medical officer, and Mark Walport from the Wellcome Trust, as champions for research. Their objective is specifically, to hold the Government to account, not only for the ambitions set out, but for going further and faster.

Debbie Abrahams MP received a reply to her written question to the Secretary of State for Communities and Local Government on what steps his Department plans to take to evaluate the implementation of the measures contained in its document Creating the Conditions for Integration. Andrew Stunell MP replied saying that the written ministerial statement Creating the Conditions for Integration of 21 February 2012, sets out the Government's approach to enabling and encouraging integration, including the role of exemplar projects. This policy document complements the Government's Social Mobility Strategy and Equality Strategy. Specific projects in 'Creating the Conditions' will be monitored and evaluated against each project's objectives. Integration is predominately a local issue which requires a local response, and therefore evaluation is a matter for local areas.

Diane Abbot MP asked what estimate the Health Minister has made of the number of NHS patients in England who are housebound. Paul Bustow said that the information is not held centrally.

Diane Abbott MP also asked the Secretary of State for Health how many older people were subject to delayed discharge from hospital as a result of malnutrition in (a) 2010, (b) 2011 and (c) the latest period for which figures are available in 2012. Paul Burstow said that the information requested was not collected centrally. He added that delayed discharges occur when a patient is medically fit to be transferred from hospital, but is still occupying an acute bed because of a lack of capacity in the wider system. If a patient is suffering from malnutrition and is not medically fit, they would not be ready for discharge from hospital and therefore could not be counted as delayed.

28 March

On Wednesday Simon Kirby MP tabled two written questions around the subject of loneliness. The first asked what engagement the Department of Health had had with WRVS at the recent Loneliness Summit. The second question asked what steps the Department is taking to reduce loneliness amongst the elderly. On the same day Virendra Sharma MP asked what proportion of the £648 million allocated for primary care trust (PCT) spending on social care was spent on (a) prevention services, (b) communicating equipment, (c) telecare, (d) crisis response services, (e) maintaining eligibility criteria, (f) re-ablement and (g) mental health by each PCT. Answers are expected for all these questions on or around the 16 April.

In the Lords on Wednesday Lord Warner asked the Government how many commissioning support services for clinical commissioning groups are expected to be identified by 1 April 2012; and how many of those are expected to be led by former primary care trust managers. Earl Howe in responding said that work is in hand within primary care trusts (PCTs), strategic health authorities and the NHS Commissioning Board Authority to develop the necessary arrangements to support the new commissioning system. The detailed strategy describing this is set out in the publication Developing Commissioning Support: Towards Service Excellence. Information on the number of emerging National Health Service commissioning support services is not yet available. The leadership of these organisations as at 1 April 2012 is a matter for the PCT clusters. The department does not hold information on PCT cluster staffing arrangements.

Both Houses are now in Easter recess. Both Houses return on 26 April.

Westminster Eye: An insight into the week of politics 27 February - 2 March

Monday 27 February

Paul Maynard MP received a reply from the Minister to his question on what proportion of the Department of Health expenditure was spent on services for the elderly in the latest period for which figures are available. In his reply Paul Burstow said that around 40% NHS acute, mental health, primary care and prescribing by general practitioner is estimated to be spent on people aged 65 years and above. Information by age is not held centrally for other expenditure by the NHS. In addition, adult social care is funded by local authorities, through a combination of central Government grant funding and locally-raised council tax. He added that provisional data for 2010-11 shows that local authority net expenditure on adult social care for people aged 65 and over was £7.42 billion. This represents 50.8% of total net expenditure on adult social care.

Simon Hart MP asked the Minister for the Cabinet Office what estimate he has made of the number of people who are full-time volunteers; and how many such people volunteer for 35 or more hours per

Nick Hurd replied saying that data from the 2009-10 Citizenship Survey suggests that approximately 163,000 people in England and Wales volunteered for 140 hours or more in the four weeks prior to interview-equivalent to 35 hours a week or more. Data are not available to determine if such individuals were full-time volunteers.

Andrew Lansley laid before Parliament the Government response to the House of Commons Health Committee's report Public Expenditure.The Committee's report was published on 24 January 2012.

In its statement the Government said that the modernisation and efficiency challenges it is seeking across health and social care are exceptional; ones that are vitally necessary to secure sustainable and improving services. They are also inextricably linked and mutually supportive. These changes are critical to bringing about a modern care system that is fit to deliver the high quality, responsive, personalised services wanted by people today. As a part of these reforms, the Government is protecting funding for the NHS and allocating additional funding for social care.

Tuesday 28 February

On Tuesday Baroness Gibson of Market Rasen received a reply to her question which asked the Government what steps it is taking to reduce the burden of administration associated with volunteering. Lord Wallace of Saltaire replied saying that the Government is determined to make it easier to volunteer and run civil society organisations by cutting bureaucracy. The Government had set up the Civil Society Red Tape Taskforce, chaired by Lord Hodgson of Astley Abbotts, to identify what stops people giving more time and money to civil society organisations. Their report Unshackling Good Neighbours, makes 17 major recommendations that we are taking forward and Lord Hodgson will review progress in implementing them in May.

Baroness Gibson of Market Rasen had asked a further question over making it easier for employers to release their employees to assist in the voluntary organisations in which they have an interest.

The Baroness Wilcox said that the Giving White Paper made clear that the Government fully supports and encourages organisations making time available for employees to volunteer. The Government has also made its ambitions clear with their commitment to turn the Civil Service into a civic service, supporting civil society organisations. This will encourage civil servants to give time by providing them with opportunities to use their skills and using volunteering as a means of learning and professional development both in terms of gaining new skills and experiences and also better understanding of the impact of government policies on the civil society sector. She added that under Every Business Commits, the Government is challenging businesses to take action on priorities including promoting employee well-being and engaging with communities, with Government committing in return to encourage enterprise and reduce red tape to create the best conditions for businesses to succeed.

Wednesday 29 February

On Wednesday Hilary Benn MP asked the Communities Minister what the average charge was for Meals on Wheels in each English local authority in each year since 2000. A reply is awaited.

Tracey Crouch MP asked the Health Minister what assessment he has made of the quality of annual reviews for patients with dementia and what measures he is taking to ensure that people diagnosed with dementia who are receiving anti-psychotic medication receive regular reviews of their progress. A reply is awaited.

Thursday 1 March

On Thursday during the House of Lords debate entitled “International Women’s Day - Motion to take note” on 1 March Baroness Royall of Blaisdon included WRVS in her closing address for the opposition.

"Earlier this week I was privileged to attend a reception for the WRVS which now has 40,000 volunteers but needs more. When one thinks of the WRVS, meals on wheels and hospital cafes and trolleys come to mind. These are important tasks but the WRVS does so much more to help older people stay independent at home and active in their community"

Baroness Royall of Blaisdon

Westminster Eye: An insight into the week of politics 10 - 13 January

10 January
Both Houses returned on Tuesday 10 January following the Christmas recess.

On 10 Sarah Newton MP asked whether the Department of Health collects data on the number of acute care patients aged over 75 years who are delayed in being discharged from hospital.

During Commons Health Oral questions, the contribution of volunteers was raised. In particular Sir Bob Russell MP asked if there was a conflict between the big society, volunteers and localism if major retail stores are brought into hospitals to the detriment of friends organizations. Paul Burstow replied saying that he was aware that it is a matter of concern that over a number of years some hospitals have chosen not to use the WRVS or friends organisations' services. These decisions have to be made by local NHS trust boards, but the purpose of the strategy the Government published last year is very much to make sure that when the boards make these decisions they are focused on the benefits of volunteering for the volunteer, the organisation and the patients.

In the same session Fiona Bruce MP raised the issue of the benefits of telecare to older people in the north-west of England, where the number of over-65s will grow by 50% and the number of over-85s is set to more than double by 2025. Secretary of State Andrew Lansley responded saying that there were an increasing number of older people in the community and that he wanted to support them to be independent and to improve their quality of life. The whole system demonstrator programme was the largest trial of telehealth systems anywhere in the world. In the three pilot areas of Kent, Cornwall and Newham, it demonstrated a reduction in mortality among older people of 45%; a 21% reduction in emergency admissions; a 24% reduction in planned admissions to hospital; and a 15% reduction in emergency department visits. Those are dramatic benefits, which is why Government is so determined to ensure, over the next five years, that it reaches out to older people who are living at home with long-term conditions and improve their quality of life in this way.

During exchanges over progress on the Health and Social Care Bill Stephen Dorrell MP said that the background of the recommendation of the NHS Future Forum, that a key priority for the future is greater integration between health care and social care a priority that was explicitly endorsed last week by the Prime Minister. He asked if the Minister agreed that the key opportunity in the Bill, through the health and well-being boards, is to drive that agenda, which has been much talked about for many years and actually to start to deliver on that rhetoric. In responding Simon Burns agreed that it is the way forward and Government fully recognised that. Government is deeply committed to achieving that aim, and that is why the Secretary of State has added an extra £150 million to the existing £300 million, to facilitate progress towards it.

Greg Mulholland MP said that care of older people is one of the most pressing issues facing this country. He asked if the Prime Minister would join him in welcoming Age UK's Care in Crisis campaign, which was launched on Monday. He asked whether he will commit to ensuring that the White Paper due in the spring will present a way forward on this vital issue. The Prime Minister paid tribute to the MP and to the Age Concern campaign. There was a huge challenge to rise to and Government wants to do so through the White Paper. There are three elements: the rising costs of domiciliary care, improving the quality of the care that people receive, and addressing the issue of people having to sell their all their assets to pay for care. Government was looking hard at all those issues to work out a way forward that is right for the system, and that the country can afford.

In a written question Andrew Stephenson MP asked what assessment the Department of Health has made of likely savings from using telemedicine technologies in care homes. Paul Burstow replied that the Department has not made any formal assessment of likely savings that might result from using telemedicine technologies in care homes. He added that initial headline findings from the Whole System Demonstrator programme demonstrate that, in the NHS, appropriate use of telehealth can lead to significant reductions in mortality and hospital admissions, leading to efficiency gains. The Whole System Demonstrator programme was set up by the Department to provide an evaluated evidence base on the benefits of telehealth and telecare. He considered that telemedicine also has the potential to offer benefits in care home settings.

Tom Brake MP asked the Home Department when it plans to publish its response to her Department's consultation on ending age discrimination in services, public functions and associations. Minister Lynne Featherstone said that the Government response to the consultation on exceptions to the proposed ban on age discrimination will be published in due course.

The NHS Future Forum published its second set of reports to the Government in which it sets out a series of recommendations to improve the quality of patient care and achieve better outcomes. The Department of Health was able to accept all the Forum's recommendations for Government

The Forum looked at four areas of health policy: the NHS' role in the public's health, information, education and training and integration. Over four months the Forum listened to more than 12,000 people and attended more than 300 events. In this phase, the Forum set out to listen to more patients and carers and sought more input from local authorities, housing and social care providers. Of particular interest were the recommendations on integration.

  • Integration should be defined around the patient, not the system - outcomes, incentives and system rules (ie competition and choice) need to be aligned accordingly
  • Health and well-being boards should drive local integration - through a whole-population, strategic approach that addresses their local priorities
  • Local commissioners and providers should be given freedom and flexibility to "get on and do" - through flexing payment flows and enabling planning over a longer term.

11 January
Greg Knight MP asked the Secretary of State for Health what spending his Department has recently incurred on radio advertisements relating to dementia; and for what reason it has commissioned such advertisements. Simon Burns responded by saying that in the 2011-12 financial year, the Department has spent £276,573 on radio advertising relating to dementia. The advertising formed part of the national dementia: early signs and symptoms campaign, which was commissioned to help more people receive an early diagnosis.

Ben Bradshaw MP asked a series of questions around the rates of admission to hospital for patients over 74 years with a secondary diagnosis of dementia in each primary care trust in England in each of the last 12 months. A reply is awaited.

Jonathan Reynolds MP asked what progress the Minister is making in implementing the recommendations contained in the report of the Dilnot Commission. He also asked if the Minister will consider raising the means-tested threshold above which people are liable for their full care costs to £100,000 and introduce national eligibility criteria and portable assessments for the provision of adult social care. A reply is awaited.

12 January

"That this House notes the recent Quest
for Quality report by the British Geriatrics
Society that suggests many of the estimated
400,000 older people resident in UK care
homes have variable access to NHS services
because of the type of accommodation in
which they live; acknowledges that many
people in care homes are highly vulnerable
with over 40 per cent suffering from
dementia and over 75 per cent living with a
disability; accepts that while NHS provision
to care homes can be excellent there is
considerable unwarranted variation in the
quality of provision, especially around
medications management, dementia and end
of life care; and calls on commissioners and
health service planners to remember their
obligations to ensure that the healthcare needs
of this vulnerable group are adequately met."

On 21 December Baroness Jolly had asked the Government what support and guidance is being offered to pathfinder clinical commissioning groups in commissioning integrated health and social care services. She received her reply on 12 January. In his reply Lord Howe said that pathfinders are receiving national and local development support. With their SHA and PCT cluster, pathfinders are exploring approaches to clinical commissioning, including integration of health and social care. Key to this will be engagement with local authorities and secondary care. The Government’s national learning network allows pathfinders to share learning and best practice. Pathfinders will be authorised to take on their full commissioning functions only when the NHS Commissioning Board is certain that they are ready.

Kwasi Kwarteng MP asked Health Ministers what steps they are taking to reduce the cost of social care provision. Replies are awaited.

It was announced that on 17 January the Health Committee will hold its final oral evidence session on Social Care. The witnesses would be Paul Burstow MP, Minister of State for Care Services, and David Behan CBE, Director General of Social Care, Local Government and Care Partnerships, Department of Health.