Westminster Eye: An insight into the week of politics 21 December - 6 January

21 December

Baroness Jolly asked the Government what support and guidance is being offered to pathfinder clinical commissioning groups in commissioning integrated health and social care services. A reply is expected after 12 January.

23 December
The Department of Health published a package of data. This included November’s figures for the delayed transfers of care. In comparison with October, November’s figures showed a drop in delays in total days from 118,664 to 116,572 made up of improvements in both acute and non acute delays. However, numbers of cases were up slightly from 4,196 to 4,215.

30 December
A new survey of care provided by local councils, published by Labour, reveals increases and disparities in charges for services for vulnerable elderly and disabled people.

Councils are increasing charges for:

  • home care: the average hourly charge is now £13.49, a rise of 6% since 2009-10
  • Meals on Wheels: the average charge is now £3.44 per meal, a rise of 13%
  • transport: for example to day centres: the average charge for a journey is now £2.32, a rise of 33%

These increases mean the average yearly cost for an older person who pays for ten hours of home care a week is now £7,015 a year. Older people who also get Meals on Wheels every day now pay an average of £8,271 a year. With transport charges to go to a day centre three times a week an older person now pays £8,633 per year. There are differences in the price people pay for care, depending on where they live. This ranges from free home care in Tower Hamlets to care costing £20.34 per hour in Cheshire East.

1 January
The Department of Health announced that additional sums of money are being made available for social care and housing support. The Department made an additional £150 million revenue available via primary care trusts in order to address delayed discharges, and a further £20 million capital expenditure to add to the Disabled Facilities Grant, making it easier for disabled people to live in their own homes.

"Older people often need particular
support after a spell in hospital to settle
back into their homes, recover their
strength and regain their independence.
This money will enable the NHS and
social care to work better together
for the benefit of patients."

Secretary of State for Health, Andrew Lansley 

3 January
In a letter published in the Daily Telegraph today, a group of more than 60 government advisers, charity directors and independent experts called on the government and the Labour Party to overhaul England's "failing" social care system. The letter follows new evidence last week of rising care bills for families, and costs to the NHS of 'delayed discharges'. It argues that, alongside celebrating the fact that the UK population is living longer, action must be taken to meet the 'unavoidable challenge' of how to support increasing numbers of older and disabled people who need care.

The letter argues that the current social care system is failing this challenge, with serious consequences for society, family life and the economy - leaving older and disabled people at risk, families facing huge care bills, businesses losing staff who are forced to give up work to care for loved ones and the NHS coping with avoidable hospital admissions and 'bed blocking'.

The signatories say that meeting this challenge this will require 'political leadership'. They urge the Prime Minister to 'seize the opportunity' of cross-party talks on the future of social care to 'deliver a social care system which can provide the well-funded and high-quality care and support we would all expect for ourselves and our families.'

In the early part of the week political commentators speculated that the Queens Speech, outlining the legislative programme for the coming year, will take place on 9 May, with a fall back to 16 May if this does not work.

It was reported that three million lives could be improved across England thanks to new high-tech healthcare. After seeing the technology in practice in Cornwall, Care Services Minister Paul Burstow pledged to make it available to more people with long term conditions.

In order to make this a reality, over the next five years the Department of Health will work with industry, the NHS, social care and professional organisations to bring the benefits of assistive technology such as telehealth and telecare to millions of people with long term conditions. Telehealth and Telecare use electronic equipment to read vital health signs such as pulse, weight, respiration and blood oxygen levels, which can be read remotely by health professionals in a different location. It means that people can stay in the comfort of their own homes with the peace of mind that a doctor or nurse will be alerted should there be a problem.

Housing Minister Grant Shapps launched a new deal to help older people to continue living comfortably in their own homes - with particular support for those leaving hospital. With nearly one in five of the whole population expected to be aged 65 or over by 2020, Ministers are determined to ensure elderly, vulnerable people get the help they need to live independent lives, and can be safe in the knowledge that they won't get ripped off by dodgy dealers and fraudsters. Mr Shapps has given £51 million towards Home Improvement Agencies, who will provide help and advice including:

  • housing advice, including help to move to more suitable accommodation if needed
  • handyperson services, including small home repairs, home safety and security adaptations
  • energy efficiency advice
  • arranging for adaptations and home repairs to be made, including grab rails, stair-lifts and major work such as ground floor extensions.

These agencies also offer hospital discharge services - ensuring older people leaving hospital care are given the support they need to be able to recuperate in the comfort of their own homes. He has also announced £1.5 million funding for FirstStop, which provides independent advice to older people looking to plan their future housing needs - whether in their own homes, or in care homes.

A number of bodies including WRVS called on the Government to affirm its commitment to volunteering by making portable Criminal Records Bureau (CRB) checks free to volunteers.

Whilst the Government has confirmed that CRB checks themselves will remain free for volunteers, a decision has yet to be made about the cost of the online system that will ensure volunteers will not have to be checked every time they begin a new role. In the current system CRB checks are free but not portable, but Government risks solving one problem only to create another if in the proposed new system they are portable but not free.

5 January
The King's Fund and the Nuffield Trust jointly called for an ambitious new goal to be set to ensure that delivering integrated care assumes the same priority over the next decade as reducing waiting times was given over the last. The new goal to improve the experience of patients with complex health needs is the central recommendation in a new report published by the two think tanks. The report argues that integrated care - which aims to co-ordinate care more effectively around the needs of patients - is essential to meet the needs of the ageing population and transform the way care is provided to people with long term conditions. The report follows the Prime Minister's pledge earlier this year to make integrated care one of his five key priorities for the NHS.

On the same day it was reported in Thursday’s Guardian that David Cameron has ordered health and social care services to be brought together in order to benefit patients in a move which government advisers are calling the NHS's most urgent overhaul. Reports suggest that the prime minister has been persuaded by senior doctors and Downing Street health advisers that, without integration, the NHS could become unsustainable due to rises in the number of patients with long-term health conditions such as obesity, diabetes and breathing problems.

6 January
Prime Minster David Cameron, made a speech in which he outlined plans to require nurses to make hourly ward rounds and for members of the public to make inspections of wards. Mr Cameron wants nurses to focus on "patients not paperwork" while all hospitals will be expected to implement regular ward rounds "to systematically and routinely check that patients are comfortable, are properly fed and hydrated". This follows a spate of critical reports last year over the levels of care of the elderly in hospitals including by the Care Quality Commission where it found a fifth of NHS hospitals were breaking the law on care of the elderly. Its study also found half of hospitals were failing to provide all-round good nutrition to elderly patients while 40% do not offer dignified care.

So not the usual cut and thrust you would find in the Chamber, but some interesting developments which set the scene for 2012. Both the Lords and Commons return on 10 January.

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