Policy News from MHA: April 2018

Welcome to MHA's April policy bulletin

 

This month the prospective funding of the NHS and social care have been in the headlines ahead of the forthcoming Green Paper as well as the issue of ‘personal health budgets’. Parliament has commissioned a Citizens Assembly on Social Care as part of the funding inquiry. The Fundraising Regulator has released guidance on the new audit requirements that come into force this year and the average gender pay gap among charities has been published and is around 8%. 

Government: - Brexit  - Finance and Pensions - Health and Social Care - Workforce and Skills

Highlights of emerging research and policy in other areas of interest:

Ageing and wellbeing: - Wellbeing - Loneliness - Planning for an older population

Dementia:- Care, Support and Wellbeing -

Finance and pensions: Charity finances - Older People's income -

Health and Social Care: Funding and Fees -NHS and Health 

Housing: - Older People 

Third Sector: - Trust and brands - Governance -

Workforce and skills: - Nursing 

Look Ahead: May and beyond: - Events of interest -

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Brexit

  • The UK government has launched a legal challenge to the Scottish and Welsh governments' Brexit bills. The two devolved parliaments passed legislation last month that is intended to act as an alternative to Westminster's EU Withdrawal Bill. But the UK government has asked the Supreme Court to rule whether the legislation is constitutional and within devolved powers. Holyrood's presiding officer has already said he does not believe it is. Lord Advocate James Wolffe, the Scottish government's top legal advisor, argues the bill is competent, and recently took the unusual step of making an address to MSPs on this point. He said the bill was 'carefully framed so that it does not do anything or enable anything to be done, while the UK remains a member of the EU', and that it was 'modelled, in this regard, on the UK government's EU Withdrawal Bill'.

  • The Government has suffered three recent defeats on Brexit in the Lords. One of these sought to require the Government to report on what steps it was taking to negotiate a customs union with the EU as part of the future relationship. Peers voted in favour of this by 348 to 225 votes. Shadow Brexit Secretary Sir Keir Starmer described the vote as an important step forward. "Theresa May must now listen to the growing chorus of voices who are urging her to drop her red line on a customs union and rethink her approach,” he argued. The Government suffered a defeat on another amendment which seeks to limit the Government's powers to amend legislation without primary legislation. The third defeat pertained to what powers ministers would have to amend retained EU law, with peers voting in favour of an amendment which specifies that ministers can only do so when it is necessary rather than when they considered it 'appropriate'.
  • The National Audit Office (NAO) has said the Treasury failed to incorporate aspects of the divorce settlement that were not included in the EU budget, which could raise the cost of Brexit by at least £10bn. Ultimately, the NAO concluded that the “total cost of the settlement cannot be defined until there is greater certainty around future events”.

Finance and Pensions

  • The Welsh Government has announced that people will be able to keep up to £40,000 of their savings before having to self-fund residential care costs. The savings cap has been increased from £30,000 to £40,000 as part of the government’s commitment to increase the capital limit from £24,000 to £50,000 during the current Assembly term. Social Care Minister, Huw Irranca-Davies said: 'This is the second step in delivering one of our top six ‘Taking Wales Forward’ commitments to more than doubling the amount of capital a person in residential care can retain without having to use this to pay for their care.'

  • The Financial Guidance and Claims Bill received its second reading in the House of Lords. Bringing the Bill before the House, Lords Ministry of Justice Spokesperson Lord Keen of Elie asserted that the Bill would make 'important changes to our personal injury compensation system', by making it “fairer, more certain and more sustainable in the future for claimants'. It would reduce insurance costs by clamping down on bogus claims and implement a new, more transparent system. Speaking for the Opposition, Shadow Justice Spokesperson Lord Beecham evidenced that the number of personal injury claims made in the UK was falling, and that costs were lower than the European average. The Opposition also called for greater action to be taken against claims management companies, which he described as 'a parasitic growth in our justice system.'

    During the report stage of the Financial Guidance and Claims Bill, Ministers inserted an amendment that would enable the Financial Conduct Authority (FCA) regulations to require trustees of a personal pension scheme who received an application from a member to access or transfer their pension to refer to single financial guidance body (SFGB) guidance and explain its nature and purpose. It would prevent them from proceeding until the member confirmed whether not they had received any guidance or wanted it. An amendment was also accepted that ensures the provider of pensions guidance are clear, impartial and providing appropriate advice, allowing individuals to opt-out of advice should they wish.

Health and Social Care

  • Norfolk County Council has agreed to investigate whether more care home residents have been incorrectly charged a top-up fee, after one family’s complaint was upheld by the Local Government and Social Care Ombudsman. When the family placed their mother in a care home, and needed to sell her house to pay for her care, the council should have offered the woman a so-called ‘affordable’ care home. This would not require the family to pay a top-up fee above what the council would contribute, for 12 weeks while the home was being sold. Instead, the Ombudsman’s investigation found the council charged the family for those 12 weeks, wrongly arguing that because the woman’s capital, including her property, was above the £23,250 threshold, it did not have to offer her an affordable placement. The council has waived the fee, and has agreed to check if they have charged other people in the county in error.

  • Responding to the Joint Committee on Human Rights’ inquiry on Deprivation of Liberty Safeguards, Margaret Willcox, President of the Association of Directors of Adult Social Services, (ADASS) said: ‘One of the most difficult challenges we face in adult social care for people who lack the capacity to make particular decisions for themselves, is balancing the provision of effective care with ensuring we protect the liberty of the individual concerned...... The change of name for the proposed scheme is helpful as it shifts the focus to protecting the individual’s liberty, encouraging a more personalised approach to meeting their needs...... It’s essential that the Government takes the opportunity of the upcoming social care green paper to promote more personalised care whilst also delivering the long-term funding solution that social care so desperately needs.

  • The Local Government Association has published Integrated Commissioning for Better Outcomes: a commissioning framework 2018 today. A joint project of the LGA and NHS Clinical Commissioners, it was developed from the Commissioning for Better Outcomes Framework 2015 and has been updated to better reflect the changing commissioning landscape. The framework was developed in consultation with NHS and Local Authority commissioners and tested in workshops across seven NHS/Local Authority areas. The ICBO standards will support local health and care economies to strengthen their integrated commissioning for the benefit of local people. Whilst the standards are primarily designed for use by commissioners in adult social care and the NHS, it is hoped that providers of services, people with personal budgets and other stakeholders are also engaged with locally when the standards are used to drive improvement.

  • See the Health and Social Care section for more policy and research news

Workforce and Skills

  • Social Care Wales and their partners, including the Welsh Government, recognise that the volume of care at home needs is increasing and individuals' needs are becoming more complex. They therefore plan to provide better support to this workforce, through workforce regulation, providing new guidance and resources, developing new qualifications, as well as launch a long-term campaign to attract and recruit people to the care sector. As a first step, the Register of Social Care Workers will open to domiciliary care workers later this month. Gerry Evans, Social Care Wales' director of regulation and intelligence said: 'There are excellent domiciliary care workers providing great care across Wales, but expectations are increasing for them to meet more complex needs. We believe regulation protects workers by clearly setting out standards and training requirements.' It will be compulsory for home care workers to register by April 2020. Social Care Wales, alongside the Welsh Government, are committed to ensuring high standards of care across Wales and to support the workforce to provide the best possible care. This month, the Welsh Government also introduced new requirements to ensure care workers are treated fairly. They involve curbing the use of zero-hours contracts and ensuring people’s care and support time is not eroded by travel time between visits.

See the Workforce and Skills section for more policy and research news

In brief:

  • Following Amber Rudd's resignation, Sajid Javid has been appointed Home Secretary and James Brokenshire has been appointed as the Secretary of State as Housing, Communities and Local Government.
  • Environment, Food and Rural Affairs Secretary Michael Gove announces that the Government will ban "the sale of plastic straws, plastic stirrers and plastic-stemmed cotton buds". He also declares that 'it’s time to show we can create a better future for the planet.'
  • MHA comments: This is an important issue and MHA will be contributing to the Government's consultation on single use plastic.
  • Current funding arrangements from Welsh Government will not cover the expected increases in cost and demand facing social care, the Welsh Local Government Association warns today. A joint report by WLGA and ADSS to the National Assembly for Wales’ Finance Committee estimates that next year’s additional pressure of £99m in social services will become £344m by 2021-22, due to unavoidable direct and indirect increasing workforce costs coupled by an ageing population in need of social services.
  • Ministers are, in amendments to the Data Protection Bill, seeking to strengthen the powers of the Information Commissioner's Office in the wake of the Cambridge Analytica scandal. It is understood that the powers in question pertain to Commissioner Elizabeth Denham's ability to carry out inspections on firms suspected of being involved in the illegal harvesting of data. 

 

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Ageing and wellbeing

Wellbeing

  • Individuals underestimate their chances of survival through their 50s, 60s and 70s, which could potentially hinder their ability to plan their retirement. As individuals are given more control over saving for retirement and use of pension wealth, their ability to plan for the future is increasingly important. In a new report, funded by the IFS Retirement Savings Consortium and the Economic and Social Research Council, IFS researchers draw on a data set to investigate individual survival expectations and their relation to health, wealth and other individual circumstances. Comparing subjective (reported) expectations of survival with official (ONS) life table survival rates, researchers reveal large and systematic biases in individuals’ expectations. They find that:

             Individuals from a range of ages underestimate their chances of survival to ages 75, 80 and 85, on average. Those in their 50s and 60s underestimate their chances of survival to age 75 by around 20 percentage points and to 85 by around 5–10 percentage points. For example, men born in the 1940s who were interviewed at age 65 reported a 65% chance of making it to age 75, whereas the official estimate was 83%. For women, the equivalent figures were 65% and 89%.

             Individuals in their late 70s and 80s overestimate their chances of surviving to ages 90, 95 and above, on average. This optimism becomes larger at older ages (10–15 percentage points when looking at age 95) and is larger for men than for women. For example, men born in the 1930s who were interviewed at age 80 reported a 32% chance of making it to age 95, whereas the official estimate was 17%. For women, the equivalent figures were 37% and 24%. 

Loneliness

  • Young adults are more likely to feel lonely than older age groups, says a study from the Office for National Statistics. The research found that almost 10% of people aged 16 to 24 were "always or often" lonely - the highest proportion of any age group. This was more than three times higher than people aged 65 and over. The research from the ONS, based on a survey of more than 10,000 adults, found that about one in 20 people always or often felt lonely. Although there has been much focus on the isolation of elderly people, this study found that younger adults were the most likely to report feelings of loneliness although that may be a generational attitude difference to reporting/ or perceived complaining about feeling lonely. ONS also found that women reported feeling lonely more often than men. Those single or widowed people were at particular risk of experiencing loneliness more often. People in poor health or who have conditions they describe as “limiting” were also at particular risk of feeling lonely more often. 
  • MHA comment: This chimes with our own research prior to our Good Deed-cember campaign which found younger people were more likely to report loneliness. Our Live at Home schemes provide opportunities for inter-generational projects and volunteering, helping to benefit all generations involved. 
  • A former pub in Leeds has been transformed into a busy ‘Welcome in centre’ that aims to reduce isolation, improve wellbeing and bring the community together. The centre runs a programme that brings together older people and school pupils to play games and socialise, increasing social contact between different age groups and building a stronger community.
  • Ambition for Ageing's new report calls for more research into the experiences of older Black, Asian and Minority Ethnic (BAME) people in Greater Manchester in order to tackle social isolation. The report, calls for researchers, policy-makers and service-providers to consider the challenges facing older people both now and in the future, their families and the communities in which they live. Current research shows that social isolation takes on different forms according to a range of factors and may be influenced by an individual’s ethnic background. Researcher Camilla Lewis said: 'Minority ethnic groups often experience a greater number of health, economic, and social inequalities compared to white groups. Such inequalities accumulate over people’s lives, increasing their vulnerability to social isolation in later life. But it is important to acknowledge differences within and across BAME groups. The risk of social isolation is not the same amongst all minority ethnic groups.'

Planning for an older population 

  • Older people’s housing needs will be addressed by Manchester School of Architecture researchers as part of a project to make Greater Manchester the UK’s first age-friendly city region. New research will help local areas understand what housing they have and where older people are living, to help inform what housing an ageing population might need in future. The Centre for Ageing Better grant has been awarded for researchers to use an area of Greater Manchester to take a detailed look at the type of housing older people live in. This will examine factors such as tenure, size, condition, and accessibility and adaptability. They will also use local data to highlight the characteristics of different ‘types’ of older people – such as their income, health and social connections. This analysis should provide insight into the different housing choices made by three groups of older people – ‘lifestyle movers’, ‘planned movers’ and ‘crisis movers’. By identifying the different needs of each group at a neighbourhood level, this research aims to support local areas to identify and respond to the diverse needs of their older population. 

  • Recently delegates from 23 countries came together focusing on a wide range of agendas, culminating in a shared understanding ofAgeing in Common. This….was a real opportunity to look at the issue of ageing across the globe, determine shared expectations and come together to form some unified action. There were two main themes that came ouf of the event. One focused on getting the skills and experiences of older people recognised and the other was how social care can help improve and promote older people’s independence and contribution.

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Dementia

Care, support and wellbeing

  • Thinking Differently: Preparing to Implement Future Dementia Treatments, a new report from Alzheimers UK, provides recommendations for the NHS and other key stakeholders to act now to strengthen the UK health-care infrastructure in anticipation of approval of a safe and efficacious therapy for Alzheimer's disease. Although the trials have yet to report, building appropriate infrastructure within the NHS now could allow patients access to a new treatment sooner and also improve their quality of life, as well as reduce the burden on the health-care system and social care. Alzheimer's Research UK commissioned the London School of Economics to model the anticipated impacts of five scenarios that might result from approval of an effective drug for Alzheimer's disease. Each scenario reflects combinations of interventions at different stages of disease, patient characteristics, diagnostic tests required, and anticipated treatment effects. The effects on patient quality of life, savings due to treatment (a combination of health-care, social care, and informal care costs), and cost of diagnosis were determined. 

  • Older people’s housing and care charity, The Abbeyfield Society, has become the first organisation in the UK to receive accreditation from a pioneering dementia music programme. Abbeyfield’s ‘Making Music Project,’ funded by The People’s Postcode Trust and delivered using tools and training developed by Playlist for Life, aims to document how personally meaningful music can ease dementia symptoms for those living with the condition. April Dobson, Head of Dementia Innovation at Abbeyfield, and project lead, said: “The project has really been such a success and, in conjunction with the People’s Postcode Trust and Playlist for Life, we have been able to use music to connect with people living with the condition.

  • MHA comments: We are well aware of the benefits music can offer to people living with dementia. Our Music Therapy service helps care home residents with dementia to re-connect with those around them. Our recent research reveals that it leads to 'moments of joy' for residents, care staff and relatives and will inform our forthcoming campaign around Music Therapy for people with dementia.
  • Dementia patients should have location finding devices – like GPS trackers – so that family carers and the police can locate the person in an emergency if they get lost, according to researchers. They said introducing such devices at a time when a person with dementia was still able to appreciate the benefits and were able to get used to it, so it became habit, could save lives. They noted that about 25,000 dementia patients will get lost repeatedly, doubling their risk of admission to long-term care, and half who went missing repeatedly for more than 24 hours died or were seriously injured. Their study, funded by Alzheimers Society, brought together people with dementia, their families and carers with police officers, charities and researchers, to assess the need and impact of GPS trackers.Part of the research involved talking with people with dementia while they were out walking in the community using their location-finding device, as well as sit down interviews with family carers.

  • MHA comments: This technology has the potential to alleviate concern for relatives, whilst enabling people living with dementia to go out and about indepentently, but it could provide an ethical challenge around privacy and consent so needs to be considered carefully. 

  • Muscliff Care Home in Bournemouth has installed the Tovertafel (‘Magic Table’ in Dutch) in its care home following an overwhelming reaction from residents. This award-winning innovation comes from the Netherlands, which is renowned for its cutting-edge approach to dementia care. The Tovertafel uses light projecting images onto a table from above, such as beach balls and flowers and it contains a series of activities for people living with mid to late stage dementia. It has been designed to encourage instinctive participation, inviting engagement and stimulating a level of physical and social activity rarely seen in people living with dementia in the later stages of their journey. Dedrey Charles, the Matron at Muscliff Care Home, said: “The Tovertafel has provided accessible games to the residents at different level in their dementia journey in a safe environment. We find the use of the magic table very stimulating through play.”

  • A study links the long-term use of some drugs with a higher risk of dementia. In England, 1.5 to two million people are likely to be taking anticholinergics for depression, Parkinson's and bladder problems. University of East Anglia researchers found more cases of dementia in patients prescribed larger quantities of particular anticholinergics. But experts said patients should not stop taking them, as their benefits may outweigh any risk. The study found no risk with other anticholinergic medicines used to treat common conditions such as hay fever, travel sickness and stomach cramps.

  • All people with a dementia diagnosis are being given the opportunity to participate in advance care planning. This is set out in a new guide for health and social care professionals.  My Future Wishes: Advance Care Planning (ACP) for people with dementia in all care settings provides signposting information and support and is available on the NHS England website.
  • The basic human rights of some of the most vulnerable older people are in danger of being neglected as local authorities opt for low cost options when allocating care home placements, argues Age Cymru.The charity has had a significant number of calls from desperate families saying they can’t afford top up fees for a loved one to move into a care home that has the capabilities to provide appropriate care. With some care homes charging up to £1,200 a week, families are being forced to accept care homes that are not capable of dealing with complex needs such as advanced dementia. The charity has heard from families who feel that inappropriate placements have led to an already vulnerable older person deteriorating even further. Sometimes the local authority will have to use a care home that is more expensive than their usual rates simply because of the lack of places in the area or because the older person may require additional specialist support.  Under such circumstances the local authority should agree to meet the extra cost and not pass the burden on to the older resident or their family. However, the charity has heard of several cases where local authorities are not always clear about the top-up-fee arrangements, or may be requesting them in inappropriate situations, leading to some families facing a very large and unexpected bill. Age Cymru’s Interim Chief Executive, Victoria Lloyd says: 'Welsh government guidance clearly says that care home residents should not have to ask their families to make top-up payments if they have moved into a more expensive home out of necessity, rather than personal preference.Top-up fees should only be applied where the resident has made a choice to move somewhere more expensive and both they, and their family, are clear about the financial implications.'
  • Over the past three decades the average age at which patients are diagnosed with dementia has increased by six years, a study has found. The findings suggested that people were developing the disease later and so were living with it for a shorter time. Improvements in the prevention and care of strokes, which can trigger the condition, may partly explain the trend, while other factors such as vaccination programmes, a reduction in lead pollution and better education and nutrition could also be linked.

  • The Older People’s Commissioner for Wales has called for a fundamental change in the way that respite services in Wales are thought about and delivered, following the publication of a new report highlighting the respite experiences of people affected by dementia. The Commissioner’s Rethinking Respite report makes clear that traditional respite services often lack the flexibility that people affected by dementia want and need, and often do not deliver positive outcomes. In the worst cases, respite services that do not meet people’s needs have a negative impact upon their health and wellbeing, and can strip them of their independence. The report also shows, however, that flexible and person-centred respite brings a range of benefits to carers and people living with dementia, and that innovative approaches can often deliver better outcomes whilst offering better value for money.

  • A report, launched by Independent Age, has found that bereavement has a huge impact on older people, including those living with dementia. The report found that:
    · People with dementia are less likely to get good end of life care.
    · Anticipatory grief is a big issue for carers of people with dementia, as it can be difficult to predict when a person with the condition will pass away.
    · Older people who experience a partner's death are up to four times more likely to experience depression than older people who have not been bereaved. 
    · Despite the effect on older people’s mental health following a bereavement, they are less likely to be referred for support

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Finance and pensions

Charity finances

  • As traditional funding streams start to dry up, charities are having to seek new sources of income. It requires courage however, and the bravery to fail. Charities have long been advised to diversify their income streams to secure their future finances. The benefits of diversifying go far beyond simply achieving an income surplus. Diversification also gives organisations the security needed to focus more on long-term strategies and ultimately have more impact for their beneficiaries. But charities often turn to the strategy only after losing their main source of funding. 'They ring us to say ‘we’ve just lost a massive grant; how do we get some corporate support?’ And sadly the answer is that you can’t,' says Steph Taylor, senior advisory manager at the Charities Aid Foundation. Taylor says it takes time for charities to consider their options and between 12 and 18 months to build a corporate partnership or secure a major donation. The process also provides an opportunity though for organisations to increase their brand reach, explore new innovations and broaden their networks, creating further avenues for volunteering, resource sharing and funding.
  • MHA comments:  It’s an interesting time for all charities as increased media scrutiny, GDPR and a more discerning supporter base are leading to more opportunities and challenges in the way we fundraise. It’s more important than ever for MHA to offer our supporters a range of different ways of supporting our work, whether that’s through traditional donations, digital platforms, events, corporate fundraising, major gifts, trusts or legacies.”
  • The best-known charity brands raised £5.1bn in fundraising income from £1.6bn of fundraising expenditure, research carried out by Third Sector has found. The accounts of 157 charities were examined and it was found that those charities had brought in £5.1bn of income from fundraising. In comparison, total income for those charities was £11.4bn and the charities spent £1.6bn on fundraising costs. The accounts that feature in the research were the most recent ones published by each charity on either the Companies House website, the Charity Commission website or on their own websites before a cut-off point of 1 December. Third Sector found that the mean average amount raised through fundraising by a charity was £32.7m, with a median of £13.2m. The mean average spending on fundraising was £10.2m, with a median of £4.1m, the research found. 

Older people's income 

  • Information on volunteering opportunities should be included in government pension information and an Access to Volunteering scheme should be created, according to the House of Lords Select Committee on Citizenship and Civic Engagement.  The report, called The Ties that Bind, says the National Citizen Service should be used to "create a lifelong habit of social action" and be expected to make partnerships with charities.


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Health and Social Care  

  • New laws will allow hundreds of advanced paramedics to prescribe drugs, improving care for patients, speeding up access to treatment and preventing unnecessary visits to hospitals and GP practices. Patients already rely on paramedics to administer live-saving treatment when they become critically ill or are involved in a serious accident. The new laws, which come into force on 1 April, will allow the most qualified and experienced paramedics to also prescribe medication for patients who do not need hospital treatment. Up to seven out of 10 patients seen by urgent care advanced paramedics may need help but do not necessarily need to go to hospital. For example, elderly patients with urinary tract infections, people with back pain who need require relief or asthma patients who could be helped with a course of oral steroids. The changes have been welcomed by the Patients Association and the Sepsis Trust, which said they could save lives. Rachel Power, The Patients Association chief executive, says 'It will make it easier for them to receive treatment at home, eliminate the need to see a second professional in many cases, and reduce the need for transportation into hospital that isn't clinically necessary.  Rather, they will be able to start treatment without delay, which for some will be critical.'

  • Professor Peter Beresford, an expert on the UK social care system has told a House of Commons inquiry that the way people's needs are assessed and care resources allocated needs fundamental reform. He argues that the approach used by local councils to allocate social care resources is fundamentally flawed, resulting in a postcode lottery of care levels around the country and a disempowering and depersonalising service for people. He has submitted evidence to a House of Commons inquiry into social care provision, which will inform a forthcoming government Green Paper on improving care for older people and tackling the challenges of an ageing population. Professor Beresford explains: 'The problem is that the eligibility process is circular – councils develop categories of needs they will fund based on what they can afford. The role of the social worker is to test each person against those categories, rather than assessing and costing all their needs.'

  • Providing care home residents with increased GP access, and continuity of primary care more generally, could help cut hospital admissions, indicates The Nuffield Trust's evaluation of a new service in East London. The service, which was piloted in the Barking and Dagenham, Havering and Redbridge CCGs, offered seven-day-a-week support from 8 am to 8 pm to four nursing homes in the area. It also provided training and advice for care home workers and help from a geriatrician. As a result, emergency admissions to hospital have fallen by 36 per cent, with the largest reductions happening during the last three months of a person’s life, the research shows.
  • Lindsay van Dijk has been appointed as a humanist chaplain at the Buckinghamshire Healthcare NHS trust, leading a team of NHS chaplains and volunteers. Although there are two other humanists among the NHS’s paid chaplains, it is the first time that chaplains in hospitals and hospices will work under a non-religious leader. It is an acknowledgment of the changing religious nature of Britain. Humanism is not the same as atheism, which implies a much sharper-edged conception of identity. Lindsay says that the meat and drink of chaplaincy is emotional healing; the management of personal relationships, which might be called counselling; and divination, or advice about the future. A lot of people don’t have an organised faith, but still have spiritual and emotional needs at difficult times. Often people are trying to make sense of their lives and the situations they find themselves in.'

  • MHA comments: MHA's Chaplaincy team and the care they show to our staff, residents and home communities is incredibly valuable and we hear many possible comments about the services they offer, from people of all faiths and none. 
  • For the first time, health and social care experts say they have developed a “definitive” set of outcome measures and key performance indicators (KPIs) for toileting and containment strategies. The measures and KPIs are based on findings from a study carried out by an expert panel set up by hygiene and health company Essity. The KPIs were launched earlier this month at the 7th Global Forum on Incontinence. The group initially carried out a comprehensive literature review to develop an initial “long list” of possible KPIs. It then distilled this list via stakeholder engagement representing patients, carers, health professionals, policy makers and payers. This work has resulted in a definitive list of 14 KPIs which are deemed relevant and practical for use in the full range of care settings and for health and social care systems to measure.  

  • A study looking at the personal perceptions and experiences of patients, families and healthcare professionals, has highlighted the need for improvement in symptom management in end of life care. The analysis by the Marie Curie Palliative Care Research Centre at Cardiff University has identified several areas of treatment which were often perceived as usually and ideally managed by healthcare professionals, including; pain, breathing difficulties, nutrition, and hydration. As well as anxiety around denial of food and fluids, some carers described instances where there was pressure from healthcare professionals to administer artificial nutrition despite it being against the patient’s wishes. Upsetting experiences of end of life care, including nurses and doctors refusing or seeming “frightened” to provide pain relief, highlight the need for urgent improvements in symptom management, say researchers. 
  • Older people are being put at risk in care homes as the rate of potentially dangerous infections rises, health officials have warned. Three residents in every long-term care facility will have a healthcare- associated infection at any one time, posing a substantial public health threat, a report by the government watchdog Health Protection Scotland (HPS) said. The report indicated that cases of such infections had more than doubled since the last survey in 2010. The prevalence rate — the proportion of individuals who have an infection at any one time — was 5.9 per cent, the survey of more than 2,000 care home residents found, compared with 2.6 per cent at the turn of the decade. The average in Europe was 3.4 per cent.
  • As many as 350,000 NHS patients could soon receive personal allowances of cash to fund their own care under new plans to "put power back into the hands of patients". The initiative will give people with mental health problems, dementia and disabilities the right to select and pay for treatments they want or need, at their own discreition. All funds will be given directly to patients to spend independently, which they'll be able to use on treatment as approved by their GP. Thousands of army veterans and wheelchair users have also been promised the "personal health budgets" - which could amount to tens of thousands of pounds - after complaints that the NHS was failing to support these groups. Ministers believe the measure will improve patient satisfaction with the NHS and harmonise health and social care budgets. Currently, about 23,000 people have personalised NHS budgets, but ministers want to expand the scheme.
  • The Relatives and Residents Association is launching its Keep Smiling campaign to highlight the importance of dental health for older people. As part of the campaign it has produced a handbook and associated video. The handbook has been developed to help anyone caring for older people, whether in residential care or at home, and for people whose dementia or disabilities make them resistant or unable to manage their own mouth and teeth care. In 2017, leading dentists estimated that 1.8 million or more over-65s have an urgent dental problem and that there is an urgent need to improve dental health for older people. Judy Downey, Chair of the Relatives and Residents Association explained what a crucial area of care dental health is, and that it matters not only for good health, but for all aspects of wellbeing and self esteem. 'Older people today are more likely to keep their natural teeth than ever before. They have higher expectations of a healthy mouth and looking good.
  • People have told us they want to feel listened to and involved in decisions about their social care. Here are six things individuals should expect from care services, according to new guidelines. With more than a quarter of a million people living in care homes and 673,000 adults relying on social care support to live independently, it’s vital that people are able to get the best out of social care. The National Institute for Health and Care Excellence (NICE) has developed guidance to help make residents, care recipients and social care professionals understand what care people can expect and how to support people to make decisions about their own care. NICE has set out six key things individuals should expect from social care services:
  • 1. You should be able to live your life with dignity and independence
  • 2. Your care should be planned flexibly around what you want and need.
  • 3. You should understand what types of care are available, and the minimum care you can expect to have.
  • 4. You should have control over how your care is provided and paid for.
  • 5. The staff providing care should develop good relationships with you.
  • 6. Providers of social care should ask you and your family for your views, and use these to train staff and improve services.

MHA comments: These guidelines chime with our MHA values and we welcome the new focus on these areas.

 

Funding and fees

  • Disabled people are being forced to skip meals and sit in cold homes in a climate of benefit and social care cuts, according to new research. Analysis by ComRes on behalf of the Leonard Cheshire Disability charity shows almost a quarter of disabled adults aged 18-65 in the UK missed at least one meal in the last year, while a fifth said they were not able to keep their home warm. Previous studies of disabled people by the Equality and Human Rights Commission and the charity Scope show a considerably higher rate of deprivation than in the general population; in 2017, less than 8% of non-disabled people were in food poverty while those without disabilities have to spend half as much on energy bills as people with health conditions. 

  • MHA comments: As well as alleviating loneliness, our Live at Home Schemes offer regular lunch clubs which provide balanced meals at a reasonable cost and in pleasant surroundings.
  • The Prime Minister’s announcement that the government is committed to a new funding settlement over several years is recognition of the growing pressures facing the NHS and the need to find a sustainable solution according to The King's Fund. Eight years of austerity have taken their toll on patient care and have led Simon Stevens, Chief Executive of NHS England, and Jeremy Hunt, Secretary of State for Health and Social Care, among many others, to argue publicly for additional resources. The Prime Minister’s conversion to the cause reflects the difficulties experienced during the winter in meeting rising demand for care and also evidence of growing public concern about the state of the NHS and prospects for the future.

  • Following Theresa May's announcement that she had accepted the case for a longer-term, and bigger financial commitment to the NHS, the question of how much to pay, and how to find the money still needs to be decided. The Health Secretary, Jeremy Hunt, has appealed to his colleagues for ideas, promising in a letter to all Tory MPs that solutions for the NHS and proposals on social care will be settled by the summer. But a cross-party group of MPs including former ministers, is again urging the government to convert National Insurance into a specific tax for the NHS. That proposal is part of a wider set of principles upon which they would base a commission to look at the health service's long-term pressures, that is being published today. Some people believe that Jeremy Hunt is open to their idea. He has made it plain he accepts there may have to be increases in tax, but hasn't made a commitment or a case for a particular option.
  • Responding to the Government’s announcement of a multi-year funding plan for the NHS, Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said: ‘It’s good to see long-term investment in the NHS, but government also needs to make the same commitment to adult social care which deserves to be given parity with the health service. If the NHS is to celebrate its 100th birthday, then it’s imperative that adult social care is seen as an essential service in its own right and fully funded to future-proof it for the rising numbers of people who need care..... Government needs to give urgent funding to councils to invest in prevention to reduce the need for people to be admitted to hospital in the first place, which will help to reduce costs to the public purse.....government needs to fully plug the funding gap facing adult social care, which is set to be more than £2 billion by 2020.'
  • The NHS needs £50bn more by 2030 in England, a former health minister and leading surgeon says. The prediction, by Labour's Lord Darzi, comes after Prime Minister Theresa May said the government planned to devise a long-term funding plan for the health service. There is speculation this will be unveiled during the 70th anniversary of the creation of the NHS in July. Lord Darzi's report has been supported by both Tory and Lib Dem politicians. IThe report also found that even if the necessary funding was provided for health and social care, ‘radical reform’ would still be required to make it sustainable.
  • Care England has expressed disappointment that the rate of NHS Funded Nursing Care increase announced for 2018/19 of 2% will not meet the huge pressure being felt in the nursing home sector. Care England chief executive Professor Martin Green said: 'Whilst we recognise and welcome that this is an increase in the rate it does not address the current cost pressures for nursing in our sector. What we need to be clear on is that the cost of the rising dependency of nursing needs of residents exceeds the proposed rate rise. The shortage of nurses – over which we have no control – means that recruiting nurses is a costly challenge along with increasing agency costs associated with rising nurse vacancies.'
  • NHS Digital has now announced the seven local areas that will be given a share of £1.4 million to support digitisation of their assessment, discharge and withdrawal notifications (ADWs). The successful local areas are Dorset, Hackney, Lancashire, Wirral, Worcestershire, Hertfordshire and Rotherham. Working with system suppliers, work undertaken will enable the electronic flow of assessment and discharge notifications from the hospital so that they are directly imported in the social care case management systems supporting workflow by care professionals. The current, non-digital systems in place to handle ADWs had been identified by local authorities and their NHS partners as one of the stumbling blocks to the transfer of care from health to social care settings.

  • Care England has called for parity of esteem between the NHS and social care workforce in it's response to the Skills for Care Workforce Strategy Consultation. The underlying theme of the submission is that the development offer to the social care workforce should be proportionate to its contribution to individuals and society in general in equal measures to that afforded to NHS staff. Professor Martin Green OBE, Chief Executive of Care England says: 'Currently the Government spends on average £3,615 on each NHS employee per year on staff development compared with only £16 on each social care employee per year.  We need a level playing field.'
  • Voters are ready by nearly two to one to pay more tax to bolster the NHS. A large face-to-face survey carried out before the winter crisis struck the health service in November has recorded the biggest-ever shift of opinion on the issue. The poll has recorded a jump from 41% support for higher taxes in 2014 to 61% at the end of last year. An even higher proportion, nearly 90% of adults, in England, Scotland and Wales, thought there was a funding crisis. It also found a matching rise in opinions about the quality of NHS care, with nearly three times as many saying healthcare was declining, with most expecting it to get worse still. Only a fifth thought the standard of care would improve.Those willing to pay more into the NHS include 61 per cent of the highest earners, according to the highly respected and long-running British Social Attitudes (BSA) survey.
  • The Chancellor says hypothecation would lead to fall in health spending if recession hit. Philip Hammond spoke out against a special tax to increase funding for the National Health Service despite pressure from cabinet colleagues for a new levy to fund the healthcare system. The UK chancellor set out the traditional Treasury argument against hypothecation, or ringfencing, of tax revenue for specific spending purposes, saying it would result in a decline in spending on the NHS during a recession. However, Mr Hammond did not rule out a wider tax rise that could channel extra funding to the health service. The chancellor’s comments to journalists on the sidelines of the IMF spring meeting in Washington signal that the Treasury is digging in its heels, despite pressure from cabinet ministers — including health secretary Jeremy Hunt — who has called for hypothecated taxes for the NHS.
  • Social care minister Caroline Dinenage has hinted more funding could be made available to prop up the social care system ahead of any long-term reforms that emerge from the green paper. Addressing the Association of Directors of Adult Social Services Spring Seminar yesterday, Ms Dinenage also said she has urged the leadership of NHS England and NHS Improvement to place a greater emphasis on the social care system. During her speech she said she “completely” understood why funding was a big issue for delegates, but highlighted variation across the country in the effectiveness of provision, adding even with 'all the money in the world, we may not necessarily choose to keep doing things the way that we are doing them.'
  • MHA comments: We support the call for funds to plug the gap in social care funding and our Chief Executive was part of a group of providers who raised this as an issue with the Minister for Social Care this week.  
  • A group of people from across the country brought together to consider the best way to fund adult social care in the first citizens' assembly commissioned by Parliament. The Citizens' Assembly on Social Care will be made up of up to 50 people chosen to reflect the makeup of the wider population and builds on Parliament's existing public engagement. It is being set up as part of the inquiry into the long-term funding of adult social care being carried out by the Housing, Communities and Local Government Committee and the Health and Social Care Committee. Over two weekends, the Citizens' Assembly members will hear from expert contributors with different views on how adult social care should be funded, before discussing the issues and reaching a set of recommendations. The findings will be considered by the Committees alongside other evidence submitted to the inquiry, which is aimed at finding the best way of funding social care sustainably in the long term and proposals that will command both public and political consensus. The event takes place in Birmingham on 27-29 April and 18-20 May.
  • Those with the most complex medical needs still face a postcode lottery of getting their full care costs outside hospital paid by NHS ‘continuing healthcare’ funding in England, Which? analysis has found. The latest 2017-18 figures show that there are huge differences between regions when it comes to the proportion of patients whose care costs are fully funded. CCGs for South Reading funded 8.78 patients per 50,000 of the population, while Salford CCG funded 25 times as many at 220.38 per 50,000 of the population.
  • Councils cannot charge people for the first six weeks of intermediate care, the Local Government and Social Care Ombudsman has warned, following an investigation into a complaint about North Somerset Council. The warning comes after a family complained North Somerset Council was not clear about the care home fees they had to pay when a family member left hospital following an amputation. The council claimed that the care the relative received was not intermediate care, but ‘enablement’ and so charged the family. Local Government and Social Care Ombudsman, Michael King, said: “Simply referring to intermediate care by another name does not allow the council to charge for it.
  • NHS and Health
  • The number of hospital admissions due to an older person falling is set to rise to nearly 1,000 a day by the end of the decade, according to figures obtained by the Local Government Association. The forecast has prompted renewed calls by council leaders for more funding for adult social care to invest in cost-effective prevention work to reduce falls, which can have devastating and life-threatening consequences on a person’s health and wellbeing. New research shows that falls prevention programmes run by councils reduce the number of falls requiring hospital admission by nearly a third (29 per cent) and produces a financial return on investment of more than £3 for every £1 spent. The LGA, which represents 370 councils in England and Wales, says that extra government funding for councils to scale up this prevention work to address a rising older population would help the NHS by reducing the need for people to be admitted to hospital after a fall and cut costs to the public purse.
  • The idea of arts on prescription and social prescribing may seem like a new one, but it is actually more than 10 years since UK government policy first referenced linking patients with non-medical support in the community. In the past couple of years, however, calls for the arts to be a core component of social prescribing in the UK have been growing. Last summer, recommendations were put forward by an all-party parliamentary group for CCG’s, NHS trusts and local authorities to incorporate arts on prescription into their commissioning plans and redesign care pathways where appropriate. At present there are a number of arts on prescription programmes operating around the UK – encompassing all kinds of human creativity including seated dance, creative writing, … and object handling in museums. There is a growing body of evidence which shows that different arts being prescribed have a positive impact on a variety of health conditions. One recent review, for instance, reported ten key benefits for those involved in these kinds of schemes. They included self esteem and confidence boosts, physical health improvements, better social connections and the acquisition of new skillsAs we age, we are at risk of experiencing loneliness and social isolation through loss of social networks, as well as facing new limitations as a result of decreasing physical health. Research has shown that participation in arts programmes enables older people to get in touch with others and extend existing networks of support in their communities, helping to alleviate loneliness and isolation.

    Not only does evidence suggest participation in the arts may delay the onset of dementia, but also that it can impact on cognitive functioning, through stimulating memories, and attention. In addition, art-making can improve the mood, confidence and social engagement of people living with dementia, and has been shown to enhance the relationship between the carer and the cared for. Whether it is traditional art lessons, joining a community singing group, or any other creative activity, the evidence is clear: participating in these activities has a positive impact on health and wellbeing.

  • MHA comments: We think social prescribing could be a great way to increase people's well-being without so much dependency on medication but will require funding to accompany it to ensure it can be sustainable. Our scheme in Hull has recently won a tender process to provide a variety of activites under a social prescribing programme and several other Live at Home schemes preovide prescribed activities.
  • The use of virtual reality to help with the exercise programme for patients has been introduced as part of the Better Care Together programme and has already been well-received amongst the patients who have used it. As well as being able to take part in breathing exercises from the comfort of their own homes, helping to avoid visits to hospital or community facilities, the trailblazing use of new technology also allows health professionals to securely monitor the exercise programme  people are using, ensuring that they can be tailored and tweaked as people take part. Dr Muhammad Farhan Amin of the Burnett Edgar Medical Centre on Walney Island in Barrow-in-Furness has introduced the technology as a way of solving two problems: Firstly many people who need to be on this programme are not able to access it, there is a national shortage of the physiotherapy staff needed to put the sessions on. Secondly – if people do some breathing exercises in their own homes – it is impossible for health professionals to monitor them. Dr Amin explains 'Barrow-in-Furness has many people with chronic lung conditions and the best treatment is to take part in a pulmonary rehabilitation programme. Usually this involves going to the hospital outpatient department, but using the latest technology we just need a mobile  phone and a virtual reality headset; and the person is transported to a ‘beach’ where they can interact in an exercise class, get educational help, receive breathing strategies and get nutritional advice.' 
  • Evidence shows getting patients up and about reduces time spent in hospital. Royal College of Nursing members will be taking part in a drive to end so-called ‘pyjama paralysis’ in hospitals. The campaign aims to get patients out of bed, dressed in their own clothes and moving about in order to speed up their recovery. The initiative was announced by the Chief Nursing Officer (CNO) for England last month, and challenges all those who care for older people to get patients up and about for the next 70 days, to mark the 70th anniversary of the foundation of the NHS. The CNO cited studies showing that three out of five older patients in hospital do not need to remain in bed all day, and that doubling the amount of walking while in hospital reduces patients’ length of stay. 
  • In brief:

  • The King’s Fund have launched a podcast into the NHS, social care and all things health policy and leadership. The first one is entitled: The NHS – are you satisfied with your health service?
  • People who have to enter care homes should be able to take their pets with them. At present, vulnerable or elderly Scots are not allowed to take their animals with them if they have to move into supported accommodation.However Scottish Labour has said it would like to see a new approach which would allow people to retain their pets. Environment spokesperson Claudia Beamish said that people should have the right to keep their animals by their sides. 
  • A care home has turned one of its lounges into a full pub - complete with a bar, pool table, darts board, poker area and more - all for residents to enjoy. The Gracewell of Camberley Arms pub officially opened on April 5. Councillor Jacqui Vosper of Rushmoor Borough Council had the honour of cutting the ribbon, along with two residents at Gracewell of Camberley - Bob House and Peter Roberts - and Mel Barden, activities coordinator and Jeorgia Jones, home admissions advisor. Both Ms Barden and Mrs Jones worked hard to create the pub for residents to enjoy. They bought the bar frame and painted it and sourced other materials via charity shops and online stores.
  • CARE home residents are caring for some feathery friends after watching them hatch over the Easter Holiday. Embryo eggs were delivered to Coombe End care home on March 26 in an incubator and by April 4 they had hatched into tiny chicks. The creatures are being doted on by residents of the Orders of St John Care Trust’s home in Marlborough. Home manager, Amanda Palfrey, said:'Coombe End Court wanted to participate in Hatch Watch because it’s about ‘new life’. Residents are amazed and fascinated about how a chick hatches. It brings joy and happiness to our residents, and acts as a form of therapy, bringing back many fond memories from their childhoods.'

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Housing

Older People

  • The population of most UK cities is getting older, which will put further pressure on stretched local authority budgets. British cities have grey weather, grey concrete, and increasingly, grey heads the Centre for Cities argues. People across the country are living longer, and this means the population of our cities are living longer too. On average, most cities are younger than the rest of the country and will remain so. A few cities are older than the rest of the country though and are ageing fast – with big consequences for policy makers. Ageing will change society’s needs, and will require more resources to be spent on pensions, healthcare, and social care. And this will have larger implications for some cities than others. Cities Outlook 2018 offers some insight into population changes in UK cities over recent years. To get a better picture of how ageing will affect different places, however, it’s necessary to dig deeper into the data and to look at the share of the population in each city aged over 65 (notwithstanding the fact that some people work beyond retirement age). 

  • Britain's planning rules are fueling a housing "crisis" for the elderly and disabled which is forcing the frail to live in dangerous conditions, a leaked report by the Equality and Human Rights Commission said. The Commission’s report, due to be released next month, found a "severe shortage of accessible and adaptable housing" with only seven per cent of homes in England offering minimal accessibility features. It warns that local councils are failing to build enough accessible homes to meet demand and were not taking action against developers who failed to comply with regulations. People were also having to wait an average of 22 weeks for home adaptation, with some waiting for more than a year.  

 In brief:

  • It is estimated that the cost of poor housing to NHS is £1.4 billion per year. So, it is in the interests of the NHS to work more closely with housing partners as sustainability and transformation partnerships develop according to The Kings Fund.

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Third Sector 

Trust and brands

  • The recently appointed Chair of the Charity Commission, Baroness Stowell of Beeston, has warned of the lack of public trust in charities following a series of scandals. Baroness Beeston said the public was no more likely to trust charities than "a stranger in the street", arguing "all charities can no longer expect the public to give them the benefit of the doubt".

Governance

  • The Fundraising Regulator has released guidance on the new audit requirements that come into force this year after the introduction of the updated legislation. The guidance, covers new reporting requirements about fundraising practices in charities’ annual reports for the 2017 financial year onwards. The Charities (Protection and Social Investment) Act 2016 requires charities to report extra information provided in agreements between charities and professional fundraisers and to provide extra information in their annual reports on compliance with voluntary regulation, such as with the Fundraising Regulator. Each charity must include a statement in its annual report that sets out the charity’s approach to fundraising activity. Any failure to comply with the charity’s fundraising standards should be included in the annual report, the guidance says, and it should say how fundraising carried out on the charity’s behalf was monitored by the organisation. 

  • The Charity Commission has also introduced changes, to the Annual Return Update. The changes focus on gathering extra financial and regulatory information. These include, amongst others, the number and total value of contracts and grants from central or local government, the number of employees with total employee benefits of over £60,000 and whether or not trustees are paid and if so, by how much.

  • The Fundraising Regulator has appointed the accountant Jill Thompson as a new board member. Thompson, who is treasurer of Breast Cancer Care, will succeed Lucy Caldicott, chief executive of youth organisation UpRising, who has decided not to stand for reappointment at the end of her two-year term in order to stand to be a local government councillor in next month's elections. Thompson is a chartered accountant and has worked as an investment manager. Until recently she sat on the investment committee of the Girl’s Day School Trust. According to her entry on the Breast Cancer Care website, since leaving full-time work in 2005, she has volunteered for a range of different charities and organisations, including fundraising for a local hospice. Thompson has been appointed for three years, will take up the role in July and will be paid £300 per day for about one day’s work a month.

  • The average gender pay gap among charities is about 8 per cent, research finds in favour of men, from the analysis of data from 568 charities. The data is taken from a government website on which more than 10,000 organisations in the private, public and third sectors have published their gender pay gap data, and the analysis focuses on information from the 568 charities identified by the researcher. All organisations with more than 250 employees had to submit their gender pay gap data to the government before last week’s deadline. The research showed the charity sector had a significantly lower pay gap than the private and public sectors, which had reported average pay gaps of 15 per cent and 13 per cent respectively.
  • MHA comments: We are fully committed to equality, and our analysis is very positive with a very small gender pay gap. Our full analysis can be viewed at https://www.mha.org.uk/news_archive/mhas-gender-pay-gap/
  • More than a quarter of charity donors over 40 have left or are preparing to leave charitable gifts in their wills, a survey by the legacy consortium Remember A Charity has found. The group found that 27 per cent of 1,000 donors aged over 40 were intending to leave legacies to charity – the highest level since it began measuring in 2009. Just 9 per cent completely rejected the idea of leaving donations in their wills, down from 13 per cent in 2009. The survey also found that awareness had risen, with 12 per cent saying they were unaware of the option to leave a legacy, compared with 17 per cent in 2009.
  • The National Council for Voluntary Organisations are to develop voluntary sector code of conduct for the voluntary sector. The initiative was announced at the umbrella body's annual conference by Sir Stuart Etherington. The announcement of the initiative comes after the recent safeguarding crisis involving Oxfam and a host of major charities. The code of conduct, which is to be drawn up by Dame Mary Marsh, former chief executive of the NSPCC, is expected to be designed to ensure that the voluntary sector’s values are reflected in the way it behaves and to act as an equivalent to the Nolan principles that apply to holders of public office. It is expected to be similar to the Code of Good Governance in terms of setting out a number of principles that any organisation could pledge to follow, sending a message to the public that treating people with respect is a priority for all charities. The final document is expected to include an overarching set of principles that reflect the aspirations and shared values of all charities, and offer a framework that will help charities to review their own policies and practices and identify where improvements might be needed
  • In Brief: 
  • Charities need to rethink their digital campaign tactics because the existing approaches are ineffective, damage trust and drown out beneficiary voices, a new report has said. The Social Change Agency consultancy interviewed charities, beneficiaries, MPs and digital technology providers to produce the report Lost Voices: Digital Campaigning and the Voices of Lived Experience, published this week. The report argues that, although digital campaigning has enabled charities to mobilise large numbers of people, "many digital campaign metrics of success are geared towards scalability rather than impact". It says that many MPs disregard mass template emails and such campaigns are more effective in terms of allowing charities to demonstrate to supporters that they are doing something than in influencing policy-makers.

  • The Department for Digital, Culture, Media and Sport has published an online guide to using the social value act. The guide, published yesterday, is aimed at commissioners, policy-makers and those in operational roles who need to procure services for contracting authorities such as local government. The Public Services (Social Value) Act was introduced in 2012 and requires commissioners who procure services to consider how the procurement could improve the social, economic and environmental wellbeing of their areas. Since then, questions have been raised about how effective it has been. A report published by the health think tank the King’s Fund in February said that, although most commissioners had heard of the social value act, their knowledge and use of the legislation in commissioning varied widely. 

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Workforce and Skills

Nursing

  • A raft of changes to pre-registration nurse education, student assessment and prescribing have been approved, following a “historic decision” by the Nursing and Midwifery Council. At an NMC council meeting yesterday, the regulator signed off changes that will see all nurses in the future trained in the same set of procedures and communication skills regardless of their field of practice. The NMC’s director of education, Geraldine Walters, told the meeting there had been some resistance to the proposal but said the new standards of proficiency for registered nurses were designed to ensure all nurses could meet the fundamental care needs of people with a range of conditions. However, she stressed students would need to demonstrate varying levels of expertise depending on their field of practice – either adult, children’s, learning disability or mental health nursing. Meanwhile, the NMC agreed to remove its cap on the number of hours students can spend on simulation activities, despite concerns this would reduce the amount of time on placements.
  • MHA comments: Given the difficulties experienced by many social care providers in recruiting and retaining nurses, we will be interested in following the impact of these changes.
  • NHS England has set out a strategy to reduce its gender pay gap, after identifying that men occupy a disproportionate number of senior roles. Its first gender pay gap report showed that 85% of its national clinical directors are men, while women make up 80% of employees in the organisation’s lowest pay quartile. According to the Government’s methodology for calculating gender pay gaps, NHS England had a mean gender pay gap of 21.2% on the snapshot date of 31 March 2017. This is calculated as the percentage difference between the average hourly salary for men and the average hourly salary for women. Although NHS England stressed that this was ‘not the same as saying men and women are paid differently for doing the same job’, which ‘would be an equal pay issue’, it did acknowledge the issue of men occupying more senior posts.

In Brief:

  • The 'All Wales induction framework for health and social care' has been launched recently and aims to help workers have confidence that they have the skills, knowledge and understanding to provide high quality care:
    • Better understand their role – what is required of them and what support can be expected
    • Get to know their working environment and the information they need to do their job well
    • Get to know colleagues and develop good working relationships
  • Skills for Care has launched a wellbeing guide for registered care home managers. The new guide: ‘Wellbeing for registered members of Skills for Care’, is designed to support registered managers and care home managers to better manage their own professional and personal wellbeing. Skills for Care CEO, Sharon Allen said: “Registered managers quite rightly take pride in their ability to care for others; it’s what they’re good at, but they can often neglect their own wellbeing.

  • See the Government Workforce and Skills section for more policy news

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Look Ahead: May and beyond

MHA will be taking an interest in the following events and milestones

  • Early 2018: Information Commissioner's Office - consultation on GDPR sanctions expected

  • Early 2018: Department of Digital, Culture, Media and Sport - consultation on Voluntary Sector Strategy

  • Early 2018: Update to NHS Continuing Healthcare National Framework

  • Early 2018: New Housing Ombudsman consultation

    Early 2018: Consultation on Charity Commission fees

Events

Listed below are details of relevant seminars, workshops and conferences that may be of interest to readers:

  • The Future of People Powered Health 2018, 2nd May, London 9:00am - 5:30pm Join professionals, campaigners, commissioners and policymakers to explore how we can create a more people powered approach to health and wellbeing. 

  • Working together to improve improve patient flow, Tuesday 15 May 2018 Kings Fund, London
    Delayed transfers of care often makes headlines in the media but what’s really happening on the ground? Join us on 15 May to see what the data is really telling us and to hear practical whole-system approaches to improving patient flow. Issues that will be covered:

    • how integrated teams are reducing hospital admissions
    • the importance of nurturing relationships between NHS and social care
    • how better communication can reduce delayed transfers
    • the role of housing in dealing with patient flow issues
    • how to harness assets from the voluntary sector and the important role the sector plays in keeping patients at home and out of hospital.

  • Care England 2018 Conference & Exhibition 14 November, London.  The speaker presentations will focus on the effective use of data & technology in the social care sector. Please click here to book your delegate place

  • International Longevity Centre Future of Ageing Conference Thursday 29th November 2018, Copthorne Tara Hotel London, W8 5SY. 10 ‘Get-in-there-quick’ tickets available at the very reduced rate of £120.00 + vat. Early bird tickets are also now available.

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Some information sourced from DeHavilland

 
 

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