Policy News from MHA: July 2018

Welcome to MHA's July policy bulletin

 

This month as a result of a Cabinet resignations, the reshuffle has meant a new Secretary of State for Health and Social Care  and Theresa May taking on the role of Brexit negotiations. The NHS will receive increased funding over the next five years and the Mental Capacity (Amendment) Bill has been introduced to the House of Lords to replace the Deprivation of Liberty Safeguards (DoLs). 

 

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 

Dementia:- Care, Support and Wellbeing -

Faith

Finance and pensions: - 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: August and beyond: - Events of interest -

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Government

  • Jeremy Hunt has replaced Boris Johnson as Foreign and Commonwealth Secretary, following Mr Johnson's decision to leave the Government. Meanwhile, Culture Secretary Matt Hancock has moved to replace Mr Hunt at the Department of Health and Social Care.

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Brexit

  • Brexit Secretary David Davis, who has been leading UK negotiations to leave the EU, resigned from government earlier this month. His departure follows the recent Cabinet meeting to agree the UK's position on the future relationship with the European Union. In his resignation letter to Prime Minister Theresa May, Mr Davis made it clear that he was "unpersuaded that our negotiating approach will not just lead to further demands for concessions [from the EU]". Mr Davis stated he was not willing to be a "reluctant conscript" to the Prime Minister's Facilitated Customs Arrangements (FCA). David Davis has been replaced by Conservative MP Dominic Raab. Elected to the Commons in May 2010, Mr Raab was previously Housing Minister at the Ministry of Housing, Communities and Local Government and a minster at the Ministry of Justice. He served on the Exiting the European Union Select Committee from October 2016 to May 2017.
  • Theresa May has since announced that she will be taking over Brexit negotiations from the Department for Exiting the European Union (DExEU). In a written statement the Prime Minister said “I will lead the negotiations with the European Union, with the Secretary of State for Exiting the European Union deputising on my behalf.” In addition, the Cabinet Office Europe Unit will “will have overall responsibility for the preparation and conduct of the negotiations” The Department for Exiting the European Union (DExEU) will lead on the Government’s preparations for Brexit including preparing for both a deal and a no deal scenario and leading on all necessary legislation.
  • Scottish Cabinet Secretary for Constitutional Relations Michael Russell and Welsh Cabinet Secretary for Finance Mark Drakeford wrote and published a joint letter to Chancellor of the Duchy of Lancaster David Lidington outlining their concerns over the involvement of devolved bodies in Brexit negotiations. The pair expressed concern that the full draft White Paper on EU Negotiations had still not been shared with the Scottish and Welsh Governments ahead of a Joint Ministerial Committee on EU negotiations.
  • Theresa May has said it's time to "get on with" reaching a Brexit deal, as she and other senior ministers attempt to sell their plan to other European leaders. The prime minister will have met with the Austrian chancellor and Estonian PM by the end of the month, with the EU and UK wanting to reach a deal by October. But divisions remain over the government's recently published White Paper, which proposes keeping close ties in some areas, including the trade in goods, but ending free movement of people and the jurisdiction of the European Court, while allowing the UK to strike its own trade deals with other nations.

Finance and Pensions

  • The new health and social secretary has told MPs the date for the decision on the long-term funding of vital sectors including public health, health education and social care has not yet been made. Speaking to MPs at the Health Select Committee recently, Matt Hancock also said decisions on the funds for non-acute NHS services will be made “in the normal way,” and more information will be revealed in the Spending Review next year. He explained: “The 3.4% funding increase for the NHS has to take into account of the increasing pressures on the NHS, not least due to people living longer which is because of the work of the NHS. There are other parts of the Department of Health and Social Care budget that have not been set yet including public health, health education in England, and the question of the sustainable funding for social care.” 

  • Nine in 10 councils think increased tax is crucial to stabilising the adult social care sector, council leaders have said. A survey conducted by the Local Government Association also found that 96% of councils believe there is a major national funding problem in adult social care. The survey, based on responses from 79 councils with adult social care responsibilities, revealed that 89% supported increased taxation to tackle the perceived funding shortfall in adult social care.

Health and Social Care

  • The new Secretary of State for Health and Social Care, Matt Hancock, has made his first major speech and outlined his priorities - workforce, technology and prevention. He said that low NHS morale is 'heartbreaking' and that he was horrifed by the reports of bullying reported by staff. He has committed £487m for technology in the NHS. The British Medical Association welcomed the sentiment but said it needed to be underpinned by action. Sally Copley, Director of Policy, Campaigns and Partnerships at Alzheimer's Society said 'while it is heartening to see the new Secretary of State’s focus on championing health and care staff, the upcoming Green Paper and social care reform is mentioned as a mere aside. This omission.. is of deep concern.'

  • MHA comments: We welcome the Ministers' priorities and have written to him congratulating him on his new post and outlining our concerns about the delay in the Social Care Green Paper. 

     

  • The Housing, Communities and Local Government and Health and Social Care Committees’ First Joint Report on Long term funding of adult social care has been published and states that 'The combination of rising demand and costs in the face of reductions in funding has placed the social care system under unsustainable strain. In its present state, the system is not fit to respond to current needs, let alone predicted future needs as a result of demographic trends. After successive attempts at reform the social care Green Paper must be the catalyst for achieving a fair, long-term and sustainable settlement. Failure to do so will undermine the effectiveness of the welcome recent announcement of an uplift in NHS England spending'.

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

Workforce and Skills

  • The nearly 10,000 adult social care and childcare workers in Scotland from EU nations are highly valued says a report, but face uncertainty about Brexit’s impact. The Ipsos Mori report, commissioned by the Scottish Government, finds EU nationals in Scotland’s adult social care and childcare are considered highly qualified, committed to caring and have a willingness to ‘go the extra mile’.  A survey of 1,500 employers in adult social care and childcare interviewed for the study said the UK’s decision to leave the EU meant many were worried about future recruitment and retention problems. They also felt they lacked information on Brexit’s potential impacts and how to help workers and services plan. All EU workers interviewed wanted to stay in Scotland, but were confused about eligibility for temporary residency status.

  •  £200,000 has been allocated from the Welsh Government’s EU Transition Fund to fund research into how the Brexit process could impact on the social care workforce in Wales, and to help the sector plan for any eventualities. The £50m EU Transition Fund was set up to help business, public services and others prepare for the impacts of Brexit. The research will collect data on the make-up of the social care workforce and determine whether there are any geographic regions or particular roles within social care that are particularly dependent on EU nationals, which could be adversely affected, depending on the transitional arrangements and migration policy agreed by the UK Government and the European Union. Having a clear understanding of the make-up of the social care workforce and the extent of EU nationals currently employed will allow stakeholders across local government, the independent and third sectors to identify whether there are any areas of particular vulnerability and to support them plan accordingly to ensure continuity of care.

     

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

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Ageing and wellbeing

  • Former Health and Social Care Secretary Jeremy Hunt announced, whilst in that role, a £215 million package of funding for research that could transform the lives of millions of people who are living with a range of conditions, including life-long illnesses, mental health issues and obesity. Leading academics and technology experts will be able to apply for research funding to develop health solutions for the future that give patients greater independence and choice about how they manage their healthcare. An investment of £150 million will fund research over the next 5 years to tackle important emerging issues, including the pressures of an ageing population and the increasing demands on the NHS. The remaining £65 million will go towards 13 National Institute for Health Research policy research units that will play a vital role in making sure the government and arm’s length bodies have the best possible information and evidence available when making policy decisions about health and social care. The units will cover a range of specialisms and conditions, including: behavioural science, adult social care, older people and frailty, cancer awareness, screening and early diagnosis.

  • Greater Manchester Mayor, Andy Burnham is asking the voluntary and community sector, public services, and older people’s groups to submit their best age-friendly schemes and help deliver more age-friendly neighbourhoods across Greater Manchester. He said: “In March this year, Greater Manchester was recognised by the World Health Organization as the UK’s first age-friendly city region in response to the incredible work being done to make this a great place to grow older. This is a fantastic accolade but we need to take practical steps to make changes and I want people to think about what needs to happen to make sure we’re living not just longer but happier and healthier.

Wellbeing

  • Older people are twice as likely to be prescribed antidepressants as twentysomethings, with concerns growing that doctors are using drugs to combat emotional problems and “medicalising” loneliness according to The Times. It suggests that Britain is suffering from an “epidemic of mismanaged distress”, with antidepressant use rising across the country and millions of people stuck on the drugs for the long term. NHS data shows that 11 % of the age group of people aged 18-24 were prescribed an antidepressant last year. This rises to 19% of the age group aged 40-59, 19 per cent of the age group, and 20% of over-60s.

  • Queens Cross Housing Association has teamed up with charity Cycling Without Age to trial its specially designed tricycles in Glasgow for the first time. The aim of Cycling without Age is to improve the lives of older people and those with mobility issues. Started in Denmark as a way of helping the elderly back on to bicycles, it currently operates in more than 1000 locations across 38 countries around the world. The tricycles are piloted by volunteers who give up their time to take older people out and about. Queens Cross’s director of neighbourhood services, Louise Smith, said: “Evidence shows that loneliness and isolation are two of the biggest factors that impact on the quality of life of our older tenants and is a major factor in health deterioration. By giving people opportunities to get out the house and meet others we can help break this downward spiral and this might be another option we could offer.”

Loneliness

  • Wealden MP Nus Ghani visited Woodlands Care Home in Crowborough to join in with ‘loneliness and isolation day’ activities. The various activities demonstrated the care home’s programme for bringing residents together, and Ms Ghani joined in to see first-hand the positive impact such activities can have. Loneliness has been a key focus of the MP since she was first elected. In Parliament, she chaired the All Party Parliamentary Group on Ageing and Older People, where tackling loneliness was a primary goal. 

    MHA comments: MHA have been working to reduce loneliness for 30 years especially through our Live at Home Schemes. We continue to work hard to reduce loneliness and minimise it's effects and have recently joined the Cabinet Office cross governmental strategy Task Force on tackling loneliness.

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Dementia

Care, support and wellbeing

    • Dementia has overtaken heart disease as the nation’s leading cause of death. Solicitors for the Elderly have worked closely with leading think tank Centre for Future Studies (CFS) to understand the impact of this, and how prepared the country is to face the rising levels of incapacity. Based on forecasting analysis of the evidence, this report suggests the UK is now facing an incapacity crisis. This is caused by the gap between the rising number of us facing incapacity (due to people living longer and the prevalence of conditions like dementia), compared with too few Britons planning ahead for a loss of capacity. This paints a worrying picture of a nation leaving our fate in the hands of strangers. Whilst more of us are making provisions for our personal assets and finances, we are still leaving our wishes around our health and care to chance and the choices of others.

    • Early-stage research has uncovered a potential approach to treat one of the commonest causes of dementia and stroke in older people. Studies with rats found the treatment reversed changes in blood vessels in the brain associated with the condition, called cerebral small vessel disease. The team, led by scientists from the MRC Centre for Regenerative Medicine and the UK Dementia Research Institute at the University of Edinburgh, say the treatment also prevents damage to brain cells caused by these blood vessel changes, raising hope that it could offer a therapy for dementia. Small vessel disease (SVD) is a major cause of dementia and can also worsen the symptoms of Alzheimer’s disease. It is responsible for almost half of all dementia cases in the UK and is a major cause of stroke, accounting for around one in five cases.
    • Street signs have been put up inside Simonsfield Care Home, Runcorn to help residents with dementia to navigate their way around. A grant of £348 from Halton Borough Council provided funding for the “authentic” street signs throughout, which help residents find their rooms. In addition, the signs are accompanied by decorated walls with brick effect and hanging baskets. Since being installed in March, staff said they were finding that residents could now recognise which number and street name is theirs. The idea follows similar initiatives involving changing how care homes look on the inside, where fake shops, pubs and even vintage train carriages have been set up inside to try and engage residents. Debbie Smith, home manager at Simonsfield, which is owned by the Hill Care Group, said: 'The street signs have made a huge difference for our residents, as they can recall the names of where they live within the home. The residents are calling their rooms by the street names they now live on, so 25 Cherryblossom Road, for example,' she said. The residents are also able to recall the homes’ hair salon on Woodlands Lane and the tea room on Ivy Street because of the signs, added Ms Smith. The names were suggested by staff and residents, with Ivy Street named after Ivy Shaw, a popular previous resident. She said: 'It’s important for all residents in the ward to feel part of the community of Halton Brook and this project supported the connection between residential care and the wider community'. 

    • MHA comments: There are growing concerns that images in corridors can be confusing for residents such as a telephone boxes that residents can’t ‘enter’ but this project seems to really be helping with the resident’s memory and helping locate other rooms within the home.
    • NICE have brought out a new report, Dementia: assessment, management and support for people living with dementia and their carers and it covers diagnosing and managing dementia (including Alzheimer’s disease). It aims to improve care by making recommendations on training staff and helping carers to support people living with dementia.
    • Although a good diet cannot slow the progress of dementia, it can make a big difference to the overall health and quality of life of someone receiving care for the condition, according to Elder, a live-in care provider. Eating habits can change with age and this combined with dementia, can lead to problems, and without the right support, those affected by the condition may lose interest in food or simply forget to eat. If your loved one is receiving Alzheimer’s or dementia care, then ensuring they have a varied and nutritious diet is important. A good diet has been proven to help with some of the physical and behavioural problems associated with dementia, as well as making sure that people with the condition are able to maintain a healthy weight. As many of our most treasured memories are often tied up with food, eating well can also be a trigger and a source of comfort and enjoyment for those experiencing memory loss.
    • MHA comments: We understand the importance of a varied and nutritionous menu and work hard to ensure this is in place across our care homes. 
    • A simple eye test carried out by opticians could help predict who is at risk of developing dementia, a study suggests.  The test is usually done to spot early signs of eye disease, by looking at tissue at the back of the eye - the retina. Now scientists have found people with thinner retinas are more likely to have problems with memory and reasoning. Researchers believe the test could be used to screen for early dementia.

    • A Londonderry taxi driver has been hailed a hero after looking after an elderly lady with dementia when she could not remember how to get home. The driver collected the lady in his cab in Derry city centre on a Sunday morning. After unsuccessfully trying to establish where she lived, he enlisted the help of police. The driver stayed with the woman until officers were able to make contact with her family. PSNI Constable Ed Murphy, one of the officers who assisted the driver, said the "hero taxi driver" had selflessly gone out of his way to help. "He was brilliant. It sounds like a retailer in town did not know what to do with this lady so had put her in a taxi," he told BBC Radio Foyle.

    • Dementia research is trailing 40 years behind the advances seen in cancer, leading scientists have warned. For years people have shied away from acknowledging dementia as a medical condition – instead describing people as ‘doddery’ or ‘senile’, they say. This stigma has delayed the kind of revolutions we have seen in cancer care. Professor Nick Fox, director of University College London’s Dementia Research Centre, was speaking at an event to launch UCL’s branch of the UK Dementia Research Institute, and said: ‘We are starting 20, 30, 40 years behind cancer. It was only when cancer came out of the closet and really hit the consciousness of the public and motivated politicians to say we must do something about this – that’s when things began to move.’  

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Faith

  • The annual Methodist Conference recently took place in Nottingham and MHA's Chief Executive Sam Monaghan was one of the main presenters. He described how MHA had been established, was celebrating 75 years of supporting and caring for older people, and looking forward to future challenges and opportunities. MHA's chaplaincy team also held a fringe event that presented our award winning approach to end of life care and our The Final Lap programme. 

  • MHA comments: We appreciate the support that we receive from the Methodist Church and value our heritage. We will be working with the Methodist Church to find ways that we can work together to cement and progress our relationship going forwards. 

Finance and pensions

Older people's income 

  • A report published by financial services firm Just Group reveals more than half thought the government would pay for their care in 2011, but that this had fallen to less than a third in 2017. A growing acceptance that individuals should be responsible for paying for themselves was found, with approximately one-third of over-45s willing to sell their homes if needed.

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Health and Social Care  

  • The Environmental Audit Committee (EAC) states that heat-related deaths are set to treble by 2050 unless the Government acts. Heatwaves place strain on the NHS and social care system. During the 2013 heatwave, double the amount of consultations for heat-illness took place compared to a non-heatwave year. Hospitals can overheat to 30 degrees Celsius when the temperature outside is just 22 degrees Celsius. However, the NHS only asks hospitals and other healthcare organisations to report on their preparation for winter pressures. NHS England’s Emergency Preparedness, Resilience and Response assurance does not account for the risk of overheating hospitals, and the Care Quality Commission do not inspect for it either. The ability of nursing homes to cope with the serious health impact of heatwaves on older people is not assessed. This is worrying, says the EAC, given that in the 2003 heatwave, excess deaths in nursing homes in some parts of the UK rose by 42%.

  • Only one hospital trust met all its main targets over the past year, with dozens failing on emergency treatment, cancer care and routine surgery waiting times, an investigation by The Times has found. As the NHS prepared to mark its 70th anniversary doctors said the findings showed a system that was teetering “like a giant game of Jenga”. The Times interactive project NHS hospitals found that in 2017-18, 25 out of 139 trusts failed to see 95% of A&E patients within four hours, treat 85% of cancer patients within 62 days and offer 92% of non-emergency patients treatment within 18 weeks. Only the Chelsea and Westminster in London hit all three key targets. Inspectors have praised the trust’s leadership and desire to learn from problems.
  • The NHS is to receive increased funding of £20.5bn a year by 2023 as part of a new five-year spending plan. Speaking at the Royal Free in London, the Prime Minister, Theresa May, announced the new funding which is intended to give the NHS the financial security to develop a 10-year plan, which will be published later this year. Simon Stevens, Chief Executive of NHS England, said: "As the NHS turns 70, we can now face the next five years with renewed certainty. This multi-year settlement provides the funding we need to shape a long term plan for key improvements in cancer, mental health and other critical services. And the invitation to the NHS to develop consensus proposals for legislation will help accelerate the move to more integrated care, and ensure taxpayers money is spent to maximum benefit.
  • Following Theresa May's announcement regarding additional NHS funding, analysis suggests that the NHS will have to spend £18 billion over the next three years just to get on top of targets, deal with a maintenance backlog and improve staffing levels and finances. NHS Providers, which represents trusts, said that “filling the gaps that have opened up after almost a decade of austerity will account for much if not most of the new money recently announced by the prime minister”.  Theresa May wants the NHS to come up with its own plan for spending the money so that it can transform the use of IT, integrate health and social care and improve outcomes for mental health and cancer patients.
  • The Care Quality Commission (CQC), has published a new series of resources – ‘Learning from safety incidents’ – to help those in charge of running health and care organisations ensure the safety and well-being of people using their services.The key themes include:

    1. Problems with the quality and use of risk assessments
    2. Issues with documentation
    3. Issues with equipment
    4. Staff training
  • Although it is not a direct result of the ageing process, constipation is the most prevalent bowel management problem in older adults. It is common for older people to develop the condition during hospital admission and this may delay discharge. In addition to the distress caused to patients, this clearly has cost implications, which are likely to grow as the ageing population increases. Non-pharmacological approaches to managing constipation are often underused in acute hospital settings, where drug treatment is often administered with a view to “fixing the immediate problem”. However, simple non-pharmacological measures may aid defecation according to Nursing Times. The environment should be assessed for lack of privacy…. Diet, fluid intake and physical activity all need to be looked at as does the proximity to the toliets.
  • The Care Quality Commission has recently released a report ‘Beyond Barriers’ which looks at the experiences of older people moving between health and social care services. The report pulls together findings from a review of 20 local systems and outlines how services are working together to support people aged over 65 and what improvements could be made. The report demonstrates the need for the health and care system to be seen and regulated as a whole rather than as separate pieces. It contains many valuable lessons for local services, but also highlights a number of gaps including that funding, commissioning and regulation needs to change to address the whole system and the interaction between different services.
  • Pepper is a 4ft tall approximation of a human being manufactured by the Japanese-owned corporate giant SoftBank Robotics. 'Pepper has been given a male pronoun, for some reason', says John Harris of the Guardian. 'Using a screen on his chest, he tells interactive stories, approximates the basics of conversation, and performs everyday gestures' – all the while, according to his creators, “recognising the principal human emotions and adapting his behaviour to the mood of his interlocutor”. There is an issue though that these robots will encourage the belief that thought, consciousness and even emotion are reducible to machine-like processes. If that is the case, the moral question of robots providing care is minimised as one 'machine' of blood and flesh is cared for by another machine of casings and processors, where is the problem?!

  • The Mental Capacity (Amendment) Bill was introduced to the House of Lords in July and seeks to replace the current system known as ‘Deprivation of Liberty Safeguards’ (DoLs). DoLs is an assessment currently carried out on people who do not have the mental capacity to make their own decisions about their care, for example because they are living with dementia. In 2014 a Supreme Court decision, significantly widened the numbers of those vulnerable people considered to be deprived of their liberty. As a result, health and social care services have been unable to cope with the huge increase in cases and the added administrative burden. The overall process was criticised by a 2017 Law Commission review for being too complex and bureaucratic. The government has now developed a new system, known as ‘Liberty Protection Safeguards’, which will become law through the bill. 
  • The population’s health and social care needs have changed greatly since the National Health Service (NHS) was established in 1948 according to the National Audit Office (NAO). People are now living longer, often with multiple and complex conditions that require managing. However, the NAO argues, the division of care into two separate systems – health and social care – has not fundamentally changed over that time. There is widespread consensus among health and social care professionals, the NHS and policy-makers in government that the changing needs of the population require changes to the way health and social care services are organised and delivered. The NAO has said that the financial pressure that the NHS and local governments are under makes closer working between them difficult and can divert them from focusing on efforts to transform services The Health Foundation agrees with the NAO's assessment of the barriers that need to be overcome and argues that it is not enough to just boost NHS funding alone.  Anita Charlesworth, Director of Research and Economics says that 'If social care funding isn’t urgently tackled, we will continue to see the knock-on effects; emergency admissions of those not receiving adequate care at home and people languishing in hospital due to a lack of resources in the community'. The Local Government's Association (LGA) also welcomed the reports assertion that councils are still trying to protect adult social care. Cllr Izzi Seccombe, Chairman of the LGA's Community Wellbeing Board stated that 'the lack of funding for care and support [however] is making it increasingly difficult for local authorities to plan effectively to bring together health and social care around the person'.
  • The Beth Johnson Foundation have produced a briefing paper into the current situation within the care home sector. This paper supports their two publications; Doing it well - dignity and compassion in caring for older people and Experiences of Being - the benefits of drama, music and dancing in improving the well being of older people in care homes. Approximately 17 per cent of people aged over 85 live in a care home, according the the Beth Johnson Foundation and the number of residents is projected to rise. In the next 20 years, the number of older people in the UK will rise significantly. Simply stated – as we all live longer, the need for more places in good quality homes will intensify espeically with a growing number of older people experiencing multiple co-existing conditions. 

     

Funding and fees

  • According to estimates from Age Uk, a lack of social care and delayed hospital discharges is costing the NHS £500-a-minute. A total of £289.1m is being used from the budget of the health service in England as a result. Around one in seven older people are living with an unmet care need – up a fifth in the last two years. Of the 1.4 million older people affected, more than 300,000 need help with three or more essential tasks, ranging from getting out of bed to going to the toilet and dressing. But these needs are not being met with half receiving no help at all from paid carers, family or friends say Age UK. 'Older people around the country are being very badly let down by the catastrophic lack of government funding for social care', said Caroline Abrahams, Age UK’s charity director.

  • A cap on care fees should be set as low as £50,000 to allow most people to benefit, new figures from England's largest councils show. The cap on care costs is intended to allow pensioners to pass on an inheritance after paying a limited amount for social care in their own home. The County Council's Network (CCN) report, Sustainable Social Care: A Green Paper that Delivers a New Deal for Counties, sets out how a £50,000 cap would benefit four-in-10 people currently paying for care costs, as opposed to only one-in-10 benefiting from a £72,000 cap. But CCN health and social care spokesman David Williams warned social care services were currently facing a £1.6 billion black hole and a £50,000 cap would still cost rural councils £700 million per year. The paper argues that if the government’s reform agenda is to be successful, then social care must remain a local service and should not be combined into the NHS.

 

  • NHS and Health
  • The NHS warned that it was “back to winter conditions” recently as the extreme heat led to a surge of patients, though this time suffering dehydration and breathing problems. The elderly and the young were most affected. Unicef, the United Nations children’s charity, warned that the heatwave was causing an air-pollution crisis for Britain’s youngsters. NHS chiefs said that operations were being delayed because beds were being taken up by older people sent from care homes. Ageing hospital buildings were putting patients and staff at risk in the sweltering heat. Nurses have reported feeling exhausted, sick and dizzy as the hot weather raises temperatures in hospitals. One nurse was admitted to A&E with dehydration after working three 12-hours shifts in a row during the heatwave, the Royal College of Nursing (RCN) said. Earlier this week, the organisation warned that patients and relatives were passing out and vomiting, with temperatures on some wards exceeding 30C (86F).
  • The Kings Fund, in partnership with NHS Providers, have produced a report on leadership vacancies. Leadership in today’s NHS; Delivering the impossible looks at the NHS nationally, regionally and locally. The data and insights it contains, include high vacancy rates and turnover that have a significant impact on culture, staff engagement and performance. The report argues that some of these conclusions could have featured in a similar report published five or ten years ago, although it recognises that much has also changed. The task, or rather the shared mission, for all leaders should be a commitment to address these issues wherever they operate in the system – as no single action or investment will close the gaps that have been set out. The good news is that length of tenure has increased since 2014, with the average tenure for a chief executive up from 2.5 years to 3 years now. This is still very short however and the level of churn in all the executive director posts that were looked at remains worrying; the ability to recruit high-calibre chief operating officers is of particular concern with growing demands on service. 54% of all Executive Directors have been recruited in the last 3 years whilst 8% of Executive Director posts are vacant or filled by an interim.
     

     In brief:

  • Technology is set to be introduced in care homes around Whitby to help reduce the number of hospital visits. Local health commissioner, NHS Hambleton, Richmondshire and Whitby Clinical Commissioning group (CCG), worked with the technology provider, Immedicare to install special laptops in local care homes.  Immedicare is a system called ‘telemedicine’ which works in a similar way to ‘Skype’ that allows nursing and residential homes to connect to a ‘hub’ in Airedale for medical advice and guidance via laptops.

  • New NHS and social care hubs - where health, social care, housing and voluntary and community organisations work side-by-side – are keeping people, most at risk, well and out of hospital. The Hubs in Wakefield, West Yorkshire, relieve pressure on primary care as GPs can potentially just call one number or complete one e-referral for a person with multiple needs. Once assessed and referred people could be seen by a nurse, occupational therapist, physio, social care worker, voluntary worker, housing officer or mental health worker depending on their problem. In six months the Hubs have seen almost 2,000 people including 636 urgent referrals. 

  • Increasing the minimum wage for low-paid care workers has seen a “rather worrying deterioration in the quality of care”, according to a new study, The Impact of the National Living Wage on English Care Homes. Care homes have responded to the introduction of the National Living Wage by cutting costs. They have not reduced the number of workers in homes or cut their hours, as was feared before the pay rise was introduced. They have also not raised fees, as local authority regulations in particular make this hard to do. Instead quality has fallen because the homes can spend less money elsewhere, according to the study of wage payments and Care Quality Commission reports by academics at the London School of Economics.
  • MHA comments: MHA values it's staff and ensures that it pays at least the Real Living Wage to all of it's employees. 

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Housing

Older People

  • On the anniversary of the NHS, Lord Richard Best looked at the potential for housing and health to improve their effectiveness by coming together. In the immediate post-War years when the National Health Service was created and large-scale council housing programmes were initiated, one government department, and one minister – Aneurin Bevan – was responsible for both housing and health. Over the decades since, the two sectors have moved further and further apart. Now each has a distinctively different culture. At a round table discussion of housing and health leaders convened by Housing Associations' Charitable Trust (HACT), participants stressed the importance of the two sectors coming back together again.

 In brief:

  • A simple online calendar is helping older people to connect in Manchester, PlaceCal. It's an idea to do something about loneliness in one specific part of Manchester by setting up a hyperlocal online calendar that lists all local events in one place. Although the project is technically simple, it is being funded by a ‘smart city’ consortium of 21 organisations called Cityverve, including Manchester City Council, the University of Manchester, Cisco and BT. So far, the calendar idea has been trialled in two areas of Manchester: Hulme and Moss Side. The 14 local partners that supply information about events in the two areas include One Manchester, Redbricks Tenants’ and Residents’ Association and the well-being service of housing association People First. The concept was developed by a Professor at Manchester School of Architecture. Professor White comments 'there are things you can do as an architect which can help people live better lives, but a key component is people’s social interactions'.

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Third Sector 

Trust and brands

  • Charity legacy income reached a record high of at least £2.8bn in 2017, new figures show. Legacy Trends 2018, compiled by the legacy information provider Smee & Ford, found that 36,445 estates included charitable gifts in 2017. In total these were worth between £2.8bn and £2.9bn, up by £37.8m on the previous year and the highest figure recorded, the report says. The number of gifts was consistent with 2016, according to the report, and the increase in value was largely due to the rise in house prices.

  • Charity Finance are celebrating awards season as it gives them a chance to look at the direct work charities do with beneficiaries. Gareth Jones argues that completing an award nomination form gives a charity a renewed focus. Clear thinking about how a charity operates, along with a detailed understanding of the problem to be tackled and a clearly defined process to solve it, means that a charity can gain a much better idea of how it can effect change and can take these lesson forward for improved effectiveness in the future.  

     

Governance

  • The Charity Governance Code is a statement of best practice and was implemented, last year after consultation with over 200 individuals and organisations, to include updated thinking on governance and promote discussion about the standard of governance in the charity sector. This briefing paper outlines advice and recommendations from New Philanthropy Capital (NPC') on how charity trustees can put the Code into practice.

      

    In Brief: 
  • The Directory of Social Change have produced a list of seven top tips for a well-functioning Board. These include having clearly defined responsibilities and roles, having clarity of purpose and expectations, and demonstrating leadership. The DSC argues that whatever skills and experiences people bring to the Board table, they also need to be open to hearing from different perspectives and able to delegate effectively as this will add value overall. 

     

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Workforce and Skills

  • Nurses working in the independent care homes need to be given “parity on pay” with their colleagues in the NHS, according to representatives from the sector. Care England suggested that nurses working in independent care homes did not seem to have been given the same priority by the government as those in the NHS, despite their “vital role”. The body’s warning comes in the wake of the 6.5% three-year pay offer for nurses in England, which was recently accepted by nursing union members. Care England has alerted the health and social care secretary Jeremy Hunt and the Department for Health and Social Care that the Funded Nursing Care (FNC), payable for nurse costs in nursing homes, rate for 2018/19 will not meet the pressure being felt in the nursing home sector.

Nursing

  • A Scheme which will see EU nurses apply for 'settled status' early to ease nursing shortage Brexit fears is to be trialled by a hospital trust. East Lancashire Hospitals Trust (ELHT) will trial the new application process for the EU Settlement Scheme. It will see EU citizens at the trust take part in a private managed live trial enabling them to make real applications for settled status.

  • MHA comments: MHA values all of it's staff including those from the EU and will be encouraging our nurses to apply for settled status when it becomes widely available so the high level of service that we commit to will not be adversely affected by Brexit. We will also be advocating for those EU Nationals working across MHA who are not covered by this scheme. 

In Brief:

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Look Ahead: August and beyond

Events

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

  • Infection Prevention in Care and at Home One Day ConferenceSunday 30 September 2018, Scottish Event Campus, Glasgow. This one-day conference is tailored for those who work providing services for people in care and those receiving care at home and will be run by the Infection Prevention Society. This day is relevant for all staff and in particular those senior staff with the accountability for infection prevention within the organisation. The cost to attend is £95 and this includes access to the UK’s largest infection prevention and control exhibition offering you the opportunity to view new and innovative products and discuss your requirements with company professionals. A large poster area will also be displayed throughout the conference within the exhibition hall.

  • The Power of Music in Health and Social Care -  The University of Nottingham is delighted to announce The Power of Music in Health and Social Care Conference in partnership with Room 217 on 12 October 2018. Further information will follow shortly but if you would like to register your interest, please email: powerofmusic@nottingham.ac.uk MHA are supporting this financially and Ming, our Chief Music Therapist will be one of the speakers.

  • National Care Forum Managers Conference, 12 - 13 November 2018, Kenilworth, Warwick. The theme for this year is Health and Well-being - looking at the people we provide care and support to, as well as our staff. Caroline Dineage, MP, Minister of State at the Department of Health and Social Care will be one of the speakers as will MHA's CEO, Sam Monaghan.
  • Care England 2018 Conference & Exhibition, Logging On on 14 November 2018, London.  The speaker presentations will focus on the effective use of data & technology in the social care sector. Caroline Dineage, MP, and Ian Trenhom, new Chief Exceutive of the Care Quality Commission will both be speaking. Please click here to book your delegate place.
  • Fundraising Now Conference, 28 - 29 November, 2018, London. The conference will cover the following topics:

    covering the following topics: Gift Aid, Legacy fundraising, Fundraising and GDPR, Safeguarding, Storytelling, Charity Digital Code,        Creative Campaigning, Crowdfunding, Diversity and fundraisers, and Diversifying income.

  • International Longevity Centre Future of Ageing Conference Thursday 29 November 2018, Copthorne Tara Hotel London, W8 5SY. Early bird tickets are now available. They are expecting over 250 attendees.Caroline Dineage, MP, Minister of State at the Department of Health and Social Care will be speaking at this conference as well as the previous two events listed - plenty of chances to hear her speak of her priorities and focus. Other speakers include Baroness Ruth Lister, Emeritus Professor of Social Policy and former Head of the Child Poverty Action Group, Dr Paul Dornan, Child Poverty expert in the Department of International Development at Oxford University and Ashwin Kumar,Chief Economist, Joseph Rowntree Foundation.

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Some information sourced from DeHavilland

 
 

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