Policy News from MHA: June 2017

Welcome to MHA's June policy bulletin

 

June was a busy month in politics with the General Election and subsequent speculation of the Conservatives and DUP deal.  Brexit negotiations also got underway and the Queen's Speech took place, with a much-reduced programme of legislation due to Brexit, with many key issues of interest to MHA found in the non-legislative announcements. 

Government: General Election 2017 - Queen's Speech - Brexit - Charity and Voluntary Sector - Health and Social Care - HousingOther -

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

Ageing and wellbeing: - Mental Health - Older Workers - Technology - Exercise -

Dementia:- Research - Technology -

Finance and pensions: - Pensions and retirement income - Benefits for older people

Health: - Strategy - Joint Working - Funding -

Housing: - Older people's housing choice - Sheltered Housing - Strategy - Housing Market -

Social Care:Care crisis - Care provision - Quality -

Third Sector: - Volunteering amongst older people -

Welfare: - Benefits available to older people -

Workforce and skills: - Nursing - Carers -

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

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Governmentclipboard image

General Election 2017 

  • Conservatives: On the 9 June, the Conservative Party was returned as the largest party, but did not achieve an overall majority in the House of Commons. It holds 317 seats including the Deputy Speaker (a non-voting MP), which  is not enough for a working majority (where 326 seats are needed). Prior to the election the Conservatives had a working majority of 13.

  • Consequently, the Government has come to an “confidence and supply” agreement, rather than a formal coalition, with Northern Ireland's Democratic Unionist Party (DUP). The key terms of the agreement are as follows:
    £2.5bn of additional spending pledged for Northern Ireland over three years; the 10 DUP MPs will support the Government on all motions of confidence and on the Queen’s Speech, the Budget, Finance Bills, money bills, supply and appropriation legislation and Estimates; the DUP will support also relevant Brexit legislation and also pledged to support legislation on national security; all other support will be negotiated on case by case basis; a coordination committee will be convened, chaired by the Government; the agreement will remain in force for the duration of this Parliament (2017-19).

The DUP has secured the following policy agreements from the Conservatives:
·  No changes to the Triple Lock and the universal nature of Winter Fuel Payments.
·  A commitment to the NATO 2% target for defence spending.
·  Enforcement of the Armed Forces Covenant throughout the UK and support for reserve forces in Northern Ireland.
· A guarantee of funds for farm support until the end of the Parliament.

  • Who are the DUP? Founded in 1971 by the late Ian Paisley, the DUP is the largest unionist political party in Northern Ireland, the largest party in the Northern Ireland Assembly and the fifth-largest party in the House of Commons. It is considered to be the more Ulster loyalist of the unionist parties and is committed to preserving Northern Ireland’s place in the UK. The party supported Brexit but has warned against the dangers of a hard Brexit since the vote. The DUP has strong links to Protestant churches and is socially conservative, opposing abortion and gay marriage.

  • Following the election, Theresa May has made some changes to her Cabinet, key appointments of interest are: new Secretary of State for Work and Pensions Rt Hon David Gauke MP and within his team Guy Opperman MP has become the Minister responsible for pensions and pensioner benefits. The Department of Health has confirmed that responsibility for adult social care will be with Jackie Doyle-Price MP. The responsibility for Housing, falls to Alok Sharma MP and Tracey Crouch MP has been announced the new Minister for Sport and Civil Society.

  • Labour: The Labour Party exceeded expectations by taking 40.1% of the vote and 262 seats in this election. The result represents an improvement of 29 seats compared to 2015. Jeremy Corbyn has reshuffled his frontbench team, although the only new face in areas of interest to MHA is the new Shadow Communities and Local Government Secretary is Andrew Gwynne MP. However following the vote on the Queen's Speech, he has since sacked three of his shadow cabinet after they defied him to back a call for the UK to stay in the single market.  Ruth Cadbury, Catherine West and Andy Slaughter all voted for an amendment to the Queen's Speech brought in by backbencher Chuka Umunna - even though staying in the single market is not Labour policy. Daniel Zeichner resigned from his frontbench role in advance of the vote.

  • Liberal Democrats: despite increasing the number of MPs in Parliament to 12 seats, the leader of the party, Tim Farron, has announced he would be stepping down. A new leader will be elected at their party conference in September. Meanwhile, some of the Liberal Democrat spokespeople were announced as: Sir Vince Cable - Treasury; Norman Lamb - Health; Wera Hobhouse - Communities and Local Government; and Stephen Lloyd - Work and Pensions.

  • SNP: The Scottish National Party failed to emulate their performance two years ago, holding on to 35 of their constituencies but losing 21 seats.  The party's Westminster Leader Angus Robertson and former Party Leader Alex Salmond lost their seats to the Conservative Party.  SNP Leader Nicola Sturgeon conceded that the results had been poor for her party and has reconsidered her manifesto pledge to push for a second Scottish independence referendum. Ian Blackford MP has been selected as the SNP Westminster Group Leader.

Queen's Speech

  • The Queen’s Speech and State Opening of Parliament took place on the 21 June, setting out the Government’s legislative programme for the 2017-19, an unusual two-year parliamentary session.  Prior to the speech the Government announced that there would not be a Queen’s speech in 2018 as it wanted to give more time for parliamentary scrutiny of Brexit legislation.  This means there will be less pressure to push things through quickly, but also means a reduced opportunity for new legislation to be tabled, such as new social care policy. 

  • MPs voted to pass the Queen’s Speech on the 29 June. The speech passed unamended with a majority of 14. Two amendments were also subject to a vote but failed to pass: an official Opposition amendment presented by Shadow Chancellor John McDonnell, attacking various aspects of austerity, was defeated by 26 votes; and an amendment moved by Labour MP Chuka Umunna on continued membership of the European Single Market was also unsuccessful but saw rebellions from several Labour MPs, resulting in more changes to the Shadow Cabinet to come.

  • Twenty-four Bills plus three Finance Bills were announced in the speech, detailed below. There were no specific pieces of legislation on health or care, although there were a few non-legislative announcements. Bills of interest to MHA include:

  • Repeal Bill: This will repeal the 1972 European Communities Act and convert EU law into UK law – this means an extensive overhaul of many areas of legislation. It also allows Parliament (and where appropriate, the devolved Governments) free to make any future changes to its laws.

    Customs Bill: This aims to ensure: the UK has a stand alone UK customs regime on exit; flexibility to accommodate future trade agreements with the EU and others; that changes can be made to the UK's VAT and excise regimes on exit from the EU, whatever the outcome of negotiations; that the Government can collect payments of customs duties, administer the customs regime and tackle duty evasion; and give control over the import and export of goods.

    Immigration Bill: This would enable the Government to end the free movement of EU nationals into the UK, but still allows the country to attract "the brightest and the best". 

    Financial Guidance and Claims Bill: to combine three financial advice bodies into one, and establish a new statutory body with responsibility for provision of debt advice, money guidance and pension guidance.

    Draft Patient Safety Bill: to help instill greater public confidence in healthcare services in England.

    Data Protection Bill: This would implement the General Data Protection Regulation (GDPR) and the new Directive applying to law enforcement data processing, whilst the UK remains a member of the EU.  It also gives people new rights to "require major social media platforms to delete information held about them at the age of 18" and updates the powers and sanctions available to the Information Commissioner.

    Draft Tenants' Fees Bill: This Bill aims to ban landlords and agents charging letting fees as a condition of their tenancy (this may not be relevant to MHA, but interesting to note) and enforces the ban with provision for tenants to be able to recover unlawfully charged fees. It would apply to England only, although some minor amendments to the Consumer Rights Act 2015 may apply to England and Wales.

Non-legislative announcements:
• Social care: The Government has indicated it will work to address the challenges of social care for our ageing population, bringing forward proposals for consultation to build widespread support.  The consultation will set out options to improve the social care system and to put it on a more secure financial footing, supporting people, families and communities to prepare for old age, and address issues related to the quality of care and variation in practice.

 Brexit - Engagement with Parliament, the Devolved Administrations and Business: the Government has indicated it will intensify engagement on EU exit with businesses and trade bodies to test and validate positions and to continue to build support from the business community. It will also engage the devolved administrations to seek a deal that secures the specific interests in those countries.

• Consumer Markets (including energy): The Government will publish a green paper that will: “Closely examine markets which are not working fairly for consumers, and is prepared to act where necessary” – this may include the findings from the Law Commission on Event Fees and from the Competitions and Market Authority’s study of the care home market, dependent on its final conclusions which are expected in December and the timetable for this Green Paper.

• Housing: The Government pledged to deliver on the reforms set out in the Housing White Paper. In particular, the Government pledged to increase transparency around the control of land, to “free up more land for new homes in the right places, speed up build-out by encouraging modern methods of construction and diversify who builds homes in the country. In addition it will “consult and look to take action to promote transparency and fairness for leaseholders.”  In regards to the housing market generally, the speech notes that the Government will: “Look at ways we can streamline the home buying process so it is cheaper, faster and less stressful for people when they make the biggest purchase of their life” – although no specifics have been given.

• Mental Health Reform: The Queen’s speech does not put forward any legislation, but some the measures outlined included, ensuring that those with mental ill health are treated fairly, protected from discrimination, and employers fulfil their responsibilities effectively.

• National Living Wage: The National Living Wage will be increased to 60 per cent of median earnings by 2020. After 2020, the National Living Wage will continue to be increased.

• Public Inquiry into the Grenfell Tower fire: as well as the Inquiry, the Government will be reassessing building regulations.

Other Bills introduced:
• A Trade Bill to allow the UK to implement an independent trade policy
• A Fisheries Bill to enable the UK to control access to fisheries and management of its waters
• An Agriculture Bill to set up a system to support farmers after Brexit
• A Nuclear Safeguards Bill to establish a UK nuclear safeguards regime to replace the regulations of Euratom
• An International Sanctions Bill to allow the UK to continue applying international sanctions after leaving the EU
• Automated and Electric Vehicles Bill to provide for the installation of charging points, allow the regulatory framework to keep pace with technology and extend compulsory insurance to the use of automated vehicles
• Space Industry Bill to ensure that the UK remains a world leader in commercial satellites and commercial spaceflight
• High Speed 2 Phase 2A Bill to provide the powers to build and operate the next stage of the HS2 network between Birmingham and Crewe
• Smart Meter Bill to extend, by 5 years, powers to make changes to smart meter regulations and deliver more transparent energy bills
• National Insurance Contributions Bill to legislate for NICs changes announced at Budget 2016 and Autumn Statement 2016
• Travel Protection Bill to update the ATOL scheme to align it with enhancements to the package travel regulations that predate people booking their holidays online
• Draft Domestic Violence and Abuse Bill to protect the victims of domestic violence and abuse and establish a Domestic Violence and Abuse Commissioner
• Civil Liability Bill to crack down on fraudulent whiplash claims an reduce motor insurance premiums
• Courts Bill to modernise the courts system and introduce digital services which will allow business to pursue their cases quicker
• Goods Mortgage Bill to increase protections for borrowers who take out mortgages on goods that they own
• Armed Forces Bill to provide Armed Forces personnel with flexible opportunities to serve the country in ways that suit their lifestyle aspirations

  • A number of Conservative Manifesto pledges that were not mentioned including; the alignment of the means-testing of homecare with that for residential care, dubbed the ‘Dementia Tax’ in the media; the removal the Pensions Triple-Lock; Means-testing Winter Fuel payments for pensioners; Lifting the ban on selective education; the Replacement Free School Meals for Key Stage 1 pupils with free breakfasts; Allowing a new vote on the ban on fox hunting; and a specific Energy Price Cap, although there will be a Green Paper on tackling unfair practices in the energy market

  • Responding Jeremy Corbyn attacked the “chaos” of the new “coalition” being formed between the Conservative Party and the DUP and criticised the contents of the Queen’s Speech, which he dismissed as a "threadbare legislative programme" for a two-year Parliament.  He welcomed the decision to exclude proposals to scrap the Winter Fuel Allowance and pensions Triple Lock, as well as the omission from the speech of the so-called "dementia tax". He also declared that he wanted Parliament to be able to scrutinise the relevant legislation on Brexit. Mr Corbyn also said the Government would win Labour's support if it decided to end austerity and tackle inequality. 

  • Theresa May responded to various questions about the Speech, including on the legal status of EU migrants living in the UK post-Brexit and committed to setting out the opportunities for EU citizens living in the UK to the House "very soon" (see the Brexit section below).  She maintained that inequality had been reduced in spite of austerity measures and said that the Government would continue to pursue a responsible fiscal policy. Concluding she noted the limits of what the Queen’s Speech could address, but stressed that it was a step forward to building more united, compassionate and confident nation.

  • The reduced programme for Government may still face challenges in passing through the House of Lords, where the Government does not have a majority even with support from the DUP.  

Brexit

  • Brexit negotiations commenced on the 19 June, with the UK agreeing to the EU's preferred structure of the discussions.

  • The Government also published details of its plans for the rights of EU nationals after Brexit. The proposals have yet to be agreed, but key headlines include:  that all EU citizens who have lived in the UK for at least five years will be eligible for a new “settled status”, with the same residency, employment, health, welfare and pensions rights as British citizens; those who have not reached five years but arrived before a specified cut-off date (to be finalised) will be entitled to stay on until they reach the threshold; and those who arrived after the cut-off date will be granted a “grace period” of two years to apply for permanent residence or return to their home countries.  Responding European Council President Donald Tusk said the offer was “below expectations” and the EU’s Chief Brexit Negotiator Michel Barnier said that “More ambition, clarity and guarantees [were] needed than in today’s UK position."

    MHA comments:  We are pleased that the issue of EU workers in the UK is being considered at the start of the negotiations, as Health and Social Care workers from the EU are vitally important.

Charity and Voluntary Sector

  • Third sector representative bodies have written to Cabinet Office minister Damian Green about the Lobbying Act, calling it a "confusing and burdensome piece of legislation that ultimately harms our democracy" and that it should be urgently reformed. The letter also called for Lord Hodgson’s suggested reforms to the Act, including reducing the regulated campaign period to four months before an election and changes to the rules on joint campaigning, to be implemented urgently, citing the "enormous administrative and financial burden" it places on the sector. The Lobbying Act sets spending limits and makes it a legal necessity for all organisations that spend more that £20k in England or £10k in Wales on regulated campaigning in the year prior to an election to register with the Electoral Commission. In the case of the snap General Election, this meant that campaigning charities had to back date expenditure to May 2016.  The letter says: "While we recognise that regulation is necessary to ensure that no one individual or organisation can exert undue influence at an election, the Lobbying Act has had a disproportionate impact on charity campaigning. This is despite the fact that, unlike organisations from many other sectors, charities are already subject to strict limitations on their political activity under charity law. The excessive and unreasonable red tape the Lobbying Act places on charities made it harder for them to campaign at the 2017 General Election. We are concerned that this caused many charities not to engage, resulting in some important voices being lost from public debate."

See the Third Sector section for more news

 

Health and Social Care

  • The Scottish Government have launched new Health and Social Care standards, which will be implemented through inspection and scrutiny of services on 1 April 2018. The standards apply to the NHS and services registered with the Care Inspectorate and Healthcare Improvement Scotland, and set out the standard people should expect when using health or social care services. They are focused on five personalised outcomes: I experience high quality care and support that is right for me;  I am fully involved in all decisions about my care and support; I have confidence in the people who support and care for me; I have confidence in the organisation providing my care and support.; I experience a high quality environment if the organisation provides the premises.  They are also underpinned by five principles: dignity and respect; compassion; be included; responsive care and support and wellbeing; which reflect the way that everyone should expect to be treated. Non-registered services will also be expected to use the Standards as a guideline for how to achieve high quality care.

    MHA comments:  We worked with MHA colleagues in Scotland to respond to the consultation on these and we are very supportive of the strong personalised standards they have put forward.

  • The Scottish Government has also published a new Dementia Strategy for 2017-2020, with three key priorities:  1.Continuing timely, person-centred and consistent treatment and care for people living with dementia and their carers, in all settings.  2.More progress on the provision of support after diagnosis and throughout the disease, taking account of individual needs and circumstances.  3.Responding to the increasing proportion of older people developing dementia later in life, often alongside other chronic conditions

  • A Bill has been launched in Scotland, aiming to support people under 65 with conditions like dementia access free personal care. Frank’s Law, a campaign in memory of former Dundee United footballer Frank Kopel, will mean people with dementia can access free care which, at present, is restricted to over-65s.  The member’s Bill by Miles Briggs MSP has the support of all the opposition parties, meaning the Bill is supported by a majority of MSPs in the Scottish Parliament. The SNP has yet to give a position on the bill, but as the SNP has no overall majority means the law could pass without the government's backing.

  • The Welsh Government have published a White Paper aiming to strengthen health and care quality and governance in Wales.  The proposals, Services Fit for the Future, Quality and Governance in Health and Care in Wales, include common standards and joint complaints handling; better decision-making across health boards through a new Duty of Quality for the Population of Wales and a clearer process for service change; as well as further promoting a culture of openness in the health and social care system through a new Duty of Candour. There are also proposals for strengthening the way the public is represented across health and social care, and for regulation and inspection.  The consultation on the White Paper will run until 29 September.

  • The Welsh Government has launched plans to curb the use of zero-hours contracts in the social care sector.  The proposals have been published for consultation and propose that employers will need to offer workers in the domiciliary care sector on zero-hours contracts the choice of moving to a minimum hours contract after three months of continued employment, if there is ongoing demand for the work.

    See the Health and Social Care sections for more news

Housing

  • The Prime Minister has endorsed a review that urged the mass sale of NHS land for housing development and floated the creation of an NHS-owned housing association, following the Naylor Review published in late March 2017.  The review by Sir Robert Naylor, former CEO of University College London Hospitals, suggested the NHS could form its own housing association to house its staff, to help the recruitment for NHS staff.  An analysis by Deloitte, which was part of the review, found some £2.7bn could be raised from selling surplus NHS land and buildings, yielding sites for 40,000 homes.

See the Housing section for more news

 

Other

  • Cardiff University is to host a new £6m research centre, the Wales Centre for Public Policy, which has been funded for five years by Welsh Government and the Economic and Social Research Council and aims to play a key role in encouraging evidence-based policy-making and professional practice. It will look at key policy issues including Brexit, supporting growth and prosperity, closing the education attainment gap, and the future funding of the health service and social care. The Centre will combine this with a broader approach that will involve working with public services and as part of the UK-wide What Works initiative.

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Ageing and wellbeing

Mental Health

  • A large research study from the Universities of Plymouth and Exeter has revealed that older people are not being referred for mental health support nearly as frequently as their younger counterparts, despite achieving better outcomes when they are referred. The researchers analysed over 80,000 mental health treatments in South West England as part of the Improving Access to Psychological Therapies (IAPT) initiative.  The analysis revealed that the percentage of people referred to mental health therapies for common conditions – such as anxiety and depression – reduced with age.  This is despite the facts that low mood and anxiety are more common in mid to old age and that older people may be more likely to benefit from talking therapies than younger age groups. The authors of the study suggest that there are a number of multiple factors which may lie at the heart of the under-referral of older people to mental health care, such as: older people may see a stigma in requesting mental health help or may prefer to try to deal with the problem themselves; they may also have multiple health conditions which could lead to a reduced recognition of mental health issues; they are more likely to be prescribed medication for common mental health problems; being frail or housebound can also prevent access to mental health care which is often designed for those who are fully mobile. The authors also cite the attitudes of professionals as an additional barrier to older people receiving mental health therapies. 

Older Workers 

  • A new report from PwC, the Golden Age Index, suggests that the UK economy could be boosted by £80bn per year if the country employed as many older workers as Sweden.  The Index measures how effectively countries harness the economic power of older workers, defined as those aged over 55 and it reveals that the UK ranked 19th out of 34 OECD (Organisation for Economic Co-operation and Development) countries. Iceland was top of the rankings, while Sweden is in fourth place. PwC found that if the UK employment rates of those aged between 55 and 64 matched those of Sweden, GDP could be boosted by around 4.2%, which equates to £80bn at current values.  John Hawksworth, PwC’s chief economist said As the number of people over 55 continues to grow and life expectancy increases, the UK needs to make it as easy as possible for people to continue working for longer if they wish to, this would boost both GDP and tax revenues.” 

Technology 

  • According to the Ofcom's annual Adults' Media Use And Attitudes report, older people are using smart and social technology in growing numbers, with a sharp rise in the number of over-75s using tablet computers. More than a quarter (27%) of those over the age of 75 now use tablets, up from 15% in 2015. Almost half of those aged 65 to 74 (48%) now have a social media profile, as do 41% of over-75s - up from 19% in 2015. The report noted "striking" growth in older people's use of technology between 2015 and 2016. Four in 10 65-74 year olds (39%) now use a smartphone, up by 11% in a year, while the use of smartphones among the over-75s has nearly doubled from 8% to 15%.

    MHA comments: This annual report presents a big shift in the use of technology and social media and will be of interest to colleagues across the organisation in how we develop services and communications with older people.

  • New research led by University of Manchester indicates that video games which involve physical activity significantly boost brain health as people age. Systems that use physical activity for gaming such as the Wii and Xbox Kinect can boost brain functioning and physical coordination in people with neurological impairment, as well as keeping our minds healthy and active as we age.  Researcher Joseph Firth said: “As people age, their brain functioning, such as memory, concentration and spatial awareness naturally decline. Various neurological conditions such Alzheimer’s and Parkinson’s disease, mild cognitive impairment, and dementia can also impede people’s cognitive functioning and reduce their ability to function day to day... Physically-active video games have, according to our research, greater impact on brain functioning than regular physical activity alone – suggesting that their benefits are more than just moving around.”  Co-author Dr Emma Stanmore added: “Our research shows the potential of active video games that can be used independently at home and remotely supervised by therapists. The brain benefits may be because these activities are physically demanding, while also requiring concentration and cognitive effort, resulting in positive effects for body and brain. We hope this research will encourage the NHS and social services to take up active gaming as part of their support packages- as some are already starting to do.” The research aggregated data from 17 clinical trials examining the effects of active gaming on cognitive functioning across 926 people.

Exercise 

  • Research from Northumbria University, has shown that older people with a range of age-related conditions including arthritis and dementia showed physical and health related improvements after doing Yoga classes.  The three-month research study conducted at Yorkshire Yoga and Therapy Centre, two community centres and a care home in Harrogate, with 52 participants ranging from 63 to 92 years of age. The study showed that a weekly group-based Yoga programme, older adults with a broad range of age-related conditions and adapted to ensure safe participation, could lead to improvements in physical function and mental health. The most commonly-cited physical benefits included improved mobility, for example improved chair rising, walking ability, improved flexibility and reduced pain. Mental health benefits included stress-relieving effects, improved mood and a reduced frequency of panic attacks. More than 70% of participants said they liked the social interaction that the group exercise class provided and many said they had developed new friendships. Dr Garry Tew, who led the research from the University’s Department of Sport, Exercise and Rehabilitation, said Yoga is a holistic therapy, which has the potential to produce a range of physical and mental benefits. The apparent social benefits of this programme were also very interesting, with many participants saying they felt the classes gave them a new lease of life and made them feel less isolated.”

    MHA comments: This research and the one from the University of Manchester (above) may well be of interest to our Live At Home colleagues as they think about designing potential future activities for their members.

In brief:

  • The Office for National Statistics (ONS) has published its latest data on Healthy Life Expectancy, newborn boys in England in 2013 to 2015 could expect to live until 80 years old, while baby girls were likely to reach their 83rd birthday. However, they report highlighted that these children are likely to spend at least 20% of their lives in poorer health. Boys born in 2013 to 2015 will enjoy just 63 years of good health on average, while girls can expect 64 healthy years - consequently ONS have also looked at the factors which impact, such as smoking, alcohol and lack of exercise.

  • At the Manchester Institute for Collaborative Research on Ageing annual public lecture, Lord Geoffrey Filkin, Chair of the Centre for Ageing Better questioned the progress made since the publication of the House of Lords Select Committee report Ready for Ageing in 2013. Lord Filkin concluded that while progress has been made in certain areas, much still needs to be done to improve the quality of life of older people. He highlighted the importance for Government needing to recognise ageing as an opportunity and see older people as an asset. "Most politicians are focusing on the cost of more older people rather than on the potential of having better later lives. Our policies would be so different and much better if they owned that."  He emphasised the need to develop a new narrative and campaign against ageism and empower people and communities. He also identified the promotion of an age-friendly economy, healthy ageing, and age-friendly places as key areas to address to better support an ageing population.

    MHA comments: We very much agree with Lord Filkin's point about the opportunities that ageing brings.  We will always do what we can to change the narrative.

  • The Older People’s Commissioner for Wales, Sarah Rochira, has published her annual Impact and Reach Report 2016-17: Changing Practice, Changing Lives, which evaluates the achievements of the role over the year.  Her 2016-17 focus was on safeguarding, quality of life, access to GPs and dementia services.  In 2017-18 she will focus on: quality of life and care of older people living in Welsh care homes; safeguarding older people in hospital; access and experiences of independent professional advocacy; phase two of the Ageing Well in Wales Programme; analysis of Health Board Annual Quality Statements; the provisions of respite care across Wales; as well as learning from casework.

  • A new research project at the University of Hull promoting the health and wellbeing of older people is looking for co-researchers, aged over 70.  The DEarEST project – Co-creating healthy ageing in Hull, aims to work with older people to find out what it means to maintain health and wellbeing in older age.  The project gets its name from what evidence shows are five key physical things that contribute to health and wellbeing – good hydration (Drink), healthy diet (Eat), exercise (movEment), rest (Sleep), and social interaction (Talk) – DEarEST. Participants need to be aged 70 or over, registered with a Hull GP and able to take part in group discussions. No special skills are required – but participants must be happy to share their experiences of living as an older person in Hull.  The deadline for applying is 31 July.  More details are available from Debbie Kinsey (07856 811873, Debbie.Kinsey@hull.ac.uk).

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Dementia

Research

  • The Alzheimer’s Society has announced its biggest-ever single investment in dementia care research, with £6m awarded to three Centres of Excellence. The Centres will focus on key priority areas within dementia care research over the next five years, including ways to measure and improve quality of life, improve access to post-diagnostic support and training for homecare workers. The centres located at the Universities of Newcastle and Exeter and University College London, are part of a initiative by the charity to address the urgent need for research into dementia care.

  • Researchers at the University of San Francisco have found that older people with persistent pain show quicker declines in memory as they age and are more likely to have dementia years later.  The researchers analysed data from 10,000 participants aged 60 and up over a 12-year period. Those participants who said they were persistently troubled by moderate or severe pain in both 1998 and 2000 declined 9.2% faster in tests of memory function over the next 10 years, than those who said they were not troubled by pain. The patients who complained about persistent pain also had a small but significantly increased likelihood of developing dementia overall. The research does suggest that further study is needed to understand the association between chronic pain and dementia and the relationship with painkillers. 

Technology

  • A new app developed by the University of Stirling, aims to make personal recommendations about how people with dementia can improve their living environment. The app will look at how suitable a home or care facility is by taking into account multiple factors known to impact people with dementia, such as lighting, colour schemes and noise. By using photos submitted and answers on a questionnaire about the surroundings, the app will provide personalised suggestions for how things could be improved.  The app, which will be available to download in September 2017, is being designed in collaboration with construction experts Space Group.

In Brief:

  • Volunteers and fundraisers from the Prince's Trust have helped to create a unique dementia village at a care home in Salford, as part of The Prince’s Trust 'personal development' programme. Over two weeks, the team of 11 transformed the courtyard at Pemberton Fold care home into a traditional English village, complete with an allotment, sweet shop and gardens. To fund the challenge, the team raised over £400 by packing customers’ bags at supermarket. 

  • As the life expectancy of people with learning disabilities increase, so too does their risk of developing conditions such as dementia. Emma Killick, Director of Adult Services for learning disabilities charity MacIntyre has written a blog on how they are working to raise awareness and improve care and support for those living with the condition, their families and carers.  In February 2016, MacIntyre was awarded a grant from the Department of Health’s Innovation, Excellence and Strategic Development Fund for a three-year project to address the issues and gaps in this area. The MacIntyre Dementia Project will create a range of learning and multi-media information resources, made freely available after the third year of the project, to address the issues.

  • The Guardian recently hosted an online discussion What makes a dementia-friendly community? It considers how the public and voluntary sectors, retail and service industries can recognise and support people with dementia.

    See also the Government section on Health and Social Care for more news on dementia, from the Scottish Government

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Finance and pensions 

Pensions and retirement income

  • A new report from the Pensions and Lifetime Savings Association and Club Vita has highlighted how socio-economic factors impact on longevity. It finds that while average life expectancy at 65 has barely risen since 2012, more affluent retirees’ are living longer. The report is based on analysis of 2.5 million pensioners in over 200 pension schemes. Using post code data as well as average Defined Benefit pension income, it has identified three groups for men – hard pressed, making-do and comfortable and two for women – hard-pressed and making-do/comfortable. Men who were in the comfortable group lived on average 3.3 years longer than those who were hard pressed. Women who fell into the making-do/comfortable group lived 1.6 years longer than those who the report identified as hard-pressed. Additional analysis of the English Longitudinal Study of Aging (ELSA) data identified the health and social habits of each group. Those who were in the comfortable group were more likely to regularly undertake moderate exercise, have never smoked and are married or in a civil partnership which is likely to have contributed to their increased longevity. Companionship also plays a role with 78% of ‘comfortable’ men saying that rarely feel they lack companionship, compared to those who are hard-pressed (67%).Steven Baxter, Head of Research at Club Vita commented: At a societal level it is concerning to see that there has been a divergence in life expectancy expectations between different socio-economic groups. The slowdown in longevity for much of society is likely to have an impact of a wide range of support services including health and long term care... For pension schemes, however, having an insight into the socio-economic dynamics of longevity trends has never been more important. Our evidence that affluent men are living longer and pulling away is hugely important. It will have a massive impact on the projections and assumptions used by pension schemes, as a large proportion of the liabilities are in this socio-economic group.“

  • The gap between women’s and men’s annual average expected retirement incomes in 2017 has grown by £1k in the last year, according to new research from Prudential. This year’s Class of 2017 research shows that women expecting to retire this year will be £6,400 a year worse off on average than their male counterparts, and nearly £200 a year worse off than women who retired in 2016. Women this year expect an average annual retirement income of £14,300, which is the second highest on record although slightly down on the £14,500 for those retiring in 2016. However, this year’s female retirees are feeling slightly more confident about their finances, with 50% saying they are financially well-prepared for retirement, compared with 48% in 2016. Meanwhile, as women’s incomes stagnate, men’s expected retirement incomes have shown a fifth consecutive year of growth. Men retiring in 2017 expect an annual retirement income of £20,700 – £900 a year more than last year which is helping drive the gender gap to its highest level for three years.  The retirement income gender gap shows that men retiring this year will be 45% better-off than women.

In brief:

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Health  

Strategy

  • London South Bank University (LSBU) has published Sustainability and Transformation Plans: How serious are the proposals? A Critical Review, looking at the 44 existing STP plans for the NHS. LSBU do not consider the plans to be fit for purpose as they stand and need to be given legislative powers and support to achieve effective collaboration and much-needed clarification on their role.  The report also recommends that STP leaders need to plan ahead based on the reality of their current situation, identify changes that are evidence-based, develop workforce plans that match their ambitions, and focus on reducing demand before removing resources from the acute sector.  At present some elements of these recommendations are missing in all of the 44 published STPs.  Overall, the review suggests a lack of comprehensive planning and evidence-based policy making.

  • Meanwhile the British Medical Association, has also criticised the STPs citing the high salaries of new managers and the use of consultants to develop the plans, which could see hospitals closed and A&E services downgraded.

Joint working

  • Simon Stevens, Chief Executive of NHS England, has announced the launch of eight 'Accountable Care Systems' (ACSs) across England that will bring together local NHS organisations, social care services and the voluntary sector. The first group of designated ACSs will be at the forefront of nationwide action to provide joined up, better coordinated care breaking down the barriers between GPs and hospitals, physical and mental healthcare, social care and the NHS. The first group of designated ACSs have agreed with national leaders to deliver fast track improvements, including taking the strain off A&E, investing in GPs to make it easier to get an appointment, and improving access to high quality cancer and mental health services. These areas will also lead the way in taking more control over funding available to support transformation programmes. The  areas include:
    * Frimley Health including Slough, Surrey Heath and Aldershot
    * South Yorkshire & Bassetlaw,
    * Nottinghamshire, with an early focus on Greater Nottingham and Rushcliffe
    * Blackpool & Fylde
    * Dorset
    * Luton, with Milton Keynes and Bedfordshire
    * Berkshire West, covering Reading, Newbury and Wokingham
    * Buckinghamshire

    MHA comments: This will be of interest to care home colleagues in these areas. These new ACSs do add another layer of complexity to the range of NHS systems and transformation programmes, which can be difficult to navigate on the frontline of our services.

  • A new devolution agreement in Surrey Heartlands, similar to the existing one in Greater Manchester, has been agreed between NHS England and NHS Improvement, alongside Guildford and Waverley Clinical Commissioning Group (CCG), North West Surrey CCG, Surrey Downs CCG and Surrey County Council. The agreement sets out how partners will work together to improve the health outcomes and more local accountability for the spending of health and social care budgets. The agreement aims to: accelerate the integration of health and social care through much closer working between partners; increase public engagement and the involvement of the people of Surrey Heartlands around the transformation of health and social care; and increase local decision-making and flexibilities to achieve the best possible outcomes for the local population.

  • Jackie Pederson, Chief Officer at Doncaster CCG has written a blog that looks back at Doncaster’s journey towards integration of local health and care services, from working with the LA to carry out a joint strategic needs assessment, to developing a plan to integrate health and care commissioning and an accountable care provider partnership. Funded by the Better Care Fund, the implementation of Doncaster’s Health and Social Care Place plan has resulted in a reduction of 85% in admission to acute care. 

  • The House of Commons Library has published a briefing paper Health and Social Care Integration, which analyses recent policy and debate on the integration of NHS-provided healthcare and local authority-provided social care in the UK. This has been a key policy priority for successive Governments, with the aim of improving patient care and saving money for the NHS and local authorities.

  • A new report from the NHS Partners Network has highlighted examples where the independent sector is working with the NHS to avoid delayed discharges of care. The examples include: providing extra back-up capacity for NHS hospitals at the weekend; providing supported discharge services which allow patients to receive complex clinical care in their home via ‘virtual wards’; providing nursing home support packages with extra capacity for acute trusts which in turn helps to prevent admissions in the first place; and improving the referral pathways and admission criteria for patients who no longer need acute care, but need extra support until they are fully ready to return home. David Hare, CEO, NHS Partners Network, said While the causes of delayed transfers of care are complex and there will be no one-size-fits-all model to tackle the issue, this report clearly demonstrates that NHS/ independent sector partnerships can help reduce delayed discharge – providing real benefits to patients as well as efficiencies across the health system."

  • John Everson, Assistant Director of Adult Social Services at Haringey Council has written a blog Reducing delayed transfers of care in Haringey which explores how the council tackled challenges they faced when addressing delayed transfers of care (DToCs) locally. The blog reviews how working with local acute trusts and implementing a trusted assessment model to manage service users through crises in their own homes have impacted on DToCs rates. 

  • The Housing LIN have published a new case study A shared understanding: Localising the integration of housing and health in Nottingham through a Memorandum of Understanding (MoU), where Rachael Harding, Housing Strategy Specialist at Nottingham City Council, presents the journey taken by the council to embed housing as the third strand of local health and social care integration through the development of a local MoU.

  • The Department of Health has announced the full list of 21 members who form the new voluntary, community and social enterprise (VCSE) Health and Wellbeing Alliance. Some of these include: Age UK, Carers Partnership, Citizen’s Advice, Faith Action, FrMental Health Consortium, National Voices,  National Association for Voluntary and Community Action, National Council for Voluntary Organisations, National Council for Palliative Care, Race Equality Foundation, The National LGB&T Partnership, and UK Health Forum. The alliance aims to make it easier for the voluntary and statutory sectors to work together to: improve health and care systems; address health inequalities; help people, families and communities to achieve and maintain wellbeing; and bring the VCSE sector’s voice and expertise into national policy making.

Funding

  • The Secretary of State for Health Jeremy Hunt, has announced a second wave of funding to ease pressure on hospital emergency departments ahead of winter 2017/18.  Over £20m has been awarded to 27 hospitals in England, following an initial £56m given to 70 hospitals in April 2017. The money is part of the dedicated funding announced in the Spring Budget to help local A&Es are prepare for the additional demands that winter brings

  • A new briefing paper from NHS Clinical Commissioners, an independent membership organisation of Clinical Commissioning Groups (CCG), has shown that rising inflation, along with a growing population, has resulted in a real terms decrease in the value of the CCG funding allocations. The analysis projects that by 2019/20, CCG funding will diminish by £5.72 per person on average when compared with 2016/17 funding.

  • In addition, The King's Fund's latest quarterly monitoring report, the NHS is planning to delay or cancel spending in half of local areas this year to meet financial targets, according to The King’s Fund. The report finds that 50% of CCGs Finance Leads, say that achieving this year’s financial forecast is likely to depend on delaying or cancelling spending. More than 40% they plan to review or reduce the level of planned treatment they commission following the recent downgrading of the 18-week referral-to-treatment target. Just under half of CCGs were also uncertain or concerned about their ability to increase funding for mental health services in line with the national commitments.

  • The Institute of Public Policy Research (IPPR) have suggested that a new ring-fenced NHS tax, funded by a rise in national insurance, could raise up to £16bn over the next five years and help solve the financial crisis in the health service is needed. IPPR said the money should be channelled through the Sustainability and Transformation Plans (STP) fund as NHS England carries out reforms to prevent a funding gap of more than £22bn by 2021. It wants the government to create a new hypothecated NHS tax by raising income tax and national insurance for the highest paid and reform pensions tax relief to deliver a £3bn a year cash boost to social care. 

  • Three new research projects have been awarded grants by the Health Foundation, as part of its £1.5m Efficiency Research Programme. The projects will explore innovative approaches to achieving greater system efficiency and sustainability in health and social care in the UK. The Programme was launched in 2014 and provides grants of up to £500k to support projects over three to five years. New funding has been awarded to:- Allocative efficiency in end-of-life care, Imperial College London: looking at whether improvements in the efficiency of health and social care delivery at the end of life could enable access to higher-quality and more personalised care for patients.
    - WORKTECC: Workforce Operations that Realise Knowledge-based Transformational Efficiency gains in Community Care, University College London (UCL): aiming to identify the scope for transformational efficiency gains in home-based NHS care. It will assess whether workforce operations used by other industries could deliver improved efficiency, and if so, how.
    - Efficiency, cost and quality of mental health care provision, University of York: looking at the efficiency, cost and quality of current mental health care provision, assess organisational factors, and estimate how mental health trusts can make changes to improve their efficiency and cost effectiveness.

In brief:

  • A project called Extending the QALY, has been launched to review the way that quality of life is measured across health and social care by National Institute for Health and Care Excellence (NICE) and led by the School of Health and Related Research (ScHARR) at the University of Sheffield. When NICE considers the cost-effectiveness of a healthcare intervention like a new drug or diagnostic, the benefit of an intervention is measured by how many quality-adjusted life years (QALYs) it provides. The research is a response to criticisms that the current measures do not capture the important benefits of treatments beyond health-related quality of life, such as independence or improved relationships with family, friends and carers.

  • Public Health Wales has published new handbooks for patients on non-emergency transport vehicles across Wales, providing advice and information to help older people avoid falls. The Get Up and Go booklets are being distributed thanks to a partnership between Public Health Wales, the Welsh Ambulance Service and the Chartered Society of Physiotherapy and is part of the Steady On, Stay SAFE national falls prevention campaign for older people.  The booklets are available to download on their website.

    See also the Government section on Health and Social Care

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Housing

Older people's housing choicesmall building image

  • Research from estate agents Strutt & Parker and Octopus Healthcare has investigated the needs and desires of the older people by surveying over 2,200 respondents across the UK aged 65 years or older. The key insights from The Platinum Generation survey include: 73% of respondents have no plans in place for retirement accommodation or their care provision in later life; 42% believe there is a lack of suitable properties in the UK to downsize into; 41% would like a six-month trial before permanently moving into a retirement community; and 17% would consider living in a professionally managed rental home. The survey also revealed the top reasons respondents looked for a new home included:
    1) 34% need more support – requiring help or a ‘crisis event’ are historically the biggest motivators for moving.
    2) 33% seek lower maintenance – modern homes that require less upkeep, or developments with on-site maintenance are particularly attractive to older residents.
    3) 26% are looking for accessible homes – with level thresholds, fewer stairs and walk-in showers.
    Richard Harris, Head of Retirement Development at Strutt & Parker said “To effect change, developers must meet the aspirations of a new generation of retirement residents… retirement developments that incorporate good public transport, a sense of community and access to health and leisure activities are most likely to succeed."

  • Meanwhile Independent Age have also published research, which suggests that poor health and mobility are the top reasons why older people would move house. The survey of over 2,000 adults aged 65 and over in the UK found that the top three reasons that would make people aged 65 and over think about moving home are: health or mobility getting worse (43%); wanting less garden maintenance (29%); and being unable to do housework and maintenance (25%). However, almost one in three (30%) people aged 65 and over said that there is nothing that would make them think about moving home.  More than four in five (83%) of those surveyed had not fully planned ahead for their future housing needs. Coinciding with the research, Independent Age, has launched two new, free advice guides called Getting help at home: Ways to stay independent and Choosing where to live: How to find the right option for you.

MHA comments: We have recently undertaken a Retirement Living survey with our residents and are currently undertaking a survey with older people across the UK on what they want from Retirement Living. The insight from both these pieces of work will inform our future developments.

Sheltered Housing

  • Demos has published research on The Social Value of Sheltered Housing, has reviewed existing evidence by analysing the qualitative data relating to the savings generated to health and social care services.  The report finds that sheltered housing saves NHS and social services at least £486m per year. Specifically, it suggest the savings as: £300m per year from reduced length of in-patient hospital stays; £12.7m per year from fall prevention by residents of sheltered housing; £156.3m per year from prevention of falls which result in hip fractures; and £17.8m per year from reduced loneliness experienced by residents. Commenting on the findings, the report’s author, Claudia Wood, Chief Executive at Demos said “Sheltered housing for older people is a low-cost, high-impact service which saves the state huge sums of money. Considering the NHS is currently under enormous financial pressure, capping the Housing Benefit of those who live there seems to be another self-defeating benefit cut.”
  • An innovative LinkAges Intergenerational Housing Project in Cambridge is looking to creating shared spaces for all ages. Postgraduate students are being recruited by Cambridge Hub to be offered flats in a CHS sheltered housing scheme at intermediate market rents, in return for volunteering 30 hours per month with existing older residents. Peter Hall, Operations Director at CHS, explains that the project is the result of some innovative thinking in a strategic review of the future of sheltered housing “The review looked at many options for the future, including demolition and redevelopment. None of the them could meet CHS’ aim of delivering the same numbers of affordable housing. And in thinking about alternative uses for the existing building, we factored in the shortage of accommodation for postgraduates in Cambridge, loneliness issues for many older people despite sheltered housing being increasingly unpopular, and some of the great intergenerational volunteering and housing work taking place in Holland and elsewhere in Europe.”  Subject to formal approval by the regulator, the project aims to move the first batch of students into flats in the sheltered housing scheme from September 2017.  Expressions of interest from postgraduate students for the initial 3 to 5 spaces available have been strong, and tenants of the sheltered housing scheme have generally welcomed the project. Amongst the intended outcomes are improved health and wellbeing and reductions in loneliness for existing sheltered housing residents, and positive volunteering experiences and affordable accommodation for students.

Strategy

  • The Lyons Housing Commission and the Institute of Public Policy Research (IPPR) have published a collection of essays - What more can be done to build the homes we need?  Three years on from the Lyons Housing Commission and following the publication of the Housing White Paper, the original members of the Commission have revisited the challenges facing the housing market. Michael Lyons urges the Government to implement bold measures that could promote an increase in the supply of new homes to meet demand. He argues that the political parties remain too strongly wedded to owner-occupation and there needs to be recognition that we cannot provide the number of homes needed without building homes of all tenures. He also makes the case for a more fundamental review of the greenbelt. Essays are included from:
    * Malcolm Sharp, on the role of land and planning. He argues for stronger measures to make sure that land with planning permission is brought forward swiftly for housing development;
    * Mark Clare, former CEO of Barratt Homes, on the role of the private housebuilders. He proposes driving the current housebuilders harder, to deliver an industrial strategy for housebuilding and increase the number of SME housebuilders;
    * Michael Lyons and Caroline Green, write about giving older people’s housing a higher priority in public policy to benefit the young. They argue for prioritising government investment and public land to deliver housing for older people, as well as ensuring there is more attractive rental offer for older people;
    * James Bailey, PwC, writes on the potential contribution of local authorities. He argues for the establishment of a new generation of housing development companies and ‘bespoke agreements’ to allow local authorities to borrow more in exchange for a commitment to build more homes;
    * Bill Hughes, Head of LGIM Real Assets, looks at the bigger contribution that could be made by the build to rent sector and proposals to support it, including simplifying VAT, improving the planning environment and encouraging capital investment.

Housing Market

  • New research from Countrywide, suggests that the amount spent by retired people on rent has more than tripled since 2007. Over the last 12 months they paid a total of £3.7bn in rent, up 216% from the £1.2bn paid in 2007. This increase means that £1 in every £14 (or 7.3%) paid by tenants in Great Britain now comes from a pensioner. In 2017 their average rent was £810 a month, up 0.3% on last year and 19% since 2007, although the average retiree paid 12% less than the typical tenant, because they were more likely to rent a smaller home and live in the places where rents are lowest. Retired people now account for 8% of all tenants, compared with 5.2% in 2007. The largest proportion is in Wales, where nearly 1 in 5 (18%) of tenants are retired. The South West (13%) and the North East (10.1%) have the second and third largest proportion of retired tenants respectively. London, where just 3.5% of tenants are retired, has the fewest. Across Great Britain as a whole 53% of tenant pensioners live alone and 81% are over the age of 65.

  • Commercial property and investment management services company, JLL, have published a Housing with Care Index, which analyses the resale values of retirement community leasehold properties. This research draws on evidence from historic sale transactions from  members of ARCO.  The key findings were:
    • 80% of ARCO leasehold properties increased in value on resale
    • The average price change between transactions was £41,391
    • Price growth in the sector also correlates strongly with average house price trends and UKHPI
    • ARCO-registered units have an annual average price growth of 6% per annum.

    MHA comments: This will be of particular interest to our colleagues in retirement living, where we have number of schemes registered with ARCO.

  • The Office for National Statistics (ONS) has published the Index of private housing rental prices (IPHRP) in Great Britain: May 2017. It shows that Private rental prices paid by tenants in Great Britain rose by 1.8% in the 12 months to May 2017; unchanged from April 2017. In England, private rental prices grew by 1.9%, Wales saw growth of 0.9% while Scotland saw rental prices decrease (negative 0.1%) in the 12 months to May 2017.

  • The ONS has also published the UK house price index: April 2017. It shows that average house prices in the UK have increased by 5.6% in the year to April 2017 (up from 4.5% in the year to March 2017). While up against March 2017, there has been a general slowdown in the annual growth rate since mid-2016. The average UK house price was £220k in April 2017. This is £12k higher than in April 2016 and £3k higher than March 2017.

  • The House of Commons Library has published a briefing paper looking at Housing market: Key Economic Indicators, which looks at data on house prices, mortgage approvals and house-building.

In brief:

  • Following the Grenfell Tower Fire, the Homes and Communities Agency has written to all housing associations to remind of their statutory duty regarding health and safety. The CQC have also written to providers urging them to check fire safety processes and "pay attention to the size and fabric of your registered premises".

MHA comments:  As a precautionary measure MHA has instigated a check of fire safety equipment and procedures across all our residences to ensure our residents are safe in the event of fire. We have established that there is no cladding like the type used on Grenfell Tower in any MHA property.

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Social Care

Care crisis

  • ADASS (Association of Directors of Adult Social Services) has published it's Annual Budget Survey 2017, which presents analysis of the state of adult social care finances drawn from the experiences of current leaders in adult social care.  It reveals that the proportion of council spending on adult social care is set to increase by 1.3% this year. However, councils are still having to make 8% cuts in overall budgets for a second year in succession due to increasing costs and demand. Despite a welcome £2bn in extra funding, only 31% of responders were fully confident that planned savings for 2017/18 will be met, falling to 7% confidence in 2019/20.  Directors also have major concerns about the sustainability of the care market - failure within the provider market affected at least 69% of councils in the last 6 months, while 74% of responders believe that providers are facing quality challenges. The Better Care Fund was not felt to be providing more resources and overall reduced council budgets were making it harder for councils to manage the tension between spending on statutory duties, and prevention and early intervention.  Professor Martin Green OBE, Chief Executive of Care England said ADASS’s Budget Survey echoes what our members have been telling us, the extra funding from Government is not reaching the front line. Without this funding combined with a long term commitment from the Government the social care sector, for adults and older people, will simply combust. Commissioners and providers need to sit down together to discuss the sufficiency of an individual’s care package, rather than this being set as part of an arbitrary standard price.  The value of high quality independent care services needs to be understood by all politicians, not just service users and their families.  Councils simply will not be able to cope with the rising demand for social care unless a viable solution is provided by Government.  The country needs clarity on social care and cannot afford to wait for more commissions, inquiries or Green Papers. The care crisis is happening now.  We need a long term vision built on the previous reports commissioned by Government. Such a vision needs to be lead by a Ministerial team that is equivalent in status to those that look after the NHS and thus provide more clarity about the partnership between the state and the individual in terms of funding”.

  • Think tank Reform, have put forward policy solution to the crisis in funding social care. In Social care: a prefunded solution, they make the case for fundamental reform: replacing the current ‘pay-as-you-go’ approach to financing later-life care with a prefunded arrangement. Under this proposal, working-age people would contribute a percentage of their income into a Later Life Care Fund. These pooled savings would then be managed privately, before being used to fund the care costs of those that contributed.

  • A new research project led by academics at the University of Sheffield will examine potential sustainable solutions to the ongoing crisis within the UK’s social care system. The Sustainable Care Research Programme, led by Professor Sue Yeandle from the University of Sheffield’s Department of Sociological Studies, brings together academics from seven universities and will take an international approach to identifying solutions to this crisis. The project will take a future-oriented and internationally comparative look at current approaches to the care needs of adults living at home with chronic health problems or disabilities, examining these in the context of care systems, care work and care relationships. Researchers will investigate how these approaches can be made economically and socially sustainable while still delivering positive outcomes for care users, for families and carers and for care workers.

  • A blog by Dr Richard Davis from the RSA (Royal Society for the encouragement of Arts, Manufactures and Commerce), considers Care as a Social Responsibility and looks at whether social care services provided on a voluntary, community basis could be expanded on a large scale. He says "Connected communities are happier and healthier. Human beings are fundamentally social creatures and social engagement tends to increase wellbeing... As professional and non-professionals, we need to learn more about how to stimulate the provision of care across our communities."

Care provision

  • The Competitions and Markets Authority (CMA) has published its update paper for its Care Homes Market Study, which sets out findings so far, future focus and possible recommendations.  The initial findings include:
    •People are struggling to make decisions about care: findings suggest that many people find it difficult to get the information they need, are confused by the social care system and funding options, and do not know how to find and choose between homes.
    •Complaints procedures are not functioning well: findings suggest that redress systems often do not work well, and residents can find it very challenging to make complaints.
    •While many care homes offer a good service, there are concerns that some might not be treating residents fairly and that certain practices and contract terms might break consumer law. 
    •The sector is not positioned to attract the investment necessary to build greater capacity needed for the future: At present, short-term public funding pressures and uncertainty mean the sector is not incentivised to undertake the investment necessary to meet future demand.

MHA comments: We have taken an active part in the CMA inquiry and supplied comprehensive information on our care home provision. We have published a response to this update paper, where we agree that social care and associated funding system is difficult to navigate, particularly at times of personal, individual crises and believe that work is needed to make it easier for people. At MHA we work very hard to provide as much information about our care homes as possible. Additionally, while it may be the case that some providers do not encourage feedback from residents and relatives, at MHA we encourage as much feedback as possible, so that we can continue to improve our services and the way we do things.  We have clear standard Terms and Conditions, we do not charge a deposit and we would never ask a resident to leave at short notice and we only charge residents up to the point when they leave us, including the notice period.  We would agree that short-term public funding pressures and uncertainty are really not helpful for the sector. The CMA has asked for further information and invited comments on the paper, which we will also be providing a response.

  • In related research, provider Younifi, suggest that the majority of older people in social care have no idea how much it costs. In their survey of 2,000 people, 71% said they did not know the cost of their care and only 5% knew the figure precisely. When asked who was responsible for their care, a third of those being cared for said it was themselves, while 26% said it was their family and friends and 24% said it was the NHS or local authorities. However, 68% said they wanted to be in control, with the majority of these wanting this to be in partnership with their close family and friends (63%), and just 12% saying they want their local authorities to have control over it. They concluded that a very process-based and complex system was causing councils to fall short of targets for people managing their own care, adding that councils should do more to link people with existing community-based services rather than taking on the responsibility themselves.

Quality

  • new study by the Warwick Medical School has been considering the effect that the design of care homes has on residents. The research is based on 50 care homes in Coventry and Warwickshire, and northeast London, concluded that the quality of design for indoor and outdoor spaces is of secondary concern for residents of care homes, who were more concerned with the accessibility of outdoor spaces in which they can relax and chat with others. The study went on to explore barriers to accessing outdoor space which included, procedural, staffing and physical barriers.  The research authors saidResidents expressed little interest in the décor of the care homes; and appreciated features of the care home that increased opportunity for social interaction and promoted independence and function. The findings of the study suggest that interventions that increase access to outdoor spaces could positively affect depressive symptoms in older people”. 

  • Care homes in Bolton have signed up to a new quality scheme aiming to improve standards across the borough. Bolton Council, together with NHS Bolton Commissioning Group (CCG), Bolton NHS Foundation Trust, and the care homes themselves, has launched the Care Home Excellence Programme. The scheme encourages residential care homes and nursing homes in the borough to commit to high standards of care, improving quality and experience. The programme has been designed in partnership with care home providers and their residents and families.  It aims to improve people’s experience of their stay, make homes safer, help to prevent care home residents from needing a stay in hospital and create a healthy market of high quality providers. 95% of care homes in the borough are already rated ‘good’ or ‘outstanding’ by the Care Quality Commission.

  • In celebration of Care Home Open Day on 16 June, SCIE (Social Care Institute for Excellence) has launched a new planning tool and four films to help managers of care homes for older people, explore what person-centred care means for residential settings.

In brief:

  • The Scottish Care Inspectorate has announced that along with Healthcare Improvement Scotland, it will be undertaking joint inspections of integrated health and social care, which includes the inspection of the quality of strategic commissioning. The methodology will consider: How well are integration authorities improving their performance in both health and social care? How well are the operational and strategic planning arrangements, and commissioning arrangements, working in a local area? How good are the vision, values and culture across the partnership, and the leadership of strategy and direction?

  • The CQC has published its Business Impact Target Assessment, which is part of a Government deregulation agenda, aiming to reduce the regulatory burden on business. It presents details of the changes in terms of regulation and how these impact the providers it inspects.

  • Social Care Wales have produced a webinar about social care changes and what it means for registration.

  • This House of Commons Library has published a briefing Social care: Government reviews and policy proposals for paying for care since 1997 (England), which considers the policy proposals of successive Governments since 1997 for how individuals should pay for their social care.

    See also the Government section on Health and Social Care

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Third Sector

Volunteering amongst older people

  • The Abbeyfield Society, has been awarded a grant of £265k, from the Big Lottery ‘Accelerating Ideas’ initiative,  to run the Residents as Volunteers project and evaluated in partnership with the Institute for Volunteering Research.  The project will develop volunteering opportunities for 100 people aged 75+, living within Abbeyfield Society care and housing facilities across England and Wales. The project will explore the positive health and mental wellbeing aspects of volunteering, encouraging active ageing and living healthier for longer.  It aims to understand the pattern and reasons while people stop volunteering over the age of 75. Learning from the project will be shared.

  • A blog from NCVO, Silver service: Barriers to volunteering among the over-75s …and how to overcome them, looks at volunteering amongst the over 75sIt reports that rates of volunteering fall sharply in the over-75s, yet evidence shows that older volunteers may benefit the most from it. The blog draws from the evaluation of the first year of Abbeyfield’s Residents as Volunteers project (above), which specifically aims to recruit over-75s from their residential homes to volunteer both inside and outside the home.

  • Dan Jones, Director of Innovation and Change, Centre for Ageing Better, has also written a blog Volunteering for a better later life, where he considers the value of older volunteers, the contributions they make and benefits they receive in return. "People who would have the most to gain from volunteering in later life – because they are lonelier, for instance, or don’t feel much sense of meaning and purpose in their lives – are actually less likely to take part. Older volunteers are generally healthier and wealthier than non-volunteers, and already have stronger relationships and social networks."  He also highlights social divisions in volunteering, "Formal volunteering is still predominantly a middle class activity. Rates of volunteering in the most disadvantaged communities in England are only half those in the richest places."

In Brief:

  • The Fundraising Regulator has announced it will be launching the Fundraising Preference Service (FPS) on the 6 July 2017. The FPS will enable individuals to: identify particular charities from which they want to stop communications; and select specific forms of communication that they wish to stop (eg telephone calls, emails or addressed mail). Once a suppression request has been made by a member of the public, the charity in question will have 28 days in which to cease contacting that person – although the public would also be warned that timeframe may not be achievable for some charities, particularly in the case of direct mailing campaigns. Once that initial 28 day period has expired, if an individual continues to hear from that charity, the FPS will issue the charity with a follow-up notification. Although the Fundraising Regulator cannot itself issue any fines for failure to comply with suppression requests, the Information Commissioners Office will treat contact from a charity to an individual signed up to the FPS as a section 11 breach of the Data Protection Act.

    MHA comments:  Anyone involved in fundraising should take note of this and contact the Fundraising team if they have any questions.

  • NPF Synergy have published a blog that considers the findings from the NCVO Almanac 2017, which indicates that 65% of paid staff in the voluntary sector are women. In Mind the gender gap: how charities can engage boys and young menthey explore what can be done to make the charity sector appealing to be men and boys, in terms of fundraising, volunteering and working in the sector.

    See also the Government section on Charities and Voluntary Sector for more news

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Workforce and Skills

Nursing

  • New figures obtained by the Health Foundation, have revealed a 96% drop in the number of nurses from the EU registering to practise in the UK since July 2016. The figures were from a Freedom of Information request to the Nursing and Midwifery Council and show that after a sharp decline from a high of 1,304 in July 2016 to 344 two months later in September, numbers have continued to fall, with just 46 EU nurse registrants in April 2017. They suggest that a fall in EU registrants requires a more sustainable long-term approach to workforce planning is urgently needed. Anita Charlesworth, Director of Research and Economics at the Health Foundation said "The recruitment and retention of nurses is one of the biggest challenges facing health and social care, with a shortage of 30,000 nurses in England alone... Without EU nurses it will be even harder for the NHS and other employers to find the staff they need to provide safe patient care. The findings should be a wake-up call to politicians and health service leaders."

  • A  new app has been launched, which enables care and nursing homes to hand-pick temporary nurses without having to use a traditional recruitment agency.  Florence enables care home managers to work directly with nurses and to clearly see their training, accreditation and ratings from previous jobs before booking them for shifts. More than 1,000 registered general nurses have already signed up with Florence.

  • A new online resource has been launched by Nursing Times and Health Education England, providing information and resources about the new Nursing Associate role.

Carers

  • A new Community Interest Company, Timewise has published a report Caring by Design, which sets out a series of recommendations for domiciliary care providers and policy makers to help solve the social care system’s recruitment and retention crisis. The report is the culmination of an investigation into how carers and their employers manage the challenge of providing a high quality service to people who need care, whilst enabling care workers, of which over 80% are women, to find the flexibility they need to manage their responsibilities outside of work. The research fieldwork behind the report was conducted among 80 individuals and 10 care providers. It included qualitative research with carers, managers and sector experts to identify the constraints on providing jobs that are compatible with carers’ commitments outside of work, coupled with a pilot of a geographical team-based approach to scheduling with a London-based community support provider, Rathbone.  The investigation identified the five key constraints on providing jobs which are compatible with carers’ responsibilities outside of work:
    1. The unpredictability of rotas
    2. The absence of slack in the system
    3. Unsociable hours
    4. Downtime in the middle of the working day
    5. The need to travel long distances between clients
    The investigation identified three different dimensions of flexible working which would improve the work-life balance for carers:
    1. Predictability of working hours
    2. Advance notice
    3. Input into schedules

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Look Ahead: July and beyond

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

  • 5 July: Competition and Markets Authority Care Home Market Study update paper - response deadline
  • 5 July: Commission on the Donor Experience - research published
  • 6 July: Fundraising Preference Service - launched
  • 11 July: New Charity Governance Code - launched
  • 20 July - 5 Sept: Parliament Summer Recess
  • July: Social Prescribing Evidence Review - published
  • July: National Social Prescribing toolkit - published
  • 4 August: Welsh Government Draft Supporting People Programme Guidance and Outcomes Framework - consultation deadline
  • 8 August: CQC Adult Social Care Inspection Methodology - consultation deadline
  • 21 August: Social Care Wales’s new research and development strategy - consultation deadline

Events

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

  • Co-production Week webinar 6 July 3-4pm, SCIE, FREE Co-production Week from 3 July will celebrate all that is good when service users and carers are central to the design, delivery and evaluation of services. The webinar will look at what the key skills and approaches are for effective co-production.  SCIE are also launching a new Introduction to Co-production course.

  • Did the Lobbying Act stifle democracy in the 2017 General Election? 7 July 9am–10.30am, FREE                                 Charities have claimed they were forced to change their key messages during the election. Some also worry that they may be retrospectively be held to account for activities when they had no idea an election would be called. But was the ‘chilling effect’ of the lobbying act real, or a matter of perception? Did charities feel they could continue to campaign and did those that had to register with the electoral commission find it restricted their activities? Hosted by Deloitte, 2 New Street Square, London EC4A 3BZ

  • Expert briefing: New MICRA report on Wellbeing & Inequalities in Later Life, 11 July 3-5pm, Manchester, FREE
    This expert briefing marks the launch of a new report, ‘The Golden Generation? Wellbeing and inequalities in later life’, which presents research findings and policy recommendations from the 5-year ‘Frailty, Resilience and Inequality in Later Life’ programme, led by Professor James Nazroo.  With input from Professor Martin Vernon, National Clinical Director for Older People Paul McGarry, Head of the GM Ageing Hub and Claire Turner, Centre for Ageing Better, this event will be an opportunity to discuss the outcomes of the report and links to policy.

  • Digital and Care Congress, 11-12 July, The King’s Fund - London, £240
    NHS England's Next steps on the five year forward view outlines the plan to harness technology and innovation over the next two years but what's really happening on the ground? Join us at this two-day event to hear the latest policy updates and learn from case studies showcasing best practice from around the country.

  • Small but Significant - innovation, impact and evidence: Practical housing interventions to improve older people's health and wellbeing, 13 July, 10am -3.30pm, Care & Repair England, MICRA, and the British Society of Gerontology, Manchester, FREE 
    This workshop will examine the evidence, cutting edge practice and related policy in the field of increasing safe independence at home for older people through practical interventions.

  • Health and Care Innovation Expo 2017, 11 and 12 September, NHS England, Manchester, £120 plus VAT
    Speakers include:  Jeremy Hunt MP Secretary of State for Health, Simon Stevens, CEO, NHS England and Professor Sir Bruce Keogh, National Medical Director, NHS England. Expo 2017 will explore the most important developments across health and social care, including: The achievements and lessons of the New Care Models vanguard programme; Delivering Sustainability and Transformation Plans; Building and maintaining the right structures for collaborative, prevention-focused services; New digital technology solutions supporting transformation of health and care services; Accelerating the uptake of successful innovations across health and social care

  • Doing Dementia Design, 14-15 September, Liverpool, £120-150 A two day conference organised by Liverpool Dementia Action Alliance to promote the adoption of dementia-friendly principles in the design of all buildings, places and spaces, sharing latest research and developments, aiming to influence public policy, professional practice, education and training. 

  • The 4th National Conference of the Older People’s Diabetes Network (OPDN) 27 September, London, £25 Led by the network’s Clinical Lead Professor Alan Sinclair.  This event and network is for anybody working in, or with an interest in, the field of older people with diabetes.

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Some information sourced from DeHavilland

 
 

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