Policy News from MHA: September 2017

Welcome to MHA's September policy bulletin

 

September has been a busy month in Parliament and for Government, with several Bills being launched and Committees being re-established. As expected, Brexit is dominating the agenda in the House of Commons and Lords and in Whitehall, however developments have been underway in the data protection and housing world.  The Scottish Parliamentary session also got underway with key developments in health and housing.  From mid-month Party Conference season got underway with the Liberal Democrat and Labour conferences taking place.

Government: - Brexit - Charity and Voluntary Sector -  Data Protection - Finance and Pensions - Health and Social Care - Housing - Party ConferencesWorkforce and Skills - Other

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

Ageing and wellbeing: - Wellbeing - Loneliness -

Dementia:- Care, support and wellbeing - Research News

Finance and pensions: - Welfare -

Health: - Technology and innovation - Funding - NHS and STPs

Housing: - Older people's housing - Health and housing

Social Care: - The System - Future need - Quality - Innovations and technology End of Life Care -

Third Sector: - Supporters and volunteers - Governance

Workforce and skills: - Social care and nursing - Learning at work

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

______________________________________________________________________________________________________________

Governmentclipboard image

Brexit

  • Theresa May has set out proposals for a two-year transition period after Britain leaves the EU in March 2019. The speech, aimed at breaking the deadlock in Brexit talks, indicated that she wants existing EU market access arrangements to apply during that period and promised Britain would pay its "fair share" into the EU budget. The deal she proposed could include payments worth 20bn euros (about £18bn) over the two years and the UK would be prepared to "honour commitments we have made" - a reference to financial commitments.  In a wide-ranging speech, the Prime Minister also proposed a "bold new strategic agreement" on security co-operation and said she was optimistic about a "defining moment" in UK history. On trade, she said the two sides could do "so much better" than adopt existing models and there was "no need to impose tariffs where there are none now". The UK would also continue to make "an ongoing contribution" to projects it considers greatly to the EU and UK's advantage, such as science and security projects.

  • The European Union (Withdrawal) Bill passed its second reading, with MP’s voting 326 votes to 290 to back the Bill. The Bill was criticised over the delegated powers of Ministers, which would enable them to make changes to the Brexit without scrutiny from other MP’s. The Opposition also chastised the Government for failing to publish the Bill in draft and for failing to address MPs’ concerns. However, the Government responded by emphasising that the Bill would “enable us to have a coherent, functioning statute book and regulatory systems on the day that we leave the EU”. They also outlined that the Bill protects the existing rights on a UK legal basis and that there are “significant safeguards” in place to prevent Ministers from using their delegated powers for anything other than their specific purpose.  

  • The Scottish and Welsh Governments have drawn up a list of amendments to challenge the Government’s plans in the EU (Withdrawal) Bill in order to prevent a “power grab” of devolved responsibilities by Westminster. Scottish First Minister Nicola Sturgeon has previously argued that the Government’s plans for the repatriation of powers, namely for all powers to first return to Westminster and then be devolved or incorporated into UK-wide frameworks as appropriate, turns the founding principle of devolution “on its head”. The new amendments include a list of 111 powers that the devolved administrations argue should be given to them, with the Scottish Government refusing to put forward a Legislative Consent Motion for the Bill until the matter of devolution is settled. 

  • The new Exiting the EU Committee has agreed to undertake an inquiry into the EU (Withdrawal) Bill to help to inform Parliament’s consideration of the Bill. The Committee will examine: Whether the Bill adequately addresses the challenges of converting the EU laws into UK law and provides for legal certainty on the day that the UK leaves the EU; what provision is made for non-legislative elements; the powers delegated to Ministers; the implications of the Bill on the devolved governments; the implicationsfor the UK’s future relations with EU agencies and future participation in Europe-wide agreements; and implications for rights protected under EU law.

  • The Exiting the EU Select Committee will also undertake an inquiry into the progress of the negotiations on the UK’s withdrawal from the EU. Chair of the Committee Hilary Benn MP said "The Brexit negotiations are the most complex our country has ever faced. They are dealing with fundamental questions about the future of our economy and our country… Our first inquiry in this new parliament will scrutinise the progress of these negotiations and the position of the UK Government and our negotiating partners in the EU."

  • The Lords EU Committee has published the Government response to Brexit: devolution report. It indicates that the Government is committed to consultation with the devolved administrations, both within the formal structures of the Joint Ministerial Committee and also through bilateral discussions, that takes proper account of the devolved countries.

  • The Government has published position papers on science and innovation and maintaining internal security cooperation, in which it argues that "new, dynamic arrangements" are needed between the UK and the EU. It stresses that close collaboration should be maintained.

  • The European Commission has published various position papers including: Intellectual property rights (including geographical indications); Guiding principles for the Dialogue on Ireland/Northern Ireland; Use of Data and Protection of Information Obtained or Processed before the withdrawal date; Customs related matters needed for an orderly withdrawal of the UK from the Union. 

Charity and Voluntary Sector

  • The Department for Digital, Culture, Media and Sport (DDCMS) has announced that secondary legislation to allow charities and community interest companies to quickly convert to charitable incorporated organisations has been put before parliament. Subject to Parliamentary approval, phased implementation of CIO conversions could begin from January 2018. This follows a recent consultation on the proposed changes by the department. 

  • The Government have rejected Lord Hodgson's proposals to reform the Lobbying Act, because there is not enough space in the legislative programme to pass the necessary law.  Lord Hodgson said the decision risked allowing problems with the act to reappear at the next general election. "Obviously I’m disappointed because it was well received by the sector and it was well received by the government… The question of course is that these things only really come to the fore when we have an election, and in between it is out of sight, out of mind. We are mid-election and nobody cares about this at all that much. But of course it will then come up during election time when there is a problem and it will be too late then to do anything about it." Minister for Civil Society, Tracey Crouch, pledged to work with charities to enable them to campaign within the law"Charities play an essential role in our democracy. Non-partisan campaigning helps to raise awareness and funds for important issues, and I will work with voluntary bodies and the charity sector to ensure that rules are well understood and they have complete confidence to continue non-party political campaigning." However, Caroline Abrahams, Charity Director at Age UK said “At Age UK we felt the impact of the Act ourselves during the last General Election campaign when social care became a topic of national discussion but we felt unable to make virtually any public comment at all, however factually based and apolitical, for fear of inadvertently infringing the legislation.  In the end the public are the biggest losers from the Lobbying Act because it discourages charities from contributing to important social policy debates on issues where they have real expertise to share.”

  • The DDCMS has published a report on cyber security in charities, which concludes that the majority of charities lack skills and understanding about cyber security. The report acknowledges that charities face many barriers when it comes to engaging with the issue, including competing priorities for time and resources, and staff not necessarily being equipped with the knowledge and skills to deal with the issue. It recommends basic awareness raising among staff and trustees, and up-skilling of those responsible for cyber security so that they know the basic technical controls that can be put in place.

    MHA comments: This report will be of particular interest to MHA, given that significant changes are coming in the form of the Data Protection Bill (see below) and the General Data Protection Regulations.

  • NFPSynergy have published findings from research with MPs, aiming to establish their priorities for the charity sector chosen from a prompted list.   Many of the top priorities are very similar for all MPs: Making charities more transparent; Finding more funding sources; Preventing CEO pay of over £200k; Comprehensive training for charity trustees; Developing codes of best practice for charity trustees.  However there were some differences between the main parties, Labour MPs favour: Repeal of the Lobbying Act and preventing private schools being charities. Conservative MPs favour: Making charities more transparent, preventing charities from lobbying and preventing charities who receive Government funding from lobbying.

See the Third Sector section for more news

Data Protection

  • The Data Protection Bill has been launched. The Bill aims to make a data protections framework which is suitable for the digital age and to allow citizens to take better control of their data, such as giving new rights to individuals to require major social media platforms to delete information held about them at the age of 18.  It will repeal the Data Protection Act 1998. The Bill also will implement the General Data Protection Regulation (GDPR) and the new Directive applying to law enforcement data processing. The Bill is likely to be a high priority, as all organisations must be GDPR compliant by 25 May 2018. The Information Commissioner’s Office  has produced new information on the differences between the Data Protection Bill and the GDPR, which mainly relate to immigration and national security. 

    MHA comments: This Bill and GDPR have significant implications for large organisations handling a lot of personal data, like MHA. 

Finance and Pensions

  • The Financial Guidance and Claims Bill, which aims to streamline the Pensions Advisory service has passed through its Lords Committee Stage, where the Lords made amendments to Clauses relating to PPI claims, the Money Advice Service, and car hire agreements. No amendments were made to pension-related Clauses, aiming to provide a comprehensive and independent information service for over-50's.

  • The Work and Pensions Committee have launched an inquiry into major reforms to the UK pensions market following concerns that savers are making poor choices and being subject to scams. It will investigate the “pension freedom” changes of 2015, which allowed those aged over-55 years-old to gain full flexibility over how they accessed their retirement money.  The Committee invites written evidence by 23 October 2017. 

  • In the launch of the Scottish Programme for Government, First Minister Nicola Sturgeon, has announced the creation of a Scottish National Investment Bank to take a “new approach” on capital investment.

  • On 1 April 2018, Stamp Duty Land Tax and Landfill Tax will be devolved to Wales. These taxes will be replaced by Welsh taxes known as Land Transaction Tax (LTT) and Landfill Disposals Tax (LDT) respectively. The Cabinet Secretary for Finance and Local Government, Mark Drakeford, confirmed his intention to announce the first tax rates and bands for these new Welsh taxes alongside the publication of the draft budget on 3 October 2017.

 

Health and Social Care

  • The Government has announced a further one-month suspension of minimum wage enforcement concerning sleep-in shifts in the social care sector to minimise disruption to the sector and seek to ensure workers receive the wages they are owed. This follows July’s decision to waive all historic penalties in the sector where employers incorrectly paid workers a flat-rate for sleep-in shifts instead of hourly rates. This was in response to concerns over the combined impact which financial penalties and arrears of wages could have on the stability and long-term viability of providers. The further suspension will allow the Government to establish how providers’ back pay bills will affect vulnerable people’s care going forward and enable them to develop a new enforcement scheme for the sector to encourage and support social care providers to identify back pay owed to their staff.

  • A Scottish Bill to extend free personal care to dementia patients aged under 65 has been announced as part of the Scottish Programme for Government. The Members Bill become known as Frank’s Law after a campaign led by Amanda Kopel. Mrs Kopel has campaigned for the change in care provision since her husband, the former Dundee United player Frank Kopel, was diagnosed with and later died from early onset dementia. The Bill has won cross-party support and is expected to be passed and implemented by April 2019.

  • In addition, the Scottish Government plan to introduce a Safe Staffing Bill to enshrine in law the principles of safe staffing in the NHS, starting with the nursing and midwifery workforce planning tools. The Bill aims to ensure nationally agreed, evidence-based workload and workforce planning tools are applied, and ensure key principles relating to professional judgement, local context and quality measures underpin workload and workforce planning.

Housing

  • In a speech to the National Housing Federation conference 2017 Sajid Javid announced that the Government would be bringing forward a social housing green paper, suggesting it will be a “wide-ranging, top-to-bottom review of the issues facing the sector”, focusing on what works and what doesn’t work, what has gone right and what has gone wrong. The green paper will look at the overall quality of social homes, service management, the rights of tenants and complaints. It will also look at wider issues of place, community, and the local economy - what role can social housing policy play in building safe and integrated communities, where people from different backgrounds get along no matter what type of housing they live in? How do we maximise the benefits for social housing for the local, regional and national economy as part of our Industrial Strategy? What support is needed for leaseholders who have a social landlord? And how can we all work together to get more of the right homes built in the right places?
  • The newly appointed Communities and Local Government Committee will continue the work of the previous Committee in its inquiry on housing for older people in England, started earlier this year. The inquiry will examine whether the housing on offer for older people is sufficiently available and suitable for their needs and, in doing so, consider how older people wish to live. The Committee will take into account the context of significant housing shortages, rising numbers of older people and pressures on health and social care. The Committee is expected to begin the public evidence sessions for this inquiry in October and will make use of the written evidence received for this inquiry during the last Parliament. New submissions and updates are welcome by Friday 6 October.
  • The Government have launched a consultation setting out a number of proposals to reform the planning system to increase the supply of new homes and increase local authority capacity to manage growth. The proposals, originally set out in the Housing White Paper include: a standard method for calculating LAs housing need; how neighbourhood planning groups can have greater certainty on the level of housing need to plan for; a statement of common ground to improve how LAs work together to meet housing and other needs across boundaries; making the use of viability assessments simpler, quicker and more transparent; and increased planning application fees in those areas where local planning authorities are delivering the homes their communities need. Alongside this consultation, the Government has published a list of areas where HM Land Registry intends to prioritise the registration of ownership of all publicly held land. The consultation closes on 9 November.
  • The public inquiry into the Grenfell Tower tragedy has begun. The inquiry is likely to call Ministers and senior Whitehall officials to testify in order to explain the failure to implement safety measures after a previous fire in a high rise block. Inquiry Chair Sir Martin Moore-Bick promised survivors that he would “provide answers to the pressing questions of how a disaster of this kind could occur in 21st century London”. An interim report is expected by Easter 2018.
  • In addition, the terms of reference for the Independent Review of Building Regulations and Fire Safety have been published. The independent review follows the tragedy at Grenfell Tower. The review will examine: the regulatory system around the design, construction and on-going management of buildings in relation to fire safety; related compliance and enforcement issues; and international regulation and experience in this area. Led by Dame Judith Hackitt, the Review’s two key priorities are to develop a more robust regulatory system for the future and provide further assurance to residents that the buildings they live in are safe and remain safe. While the Review will cover the regulatory system for all buildings, it will have a specific focus on multi-occupancy high rise residential buildings. The Review will co-operate fully with the Public Inquiry. An interim report will be published in November with full recommendations made in spring 2018. The formal call for evidence has been opened and the deadline is 13 October. The National Housing Federation is hosting a webinar on the 4 October, 1-2pm to discuss key aspects of the review and gather views. 
  • In Scotland, Housing minister Kevin Stewart has announced two leading experts as the chairs of the groups that will take forward a review of Scottish building standards in the wake of the Grenfell Tower tragedy. Professor John Cole will chair the review of enforcement and compliance and Dr Paul Stollard will chair the review of fire safety in building standards. The Ministerial Work Group on building and fire safety was set up in the wake of the Grenfell Tower tragedy, with the primary aim of offering public reassurance. Part of the group’s focus has been on a wider range of measures to enhance and strengthen building regulations enforcement and compliance as well as fire safety.
  • The Scottish Government has launched Housing (Amendment) (Scotland) Bill, aimed at reversing the autumn 2016 reclassification of housing associations as public bodies. Key measures to address this will be: removing the need for the Regulator’s consent to the disposal of assets by Registered Social Landlords (RSLs); limiting the Regulator’s ability to appoint members and managers to RSLs; and removing the need for the Regulator’s consent to the restructuring, winding up and dissolution of RSLs.
  • In addition, the Scottish Government also plan to introduce legislation in response to an independent review of the planning system and measures to tackle fuel poverty. The Planning Bill aims to ensure a simpler, more effective system of development plans, to set a clear view of how areas will develop in future. Procedures for preparing plans will be improved and communities will have better opportunities to influence the future of their areas.  As part of their long-term Fuel Poverty Strategy, they will introduce a Warm Homes Bill to set a new statutory fuel poverty target to help ensure that progress is made on these issues, and that support is given to those who are most in need of help to heat their homes.
  • The Scottish Government has also issued new guidance to LAs on regulating landlords in the private rented sector. The Landlord Registration Statutory Guidance will support local authorities to effectively regulate the landlord registration system, which requires councils to maintain a register of private landlords and ensure that only landlords it judges to be fit and proper are allowed on the register. Landlord registration gives LAs the ability to control and regulate who can operate legitimately as a private landlord. The guidance highlights best practice examples where local authorities are using their landlord registration powers to deliver improvements in the sector. Examples include communicating effectively with all landlords on the register and successful working with the police and other agencies to take action against landlords who deliberately flout the law. 

Party Conferences

Liberal Democrats 16-19 September

  • In his conference speech, Leader Sir Vince Cable, called on "sensible grown-ups" from all parties to work together to prevent a Brexit "disaster". He stated that what was needed was "political adults", arguing that it was important to set aside tribal differences in favour of collective efforts to keep Britain in the Single Market and Customs Union. He added that existing standards and safeguards needed to be maintained." The Liberal Democrats are the party of Remain," he stressed. He went on to call for the Government to unilaterally declare a "Right to Stay" for all EU citizens living in the UK, and for a second referendum at the end of Brexit negotiations on the final terms of exit.  The Liberal Democrats recognised that decent services needed to be paid for, he said, citing the Party's plan to add another penny in the pound on Income Tax and use this to give an extra £6bn for the NHS and social care. In particular, he highlighted spending on mental health as a priority.

Labour 24-27 September

  • In his keynote speech Labour Leader Jeremy Corbyn said that only Labour could unite Leave and Remain voters, promised to "repair the damage done by austerity", argued that the Government was "weak and divided", and called on Prime Minister Theresa May to call another snap election. He highlighted Labour’s plans for a “publicly-owned engine of sustainable growth”; said Labour was primed to campaign in another General Election; rejected the Government’s approach to Brexit as ineffective and promised to guarantee the rights of EU citizens living and working in the UK; Offered a portfolio of pledges on housing including a review of social housing policy, including planning, building, regulation and management; reiterated his plans for a National Education Service including free tuition for technical and further education courses; and called for democratic ownership of natural monopolies in the form of the renationalisation of major utilities.

  • In her conference speech, Barbara Keeley MP, Labour’s Shadow Minister for Mental Health and Social Care, laid out Labour’s plans for a National Care Service and restated the party’s pledge to provide an extra £8bn for social care, with an immediate injection of £1bn to ease the pressure on services. She indicated that their plan would be “Enough to place a cap on what individuals have to pay towards care. Enough to raise the asset threshold for paying for care. Enough to provide free end of life care.” An independent, expert panel will be created to advise how to move from the “current broken system of care” to a sustainable service for the long term.

  • Opening his remarks, Shadow Health Secretary Jonathan Ashworth highlighted how Labour wanted to rebuild a “comprehensive universal reintegrated public National Health Service”, free at the point of use for all when needed. Labour would allocate an additional £45bn in funding for health and social care, he promised, and would establish a £500m emergency winter fund for the health service. He paid tribute to the NHS workforce and promised to scrap the public sector pay cap and bring back bursaries for student nurses. He also emphasised his desire to reassure NHS employees from other EU nations. He also promised to stop Sustainability and Transformation Plans (STPs) and integrate health and social care.

  • At Labour Party conference fringe event, Mayor of Greater Manchester, Andy Burnham, proposed radical reform to the health and social care system, suggesting that "change will come from a bottom up approach and through devolution because the issue of care was becoming too complex within Westminster". He called for the need to move towards a 21st Century model that does not treat physical, mental or social health as separate silos, but as one health issue. The Greater Manchester region will be submitting a pilot to the Chancellor, where LA social care funding, primary care funding and CCG funding would be consolidated into a single payment, paid to a local, governing NHS organisation. This would give a holsitic view across health and social care, for example with the NHS employing its own staff in social care.  The idea would be to make Manchester a pilot for the rest of the country in what he called a “Year of Care” approach. 

Workforce and Skills

  • The Health Committee has launched an inquiry into the shortage of nursing staff in England. The Committee wishes to examine whether the Government and other responsible bodies have a robust plan in place to address the shortfall of nursing staff and to ensure they are held accountable for their performance. It is seeking evidence on the current and future scale of the shortfall of nursing staff and whether the Government, arms-length bodies, NHS, community and specialist providers and other partners have effective plans in place to recruit, train and retain this workforce. It will also assess the impact of new routes into nursing (including student funding reforms, the Apprenticeship Levy, Nurse First and nursing associates). In particular, the inquiry will examine the effect of changes to funding arrangements for nurse training, including the withdrawal of bursaries, and consider alternative funding models and incentives. The Committee would like to receive suggestions for how policymakers could optimise the potential of new routes into nursing, as well as how they might retain and deploy existing staff more effectively. The committee is also interested in the impact of language testing and Brexit. Submissions are welcomed by 12 October 2017.

  • The Women and Equalities Committee has reopened its inquiry into older people and employment, looking at current Government policies to help people extend their working lives, and considering further steps which could be taken to tackle issues including age discrimination. The deadline for written submissions is 3 November 2017.

  • The Work and Pensions and Business, Energy and Industrial Strategy Committees will be questioning Matthew Taylor on his recent report on modern working practices, including how the Government should act to ensure rights and fair pay for gig economy workers. The Taylor Review examined the implications of new forms of work on the rights and responsibilities of workers and employers, and this session will build on the related work of the previous BEIS Committee’s inquiry into the Future World of Work and the Rights of Workers, and the previous Work & Pensions Committee report and inquiry into Self-Employment and the Gig Economy. The session is scheduled for 11 October 2017.

  • The National Audit Office has said that a Conservative pledge made in the 2015 General Election to fund apprenticeships from £227m raised from Libor fines has been unfulfilled. However, although the money was used to fund apprenticeships in general, the Government did not report any increase in its already announced 3 million target. Investigators concluded that civil servants could not show that the apprenticeships, specifically for unemployed 22-24 year olds, had been set-up.  

  • The Trade Union (Wales) Bill has received Royal Assent. The Act amends specific provisions within the UK Trade Union Act 2016 that apply to “devolved Welsh authorities”. The provisions being dis-applied are: Publication requirements in relation to facility time; Restrictions on deduction of trade union subscription fees from employee wages in the public sector; and specific ballot threshold requirements on trade unions before industrial action.

Other

  • The Government has lifted the 1% public sector pay cap for both police and prison officers. The higher pay rises for police officers and prison officers are based on the recommendations of independent pay review bodies, with recruitment and retention issues being highlighted. Following the announcement, the Government was defeated in votes on two non-binding Opposition Day motions after the DUP opted to back the Labour Party. The two motions called for an end to the public sector pay cap for NHS workers and opposed the £250 a year increase in student fees. 

  • MPs have voted in favour of giving the Government control of the Committee of Selection. This Committee is responsible for nominating Members to serve on General and Select Committees in the House of Commons, allowing the Government to secure a majority on Public Bill Committees, charged with scrutinising and approving legislation at the Committee Stage. Opposition MPs have described the move as a "power grab". 

  • The Government has confirmed that it will need to seek Parliamentary approval for the £1bn in funding that underpins the confidence and supply agreement it holds with the DUP. The money was negotiated by the DUP in June as part of its deal with the Conservatives. But Government lawyers have said it has yet to be made available and any additional payments must be authorised by parliament through the normal budgetary process. 

  • The Welsh Government have published a Welsh Language White Paper outlining proposals for a new Bill that will amend the Welsh Language (Wales) Measure 2011. Some of the most significant proposals include:Abolishing the Welsh Language Commissioner; Establishing a single main body – The Welsh Language Commission to promote the language; The Welsh Government retaining responsibility for national policy and strategy, along with the funding of some bodies of national significance; Budget and resources for other specified promotion work currently undertaken by Welsh Government transferred to the new Commission; Concept of Welsh Language Standards to remain, but should only apply to services; The Welsh Government should be responsible for making and imposing Standards, the newly formed Commission should monitor and enforce compliance of the Standards.; Only serious complaints should be investigated by the Welsh Language Commission. The consultation is open until 31 October 2017. 

  • At the start of the month, Kezia Dugdale resigned as Scottish Labour Leader. Richard Leonard and Anas Sarwar have declared their candidacies to replace her.

Back to top

______________________________________________________________________________________________________________

Ageing and wellbeing

Wellbeing

  • new study conducted by older people has provided valuable insight into what people want and need to make them happy as they age. People aged 50 to 84 were recruited in Scotland to conduct their own research into what they constituted a good quality of life. Findings concluded that being part of a community was the most important aspect, with 96% of survey participants indicating such. Other important factors include good health, fitness activities such as walking, mental activities such as crosswords and having access to technology contributed to a good later life.

  • Research from Independent Age, as part of their collaboration with ITV on the 100 Year Old Driving School, suggests that from a poll of over 2,000 drivers aged over 70, almost half (44%) said they would feel like they’d lost part of their identity if they were not able to drive. Nine in 10 (91%) said it would mean a loss of independence, and almost three in five (57%) say they wouldn’t be able to spend as much time with family and friends. The negative emotional effects of not being able to drive increase for older people in rural areas, who said they would be more likely to feel lonelier or more isolated if they were no longer able to drive and that it would negatively affect their health and wellbeing.  The top three things that older drivers use their cars for are: shopping (96%), visiting family and friends (90%) and visiting the GP or accessing other health services (72%).  In addition 27% of those surveyed were relied on by other people, such as driving friends or family to hospital visits or helping with shopping.

  • A survey for the Chartered Society of Physiotherapy has found that 24% of people aged 65 and over do no strengthening activities at all each week, potentially putting themselves at risk of falls and other serious ill health. A further 9% only did it once, leaving them one short of the official target. 35% of respondents said a health condition prevented them from strengthening.  The national activity guidelines recommend doing two strengthening sessions a week – in addition to the better-known call to be active for 150 minutes. Prof Karen Middleton, CEO of the Chartered Society of Physiotherapy, said: "We must move past the idea that becoming weaker and frailer is inevitable as we get older. Research shows getting stronger brings a whole host of health benefits so it is incredibly important that people don’t overlook strengthening when being active.  As the guidelines set out, it doesn’t mean immediately hitting the gym to lift weights - to start, it can be digging in the garden or simple bodyweight exercises like standing up out of a chair 10 times. There are easy ways to do it but the essential thing is to get started and these poll results show a lot of work needs to be done to get that message out."

  • The Office for National Statistics (ONS) has published their sixth annual update on national wellbeing data. This data provides insight into people’s feelings about their lives and surroundings which other statistics by themselves, do not provide. The findings can be broken down to LA areas.  ONS also report that they are looking at what causes people to report low measures of personal wellbeing by identifying groups of individuals that share similar characteristics and looking at the factors that determine their reported low wellbeing. They are also hoping to release some analysis towards the end of the year looking at how personal wellbeing ratings compare between UK and non-UK nationals.

MHA comments: This will be of interest to our Live At Home schemes, who are starting to measure wellbeing of members, to help establish how LAH services help to make a difference to a persons life, including their sense of wellbeing. This data will enable us to compare the wellbeing of LAH members to the wider population both nationally and locally. 

Loneliness

  • Researchers from the London School of Economics have put a financial price on loneliness – estimating it costs £6k per person in health costs and pressure on local services. There are an estimated 1.2 million people in the UK who have chronic loneliness, linking to poorer physical and mental health. The study outlines that every £1 spent preventing loneliness could save around £3 in savings in health costs. The research also found in a survey of over 2,000 people found that 9 in 10 people (89%) believe loneliness in older age is now more likely than ever - rising to 93% when asking those aged 65+. Three quarters of over-65s (76%) say they would find it hard to admit to feeling lonely because they do not want to be a burden.

    MHA comments: This will be of interest to our Live At Home schemes, in helping to bid for funding and demonstrate return on investment for commissioners and grant-giving bodies. 

  • The Silver Line took more than 45,000 calls from older people in August – up from 43,800 in August 2016. Since it began in 2015, the organisation has received over 1.5 million calls, with around 80% of calls being from new users. According to the charity, older people said “the summer can be an equally challenging time as the winter months”. Head of the organisation’s helpline, Alan Walsh said “the helpline typically receives around 10% more calls during July and August from people whose family and friends have gone away”.

In Brief

  • A study of the technology market shows that 71% of 55 to 75 year olds now have an app-capable device. The research also suggests that the age group has seen a faster adoption rate than any other over the past five years. Around 50% of the sample had social apps such as Facebook downloaded on their device, enabling them to be social with family and friends who may be at work or living away. Improved accessibility and apps aimed at older people are highlighted as contributing factors to the growth. The study is based on a sample of over 1,000 people.

  • According to the Department for Work and Pensions workers are retiring at a younger age. Figures show that in 1950, most men left the labour market at an average age of 67, compared to 65 now. Women typically retired around 63 both in 1950 and now. However, experts say that we should expect to retire at an increasingly older age as the state pension age rises. The Government recently announced that the state pension age will rise to 68 for men and women between 2037 and 2039. 

  • Ulster University has been awarded €3.7m to lead on two major international research projects with a focus on improving the lives of older people in remote and rural areas through improved access to technology.  The first project will seek to develop low cost, transnational solutions to improve the health and wellbeing of older isolated people in remote rural areas through innovative approaches to social inclusion, using technology to create a range of digital solutions to the challenges identified by older people. The second project will assess the technical, clinical and social acceptability of wearable technologies and their impact on patients, on health and care delivery, and on rural communities.

  • The Centre for Ageing Better has three new trustees and two new co-optees, including Margaret Dangoor, an expert in health and patient safety; Dame Lin Homer, a former civil servant at the Department for Transport and Her Majesty’s Revenue and Customs; Lord Spencer Livermore, a Senior Fellow at the London School of Economics and former civil servant at HM Treasury; Julika Erfurt, a specialist in health strategy; and Albert Tucker, CEO of the Fairtrade Company, Twin Trading.

Back to top

_________________________________________________________________________________

Dementia

Care, support and wellbeing

  • A new app, created by the University of Stirling Dementia Services Development Centre (DSDC) and Space Architects, could help enhance home and hospital environments for people with dementia. Iridis can be used to assess and provide feedback on how suitable a residence, care facility or other environment is for older people, particularly those with the condition. The technology asks users – including people with dementia, their family members and healthcare professionals – a series of questions about their surroundings and requests photographs of the environment. It then uses the data to highlight potential problems – such as issues with furniture, lighting, colour contrast and noise – before recommending changes that could enhance the environment for people with dementia. The app is an updated, digital version of the DSDC’s existing paper-based Dementia Design Audit Tool.

  • A UK-wide project that brings together people’s diverse experiences of living with dementia as a series of audio diaries, has today been awarded £150k from the Big Lottery Fund and Comic Relief. Dementia Diaries is run by Innovations in Dementia. Launched in 2015 by On Our Radar, it documents the day-to-day lives and views of people living with dementia across the UK, aiming to a drive change attitudes and perceptions about dementia.  Diarists are able to record their audio diary entries on their own mobile phones or landlines, or on easy to use mobile handsets, capturing thoughts and experiences as they occur, which are then sent digitally to the Dementia Diaries website. Previously, the platform has been used to raise awareness about the realities of life with dementia, but now Innovations in Dementia will be able to expand its work, for example by providing more insight into the development of services that will meet the needs of people living with dementia.

  • Research by Marie Curie Cancer Care has found that, despite having complex needs, most of the healthcare received by people in the later stages of dementia is provided by GPs or emergency services, with little support from specialist healthcare professionals  such as palliative care, geriatrics or mental health. The small study of 85 people with advanced dementia across Greater London, lived in care homes or at home. Only 1% of those people were seen during the study period by a geriatrician or an older persons’ psychiatrist. The care homes were found to be poorly served by specialist services, which reflects the findings of previous studies showing that nursing home residents receive less planned and more emergency healthcare than those living in their own homes. Where palliative care teams were involved, they assisted with symptom management, although this was predominantly in the month prior to their death. When advance care planning did take place, this focussed on resuscitation decisions and place of death, rather than the type and quality of care that the person would like to receive at end of life. 

  • The Housing LIN have published Enabling People with Dementia to Remain at Home: A Housing Perspective, which sets out the key role of housing providers, particularly social housing providers, in supporting people living with dementia to stay independent in the home of their choice for as long as possible. The findings of the report suggest issues arise: in accessing information; there are good examples of services working together to support individuals, but some housing professionals felt excluded from discussions; housing professionals need to have dementia-awareness training; sympathetic housing design is essential; there is a lack of data in terms of dementia and housing; and housing providers with a dementia strategy appear to be in the minority.

  • Scottish Police are gathering the personal details and former addresses of new dementia patients as part of a pilot to help find them if they go missing. Officers are working with nursing homes, GPs and families to find out the favourite haunts and walking spots of people diagnosed with dementia and other background details such as where they went to school and where they used to live, hoping pre-emptive action will allow them to respond more quickly. The files will not be kept by police but will be held by family or a nursing home in an agreed place. The pilot, which currently covers seven local authority areas, also involves looking at ways to prevent the person going missing in the first place by identifying triggers which might unsettle them and result in them trying to leave their home. 

Research news

  • The University of Exeter Medical School has been awarded £577k, by the Alzheimer’s Society in funding to advance understanding of how dementia affects the brain. The largest pot of money, £278k, will go to Dr Jon Brown, a neurophysiologist who will investigate how nerve cells in part of the brain malfunction to cause patients with dementia becoming lost and disorientated.

  • A study to improve the diagnosis and post-diagnostic support for younger people with dementia and their families is seeking participants to further research in this area. The Angela Project, led by Bradford University, is dedicated to a woman who had young onset dementia, but went undiagnosed for three years before her symptoms were recognised. The aim is to produce information and guidance on how best to support younger people with dementia and their families or those close to them, during and after diagnosis. Researchers are keen to hear from people with a diagnosis of dementia given before their 65th birthday or primary carers of people who were diagnosed with dementia before the age of 65. Other family members who are affected by young onset dementia are also invited to take part in the online questionnaire.

  • In an interview with the Daily Telegraph, the outgoing Chair of the World Dementia Council, Dr Dennis Gillings  says he is optimistic that the first cure to halt or reverse the disease is on the horizon, with two potential breakthroughs having occurred recently. Importantly he highlights the change in view of responding to the different sub-types of dementia, rather than treating it as one disease. The new Chair is Dr Yves Joanette of the Canadian Institute of Health’s Institute of Ageing.

Back to top

__________________________________________________________________________________

Finance and pensions 

Welfare

  • A study by Age UK, suggests one in four older people are struggling financially, with more than £3.5bn worth of benefits for pensioners is going unclaimed each year. The charity said that despite so many older people experiencing financial hardship huge sums are going unclaimed every year in benefits, including help with council tax and pension credit.  Age UK surveyed more than 1,300 people showed that those who are in advanced old age or are single or who rent homes rather than own them were at increased risk of living in poverty, with nearly one in five (19%) of all 80 to 84-year-olds and 21% of over-85s in poverty, compared with 13% of 65-69 year olds. One in five (20%) single pensioners live in poverty, compared to 13% of couples. Key difficulties included keeping their homes adequately warm, unable to pay regular bills and unable to keep their homes damp free.

In brief: 

  • The Financial Conduct Authority (FCA) has called on the Government to act on the issue of long-term care advice and products to avoid people sleepwalking into a harmful or vulnerable old age. In a paper on the ageing population, the FCA identified a number of issues facing the financial services sector. Its research found the cost of long-term care in England is “substantial”, averaging around £28k a year and reaching over £38k a year if nursing care is needed. The FCA has said this cost is likely to increase over time and without adequate financial planning or provision for long-term care, consumers may experience poor outcomes, harm or vulnerability. But some in the industry also warned the regulator about a limited availability for insurance products and savings vehicles for long-term care. The regulator said providers may be put off from entering this market because of uncertainty around Government policy and a lack of interest from consumers who have many misconceptions about long-term care.

Back to top

__________________________________________________________________________________

Health  health staff graphic

Technology and innovation

  • The Social Prescribing Network has published Making sense of social prescribing a guide, commissioned by NHS England, which outlines what social prescribing is and introduces different models of social prescribing. It also highlights the key factors for successful social prescribing schemes.

  • The NHS is trialling new wearable sensors, to help identify older patients at risk of falls as part of a new drive to tackle frailty, using technology to analyse how someone walks so that physiotherapy care can be planned to reduce their risk of a fall. The microelectromechanical (MEMS) gyroscope equipment used in the miniature devices, are partly based on technological breakthroughs from the USA space programme and motion capture system and magnetic tracking systems used in CGI films.  In Sheffield, they are testing the Kinesis’ QTUG device for patients over 65 who have no recorded falls and score as ‘moderately frail’. The system monitors a patients walk with the motion sensor attachments on their shins while an app carries out the analysis. Those patients at moderate risk will receive treatment before they fall, rather than current practice which sees patients only referred after a fall. In a second testing site in London, patients are trailing GaitSmart technology, which uses six sensors placed on the calves, thighs and hips to measure the full motion of walking. The 10 minute test can be used within clinics, care homes, and in the home to measure any individual’s walk and to produce a personalised exercise prescription programme.  Once an individual’s gait has been assessed, a remote physio from GaitSmart can prescribe tailored exercises using an online exercise library accessed via a smart device or delivered in the post.  Professor Martin Vernon, National Clinical Director for Older People and Integrated Care at NHS England, said: “It is fantastic that space-age technology, aimed at putting a man on the moon, is now helping vulnerable patients back on earth to live better while steering the NHS away from financial black holes. It’s one small step for Nan, one giant leap for the NHS!”

  • Speaking at the Health and Care Innovation Expo, Health Secretary Jeremy Hunt has said that by the end of 2018, he expects every patient in England to be able to do the following online through an app: access NHS 111; access their healthcare record; book a GP appointment; order repeat prescriptions; express their organ donation preferences; express their data sharing preferences; access support for managing a long term condition. Pilot schemes are already currently underway, with ongoing evaluation before a potential national roll-out. In addition, to ensure independent ‘digital doctors’ are operating at the same high standard as the rest of the NHS, the Department of Health has launched a consultation about expanding the number of providers included in the CQC ratings system. In his address the Health Secretary also announced the launch of MyNHS open data challenge - a £100k fund to reward most creative apps and digital tools to improve services.

Funding

  • Thirteen West Midlands council leaders have written to Health Secretary Jeremy Hunt seeking 'urgent assurances' that £150m intended for adult social care but linked to meeting targets on delayed discharge targets will be released. In July, the Government told councils that if they did not meet targets for reducing delayed transfers of care (DToC), by September their funding allocations could be cut. Echoing a recent report issued by the County Councils Network, the West Midlands leaders criticised the Government’s targets for reducing DToC numbers as unrealistic. The leaders warned that “every pound that is withheld risks harm to our most vulnerable citizens”, adding that funding cuts to services such as home and residential care would be counterproductive in terms of reducing DToC numbers. The Department of Health declined to comment on the letter or the status of the funding, saying that there would be a response in due course. Commenting on the issue Cllr Izzi Seccombe, chair of the Local Government Association’s Community Wellbeing Board, said “The sudden and last-minute setting of unrealistic and unachievable targets for councils to reduce delayed transfers of care by government is unlikely to be effective in relieving pressure on the NHS. Councils are doing all they can to get people out of hospital and back into the community quickly and safely.  But instead of treating the symptoms of the pressures on hospitals, councils want to be able to focus on the root causes, and to stop people ending up in a hospital bed in the first place.” 

  • NHS Providers, which represents hospital trusts in England, has warned that the NHS may face its worst winter yet if it does not receive an emergency bailout from the Government. They suggest between £200m and £300m is needed for extra staff and beds. The Department of Health claimed the NHS is “more prepared” than ever before for this Winter, in part due to an extra £1bn fund given to social care services in order to relieve hospital pressure. However figures have revealed waits and shortages are still problematic. Since then, 19 hospitals across England have been given extra funding of over £13m for emergency care, in the latest wave of winter funding announced by Health Minister Philip Dunn, although the additional funding is part of the dedicated funding announced in the Spring Budget 2017.

NHS and STPs

  • The King’s Fund have undertaken a survey What does the public think about the NHS? The NHS occupies a unique place in public consciousness, but is under significant pressure and facing its biggest challenges since it was established. With some questioning whether the NHS can be maintained in its current form, the King’s Fund want to initiate a debate about the ‘contract’ between the NHS and the public – what people can expect from the service and what their obligations are in return. The survey of over 1,100 people aged 15 and over in England found: unwavering support among the public which endures across the generations; 77% believe the NHS should be maintained in its current form; 90% support the founding principles of the NHS, indicating that these principles are just as relevant today as when the NHS was established; 66% of adults were willing to pay more of their own taxes to fund the NHS; 67% think that treatments and services should only be available on the NHS if they are available to everyone and not dependent on where people live, while 31% think that treatments and services should be based on local need; 65% believe that keeping healthy is primarily down to the individual, with just 7% placing this responsibility with the NHS. 

  • The King’s Fund and Nuffield Trust have completed an analysis of Sustainability and Transformation Plans in London. The report, commissioned by the Mayor of London looks at the five STPs in London and assesses the main issues and risks to be addressed across the five plans.  All five STP areas are seeking to give greater priority to prevention and early intervention, while also strengthening and redesigning services delivered in primary care and the community. This includes more closely integrating NHS and social care services. The report highlights significant issues that need to be considered - while the plans are ambitious they are unrealistic, particularly in terms of efficiencies, captial investment and not taking account of other cuts in public spending in LAs, such as public health. They also add that health and social care professionals, patients and the public, local government and other partners must be meaningfully involved in developing the content of the plans and their implementation.

  • The Care Provider Alliance has published a new report to encourage engagement between STPs and adult social care providers. Despite the size and vital importance of the sector, the engagement of STPs with it is generally still at an early stage. The CPA has written to STPs to encourage greater engagement and also make practical suggestions as to how this can be done. The Alliance is calling on each STP to review its engagement with the independent and voluntary adult social care sector and, by March 2018, to share information on its website (or otherwise) about how it is taking engagement forward with the sector. The CPA is also calling on the providers of adult social care services to take time to understand the role of STPs, and to be ready to engage positively and openly on behalf of the sector.

In brief:

  • Health Secretary Jeremy Hunt has announced new measures to help combat Sepsis, through an awareness campaign aimed at nurses, care home staff and pharmacists, who will be informed how to check for signs and symptoms of the illness, as part of a new NHS plan to improve treatment of the condition. Sepsis kills around 37,000 people in England every year and is known as a ‘silent killer’ because it is very difficult to spot. Triggered by an infection, sepsis causes the body’s immune system to go into overdrive, setting off a series of reactions that can lead to organ failure and, in some cases, death. The new measures include: a clear definition of adult sepsis for clinicians, so sepsis is identified and recorded more quickly; educational materials to ensure awareness among all primary care, pharmacists and health care professionals; targeting care homes, pharmacists and other areas of the NHS which deal with frail and older people to prevent Sepsis.

Back to top

_________________________________________________________________________________

Housing

Older people's housing small building image

  • Analysis published by the Local Government Association (LGA) suggests that because of England’s ageing population, specialist housing stock for older people will have to increase by 400,000 in less than 20 years.  According to the report, currently just 0.6% of people over 65 live in specialised accommodation with care support. The LGA call on Government to support a “residential revolution” for older people’s housing by giving councils sustainable funding to adapt existing homes and support independent living. It also said LAs need extra planning powers to ensure developers build suitable age-friendly housing. Martin Tett, housing spokesman for the LGA and leader of Buckinghamshire County Council said “Councils across the country are innovating when it comes to delivering housing for older people. However, councils cannot tackle this issue alone. Support from government, which incentivises housebuilding and provides councils with the funding and resources they need, is crucial to our efforts to support positive ageing.” The report recommends that: Government sets out a plan to comprehensively address the housing needs of an ageing population for England; guidance and support is provided to councils along with tools, to robustly project future housing and care needs; local plans and strategies set out the full spectrum of housing types and choices across all tenures, ‘care ready’ and housing with care, including futureproofing mainstream housing; and councils promote new innovative housing designs using the HAPPI guidance.

  • The National Housing Federation has undertaken a survey amongst 69 housing associations, to assess the impact of the proposed new funding model for supported and sheltered housing. The survey found:  Almost 4 in 10 (39%) respondents said that they have postponed new developments, 10% have cancelled new developments, 7% are planning to close existing schemes between now and 2019 and 1% said that they have decommissioned existing schemes; the planned development output of supported, sheltered or extra care homes pre and post announcement of the new funding model has dropped from around 8,800 to 1,350 homes, representing a decrease of 85%; the two most important reasons for schemes still going ahead are the LHA rate being high enough to cover rents and service charges, and the fact that associations believe that local top-up funding will be available when the time comes; the areas of certainty that are most needed are a higher cap than the LHA level to cover a greater proportion of rent and service charges, and a long-term commitment (set out in legislation) from the Government to maintaining any ring fence; more than half of respondents also provide short-term/transitional services. These organisations have a slight preference for a funding mechanism where funding is delegated to local authorities (as opposed to tenants having to claim costs through the benefit system); 77% of respondents said that their organisation has performed an impact assessment on the potential impact of the Government’s proposed model.

    MHA comments: The sector did warn the Government that these proposals were likely to affect the future development of specialist supported housing. We watch with interest to see how the Government responds. 

  • The Housing LIN have published a case study featuring a review of services for older people based on co-production principles carried out by Pembrokeshire Housing.The project focussed on five sheltered schemes and three linked semi-sheltered schemes, aiming to fully engage with residents, tapping into their unique expertise as a prerequisite for designing services, to meet their needs now and in the future.      

Health and Housing

  • A National Housing Federation report Home from hospital: How housing services are relieving pressure on the NHS, has found that housing providers are helping the NHS save money by helping people out of hospital into homes faster with the right care and support. The report, showcases 12 examples of schemes where people get the care and support they need outside of hospital wards. It articulates the housing offer and the diverse housing and health services provided by housing associations and LAs. These include: temporary homes for people who cannot return to their own home immediately (known as a “step down” service); extra care, and health and wellbeing services; home improvements, including safety, sustainability and suitability of homes; and occupational therapists, telecare solutions and advice on housing options. But this contribution is small-scale and localised – and the cost-benefits of extending these services would be significant. Helen Rowbottom, Policy Officer at the Federation, said: “Delayed transfers of care come with a huge price tag for the NHS and at a high personal cost for patients. But housing associations have been hard at work. As this report shows, their innovative schemes are already helping the NHS make substantial savings and enabling individuals to make a full recovery. Housing associations are natural partners and are ready to do more. Helping people out of hospital requires coordinating partners and services in the community. While this can be time-consuming for hospital staff, housing associations can do this effectively as landlords and providers of vital care and support services. This is an opportunity we mustn’t miss – there is a strong case for scaling up this work. The sector is ready to partner with NHS commissioners to find the best way of doing this."
  • Foundations, the national body for home improvement agencies has published a blog that acknowledges the importance of the role that housing plays in health and social care. It recognises a rising trend in the number of Disabled Facilities Grant approvals over the last two years, and introduces the social value calculator, a tool that is being developed by the Housing Associations’ Charitable Trust and a group of home improvement agencies with the aim of quantitatively measuring success.  

In brief:

  • The Housing LIN has published a viewpoint from Damian Utton of Pozzoni Architecture on The challenge of a generation: A reflection on my past 20 years in the senior living sector, reflecting on some of the design considerations that have emerged over the past two decades and draws on the learning gleaned from his travels during a six-month sabbatical to research dementia design overseas. 

  • Independent social investor Big Society Capital has partnered with the National Housing Federation, on a new investment programme, Creating our Future, to invest £15m to create products and services that transform people’s lives on a national scale. The winning ventures must be innovative, socially impactful and financially sustainable, with a robust business model that requires investment. The National Housing Federation will then hold a Futures Expo in 2019 to launch the ideas on a wider scale.

Back to top

_________________________________________________________________________________

Social Care

The System 

  • A survey of 469 social workers from every region of England, conducted by Community Care Magazine and the Care and Support Alliance, reveals the difficult position they are often find themselves in as they strive to support people in desperate need without enough funding in the system. Nearly seven in 10 (68%) of respondents said they felt expected to reduce care packages because of cost pressures in their LA; more than 1 in 3 (37%) said they believed they couldn’t get people the care they needed; more than 1 in 4 (28%) were not confident that the reduced care packages they had to administer were ‘fair and safe’; and  addition, 4 in 5 respondents (81%) said family and friends were being expected to provide more support to ‘fill in’ where care has been reduced. In the survey the reason given most often by social workers for having reduced a person’s care package was because their needs had changed, although this was followed by budget pressures. The survey also found that support to get out and take part in social and leisure activities was the type of help which was most commonly being reduced (72%), followed by help with domestic tasks such as food shopping and cleaning (67%). In addition, more than 4 in 5 respondents (83%) did not think there was enough variety and quality of social care provision in their area for people to exercise genuine choice and control over the care they received.

  • A report from the British Red Cross, Prevention in Action 2017 has criticised the progress being made on the Care Act 2014, two years on from its implementation. The report finds that LAs are struggling to meet their obligations to prevent, reduce, or delay the need for care as set out in the Care Act.  While it finds some positive examples of change on a local level and even some pockets of excellence that suggest there is a real willingness to change the way the system works, this is not happening at the pace and scale needed for transformation to be realised by the Government’s own deadline of 2020. The report also finds: that at a time when local government should be investing in prevention and integrating health and social care services, budgets are being cut despite acknowledging that prevention will reduce costs in the future; there is inconsistency between LAs when it comes to defining the meaning of ‘prevention’ as set out in the Care Act; varying interpretations of how to fulfil government ambitions for full health and social care integration; and a lack of clarity on how to implement practical measures to prevent, reduce or delay the need for care and support. The British Red Cross is calling on the Government to reassess the resources required to implement the duties outlined by the Care Act 2014 and explore what is needed to make integration and prevention work in practice. Mike Adamson, CEO of the British Red Cross, said “It is concerning that spending on preventative care has gone down at a point when local authorities should be scaling up. The Red Cross is concerned that intentions to fully integrate health and social care might remain a mere aspiration too. The proposed Green Paper on social care provides a good opportunity to reconsider what is needed to make the Care Act’s vision for prevention and the integration of health and social care services a reality.” 

Future need

  • Charity Future Care Capital, has published a report Securing the future: planning health and care for every generation, which includes a UK-wide survey of over 2,000 people, that found that most people surveyed support income tax rises to increase funding available for adult social care. A key finding was that most of those questioned said people should be required to plan ahead – 67% agree that people should be required to plan and prepare financially for later life, whilst 49% agree that they should be required to plan and prepare financially for adult social care services they might require later in life. The report also calls for a more concerted effort to be made in the short-term to adapt homes and the public realm so that they are ‘designed for age and mobility’, together with recognition of the economic contribution of carers to the overall economy and measures to improve carers’ ‘work-life-care’ balance.

  • A blog by Professor Carol Jagger at the University of Newcastle, explores the various ways in which dependency has changed compared to 20 years ago, and suggests some of the solutions the government should consider. Following research published last month about the ageing population and the increase in dependency, she writes “What is most surprising is that there has not been more notice taken of these trends which have been visible for many years. Perhaps it is because some have equated longer life expectancy with a healthier population and, indeed, anecdotally there is a belief that today’s older adults are fitter and healthier than previous generations.” Her research suggests that alongside extra funding, there should also be a focus on maintaining independence and low level dependency for longer. “... we need to convince older people and their families that much of ageing is malleable. There is good evidence from around the world that functional decline can be halted and even reversed if treated early.”

MHA comments: This commentary offers an alternative perspective on ageing an increased dependency, suggesting that initiatives such as our Live at Home schemes have a big part to play in helping people stay active, connected, happier and independent for longer.

Quality

  • Care homes which champion equality and human rights are more likely to be rated ‘outstanding’, according to the CQC. The care regulator claims there is a clear link between a provider’s quality of care and how well it treats its staff and residents in terms of human rights and treating them equally. In its resource Equally Outstanding, which it has developed to promote equality and human rights and show best practice, such as staff being well supported with supervision, discussion at staff meetings and development sessions which include human rights topics such as Deprivation of Liberty (DoLs), confidentiality and duty of candour. All staff attend the sessions including staff such as the cleaners.’  Paul Corrigan, CQC non-executive director and Board Equality and Human Rights Champion, said: “There’s a clear link between the quality of care a service provides and whether the people who use it and its staff feel that their human rights are respected and they are treated equally.”

  • National Voices has published a report examining Person-centred care in 2017. It finds that people's experiences of person-centred care vary immensely and while personalisation in adult social care has advanced, there is little evidence that its happening, in part becasue there are no consistent outcome measurements for personalisation. They recommend 1) make person-centred and community based approaches part of normal business, 2) Make a clear commitment to develop new, simplified, cross sector outcome measures 3) Support a small number of super demonstrator sites to develop these approaches at scale 4) Commission a pool of VCSE partners able to support local systems to develop person-centred, community focused interventions.

  • The Scottish Care Inspectorate has set out its expectations regarding the new care standards, being implemented in April 2018. Karen Reid, CEO of the Care Inspectorate has written a letter to all care providers which indicates that the new standards replace the National Care Standards, and instead of separate standards for different settings, there is a single set of standards that are intended to be more rights-based, person-led and outcome-focused. The standards are not just relevant for care delivery, but for planning, commissioning, and assessment. This is to allow coherence and improvement activity at every level, and reflects the fact that many people use different types of care at the same time.  The law requires the Care Inspectorate to take the standards into account when regulating and inspecting care. From April 2018, we will refer to the new standards in all our scrutiny work in care services and cease using the current standards to inform decisions.We are also making changes to our inspection methodology for care services to better reflect the standards and what we look at during inspections. We will start the new inspection model in care homes for older people from April 2018, and in other settings thereafter.”

  • A new guideline from NICE, is urging health and social care staff to support people to safely continue with everyday activities such as climbing stairs, dressing themselves or cooking after a period of illness or if they have been struggling at home. The guideline Intermediate care including reablement  sets out how health and social care staff can support people to be independent following a hospital stay or when daily life at home becomes too difficult. It covers how to assess intermediate care needs, including setting goals with the person so that they can overcome the problems they are experiencing.

Innovation and technology

  • Earlier this month the Apples and Honey Nightingale nursery opened in Jewish Care Homes’ Nightingale House in south London, offering daily joint activities for the children and residents including exercising, reading, cooking and eating meals. The new nursery, housed in the care home’s refurbished maintenance block, has 30 places for two- to four-year-olds and a number of spots reserved for the children of care home staff. The proposal came when the home was reassessing its own approach to care, says Simon Pedzisi, director of care services at Nightingale House, Our average age on admission is 90, so we have to think in an innovative way about activities,[Care] has to be more meaningful, deeper and measurable. It’s about social interaction because that’s what older people really [need].” Stephen Burke, director of United for All Ages, expects the UK’s first housing development for students and older residents (as seen in the Netherlands) to launch soon and said there can be economic benefits for care homes considering sharing their sites, including gaining additional rent and sharing administrative, ground maintenance and catering costs. Co-location can also improve recruitment and retention of staff, who take advantage of flexible on-site childcare or find satisfaction in the increased variety in their roles.” The opening follows the  Channel 4 programme Old People’s Home for Four Year Olds broadcast at the start of the month, in collaboration with the St Monica Trust, who have announced plans to develop care homes and retirement living schemes with nursery provision. 

  • A new report from New care models: harnessing technology, explores how five vanguards are implementing innovative digital technology solutions at the heart of a new approach to care. They are: East and North Hertfordshire; Better Care Together Morecambe Bay; Better Together Mid Nottinghamshire; Salford Together; and East Midlands Radiology Consortium. The experience of these vanguards show the potential for technology to enhance, rather than replace, existing services.  However, new technological solutions need to be considered within the context of local needs, and anchored to wider change programmes across organisations and whole health and care systems. In isolation, small-scale technology projects will not bring about the fundamental shift envisioned in the Forward view.

  • A new report the Royal Society for Arts, Manufactures and Commerce (RSA) says robots and artificial intelligence could ease the pressure on care providers. Robotics and artificial intelligence have the potential to play a major role in social care, taking on the more mundane functions of care. In The Age of Automation: Artificial intelligence, robotics and the future of low skilled work, the central argument is that the deployment of AI and robotics could help to phase out mundane jobs, raise productivity levels, open the door to higher wages, and importantly allow workers to concentrate on more human-centric roles beyond the technical reach of machines. While much of its focus is on the prospects for business areas including retail, transport and hospitality and leisure, it includes a sector case study on social care, highlighting the potential for robots to take on some of the tasks currently performed care workers. This would allow them to become attentive to patients and become absorbed in the core act of caring. 

End of Life Care

  • Marie Curie Cancer Care has undertaken an analysis and updated a population-based estimate of palliative care need, based on the number of people dying from particular illnesses, specifically those illnesses that could reasonably assumed to benefit from specialist palliative care. They suggest that any comprehensive end of life care strategy or approach to caring for people with a terminal illness should therefore take into account the size of the population that will need palliative care, to inform effective provision of services. Their analysis also shows that the growing number of deaths recorded with Alzheimer’s disease, dementia and senility as the underlying cause has a significant role to play in understanding the rising need for palliative care. 

  • The Government has published Choice in end of life care: Government progress, setting out progress the National End of Life Care Programme Board has made in implementing the Government’s choice commitment. The measures considered include: supporting the roll-out of digital palliative and end of life care records to all areas by 2020; inspecting and rating NHS hospital and community services for end of life care; providing support to trusts to help them improve end of life care services; testing personal health budgets for people approaching the end of life to give them choice and control over their care; developing metrics to assess quality and experience in end of life care; and working to change the nursing and medical undergraduate and postgraduate curricula to improve patient choice and quality of care.

In brief:

  • A new useful online resource from SCIE (the Social care Institute for Excellence) in association with NAPA (National Activity Providers Association), provides practical guidance on how to engage residents in creative arts, such as dance, puppetry and digital arts. 

    MHA comments: This will be really useful to our care home colleagues, as an extra resource for new ideas for their activity programmes. 

  • NHS England has published a revised version of the Accessible Information Standard Specification.  The Accessible Information Standard, applies to care homes and directs and defines a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents, where those needs relate to a disability, impairment or sensory loss.

Back to top

__________________________________________________________________________________

Third Sector

Supporters and Volunteers

  • NFPSynergy have published Volunteering Trend Data charting volunteer involvement from 2003 to August 2017. Key findings include: Overall volunteering levels are fairly stable; however, individual waves show volatility, possibly due to a season increase over the summer; 16-34 year old men are now one of the most likely groups to volunteer closely followed by women in the same age group; Volunteering levels in both 45-54 year olds and 55-64 year olds have declined between 2012 and 2017.

  • The Centre for Ageing Better will lead a review in partnership with the Department for Digital, Culture, Media and Sport into how to enable more people aged 50 and over to contribute their time, skills and experience to their communities. The review will focus particularly on how to increase voluntary and community activity among under-represented groups, such as people on low incomes and those with long-term health conditions. Older people in these groups can face particular challenges to taking part, and the review will explore how best to tackle these barriers. The review will involve calls for evidence from people with direct experience of volunteering in later life, as well as practitioners and researchers. Ageing Better will also host a series of roundtables chaired by sector leaders and experts and the review will culminate in summer next year with a set of practical recommendations to inform the work of government, funders, voluntary, public and private sectors.

  • The UK has slipped down the list of the world’s most generous countries, the Charities Aid Foundation’s World Giving Index 2017 has found. The UK moved from eighth in 2016 to 11th position on this year’s list, which gauges the generosity of countries by combining how much the public donate to good causes, how much time they spend volunteering and how likely they are to help strangers. The UK was in sixth place in the 2015 index. The index is based on a survey of more than 146,000 people in 139 countries, asking whether they had in the past month donated to a good cause, volunteered or helped a stranger. It says that 64% of people in the UK said they had given money to charity, a fall of five percentage points compared to 2016. The proportion of people in the UK who said they had helped a stranger fell by three percentage points on last year to 58%, and those who said they had volunteered fell by five percentage points to 28%. Myanmar retains its position at the top of the list for the fourth year running, but has experienced a drop in its overall score, from 70 to 65%. Myanmar’s position at the top of the list is likely to be because of the high proportion of Buddhists in the country, the report says, but it acknowledges the achievement is likely to be contrasted with recent news stories about the treatment of the Rohingya Muslim minority in the country.

 

Governance

  • Changes to the law could help charities run more effectively, according to the Law Commission.  In a new report Technical Issues in Charity Law, the Commission says that problems in charity law prevent or delay legitimate charitable activities, discourage people from volunteering, and force charities to obtain professional advice that should not be necessary.  They recommended changes to remove unnecessary bureaucracy whilst ensuring proper protections for the public including: giving charities more flexibility to obtain tailored advice when they sell land, and removing unnecessary administrative burdens; changes to the law to help charities amend their governing documents more easily with Charity Commission oversight where appropriate; increased flexibility to use their permanent endowment, with checks in place to ensure its protection in the long term; removing legal barriers to charities merging, when a merger is in their best interests; giving trustees advance assurance that litigation costs in the Charity Tribunal can be paid from the charity’s funds. For the Charity Commission the Law Commission recommends: bringing in a single set of criteria to decide changes to a charity’s purposes; increased powers to prevent charities using misleading names; and the ability to confirm that trustees were properly appointed.

Back to top

__________________________________________________________________________________

Workforce and Skills

Social care and nursing 

  • The latest State of the Adult Social Care Sector and Workforce report, from Skills for Care, estimates the sector contributed £41.8bn to the English economy in 2016/17, using pay, hours and total jobs data from its National Minimum Data Set for Social Care (NMDS-SC) in conjunction with data on private sector profits, indirect effects like the sector’s extensive supply chain and induced effects, including money spent by people working in adult social care. The report also reveals that the overall workforce continued to grow, with the number of adult social care jobs estimated to have increased by around 1.5% (20,000) between 2015 and 2016 with the number of adult social care jobs in England as at 2016, estimated to be 1.58 million and the number of people working in adult social care estimated to be 1.45 million. 

  • The British Association of Social Workers (BASW) and Social Workers Union (SWU) have launched a Respect for Social Work campaign demanding respect for their profession after an independent study from Bath Spa University revealed that social workers work more than £600m of unpaid overtime a year, contributing to high sickness levels and over half of those surveyed reporting intention to leave the profession early. The research found social workers love their job – but conditions for practice are pushing many away. 52% of UK social workers intend to leave the profession within 15 months.
  • Research from the Royal College of Nursing (RCN), they highlight reports from nurses who have revealed that  patients are dying alone on hospital wards because staff do not have enough time to care for them and in other cases  medicines being given late and patients being left in pain. Around 30,000 staff, including midwives and health care support workers, took part in the anonymous online research. Staff revealed how they had ended up parachuted into departments they were unfamiliar with to provide emergency cover at the last minute. Others described how the demands on them had compromised care and left them in tears after their shift. There were also reports of situations where patients had died alone on their watch because they simply did not have time to do everything that was needed. The RCN said more than a third of those who took part in the online survey in May reported having to leave elements of patient care undone because of a lack of time, while two-thirds worked extra time unpaid.  It was also reported that: patients are no longer afforded enough dignity, even dying alone; colleagues have burned out and have become sick themselves, unable to work; many nursing staff question their future and contemplate leaving the profession; and members struggle to give their families enough support after shifts that can exceed 12 hours. The Department of Health highlight that numbers working in the NHS have increased since 2010, but the RCN maintains this has not been enough to keep pace with demand.

Learning at work

  • The What Works Wellbeing Centre has published research which explores Job-related learning: who benefits, and how much? Using survey data collected from a survey of UK residents covering a period of 5 years from 2010-2014, the researchers found: Job-related training improves the wellbeing of workers, but not as much as we might expect. The rise in job satisfaction caused by job-related training is comparable to the increase gained from a 1% increase in hourly wages; At the national level, there is little regional variation in the impact of job-related training on job satisfaction. However, we can see regional differences when it comes to how the the duration of training hours affects wellbeing: employees living in the Midlands and Northern Ireland gain more from fewer (1-17 hours) hours of training; Younger workers are more likely to gain wellbeing benefits from job-related training than older workers; Job-related training delivers wellbeing benefits for both men and women compared with those that receive no job-related training, but there are gender differences. Longer training periods only deliver wellbeing benefits for men, and generate almost no wellbeing gain for women.  

  • Social Care Wales has announced reform to qualifications in health and social care in Wales. A suite of up to 20 new qualifications will replace more than 240 existing ones. The new qualifications will be taught from September 2019, to learners aged 14 and upward, with the first certificates awarded in 2020. The suite of up to 20 qualifications, from Level 1 to 5, are designed to reduce complexity, raise quality and increase coherence in the sector. The awarding body will be a consortium of City & Guilds and WJEC, who will work with Qualifications Wales, Social Care Wales, NHS Wales, teachers, trainers and assessors to design and deliver the new qualifications.

Back to top

__________________________________________________________________________________

Look Ahead: October and beyond

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

1-4 Oct: Conservative Party Conference

3 Oct: NICE - People's experience in adult social care services (strong focus on learning disabled), consultation deadline

6 Oct: Communities and Local Government Committee - Housing Older People inquiry, deadline for further submissions

8-10 Oct: SNP Conference

12 Oct: Business, Energy & Industrial Strategy Committee & Work and Pensions Committee - oral evidence session with Matthew Taylor on his report Good work: the Taylor review of modern working practices

12 Oct: Health Committee - Nursing Workforce inquiry, submission deadline

16 Oct: Social Care Wales - Transforming care in the 21st century (workforce standards and profile), consultation deadline

27 Oct: Migration Advisory Council - EEA-workers in the UK labour market, consultation deadline

31 Oct: Welsh Assembly - White Paper – Proposals for a new Welsh Language Bill, consultation deadline

6 Nov: Department of Health - Expansion of CQC inspections, consultation deadline

7 Nov: Care England Judicial Review against Essex County Council, hearing

9 Nov: Department of Communities and Local Government - Planning for the right homes in the right places, consultation deadline

22 Nov: Autumn Statement

Events

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

Wellbeing and Cost-effectiveness in Policy, Wednesday 4 October, What Works Wellbeing, London, FREE.  This one-day course in partnership with LSE will offer new ways to measure the direct relationship between any policy or programme and its impact on people's wellbeing. It draws on fresh, practical thinking from Lord Gus O’Donnell, Professor Richard Layard and other leading policy and wellbeing experts.

Future of Commissioning, Wednesday 11 October, The King’s Fund, London £200 (+VAT). This event aims to help understand how commissioning is changing. The move towards place-based systems of care in England will require commissioners to work in more collaborative and strategic ways when planning and commissioning services for their local areas. Developed in partnership with NHS Clinical Commissioners, this event aims to help prepare health and care commissioners for the changes that face them.

From Rhetoric to reality: Making a difference to health and social care, Tuesday 17 October, ACEVO, Manchester, £50/£100.  The Association of Chief Executives of Voluntary Organisations is hosting an event to give health and social care leads an opportunity to discuss how charities can contribute to developing health and social care policy to bridge the gap between commissioners and local communities to provide high-quality integrated care for service users. The Better Care Support team (BCST) will chair a roundtable discussion about the role of the Better Care Fund (BCF) in promoting integration, implementing the wider BCF agenda, the role of charities in delivering integration, and the ways in which the BCF intersects with other health and social care spending.

Community health services: shifting the focus to out-of-hospital care, Tuesday 31 October, The King’s Fund, London, £240. This one day conference will look at how the health and care system can make the best possible use of community health services to meet the changing needs of the population.

Fuller Working Lives: Supporting Older Employees in the WorkplaceWednesday 8 November, London, £150. Hear from the Department for Work and Pensions on how to implement the Fuller Working Lives strategy, including best practice examples on enabling older employees to fulfil their roles to the fullest whilst ensuring they are supported through to retirement.

Norfolk Care Convention, Wednesday 15 November, Norfolk Showground, FREE. At the Norfolk Care Convention will see the launch for a call to action for the biggest transformation in the Norfolk care market in decades.  

Shaping Tomorrow Care England Conference, Thursday 16 November, London, £125 for members. The conference aims to provide an unrivalled opportunity to hear and debate the views of leading sector figures from government, regulation and commissioning on a topic of national importance. 

The Future of Ageing Conference, Wednesday 29 November, ILC-UK, London, £210. This conference focuses on the importance of ageing. ILC-UK argue that more people need to be convinced of this - businesses, entrepreneurs, people managers, and marketing professionals to work with the charity sector and policy makers and politicians, who can deliver change. ILC_UK need to help provide the evidence to make the case for action.

Improving Hospital Discharge and Reducing Delayed Transfers of Care in Your Area, Wednesday 29 November, Westminster Briefing, London £150. This event will examine hospital discharges and delayed transfers of care and explore a whole-system approach to integration, culture change and new ways of working.

Back to top

_____________________________________________________________________________________________________________________________________

Some information sourced from DeHavilland

 
 

blank space

© 2018 MHA