By Debbie le Quesne

Posts Tagged ‘NHS funding

‘Make or break’ time looms for social care

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Councils in England face a funding gap of £5.8 billion between March 2014 and the end of 2015/16, new Local Government Association analysis shows.

The figures are scary and according to Care Industry News, the online magazine, local authorities will need to make huge savings equivalent to 12.5 per cent on their total budgets before next April.

Successful integration of health and social care is vital, says the LGA to stop the care system from collapsing.

The £5.8 billion shortfall in council budgets will be caused by a combination of reduced government funding and rising demand on services – particularly from the elderly.

The funding gap in adult social care alone already amounts to £1.9 billion by 2015/16 – based on council adult social care budgets in 2013/14, says the Care Industry News report.

My abiding fear is where new saving will be made. Already we have heard pledges to protect spending on adult social care next year as much as possible, but I can’t help worrying worse is to come.

Next April, will mark a critical point for adult social care in England with the pooling of £5.4 billion from councils and the health service. The Better Care Fund will aim to improve care for older people and reduce financial pressure on councils and the health system through stopping lengthy waits for discharge from hospitals and avoiding unnecessary admissions to care homes.

Initiatives like the Vitality Partnership are already under way to make a difference in the community and funding for such work has been assigned for the year.

But the scale of savings which need to be found next year illustrate the urgent need for the Better Care Fund to “quickly succeed in radically improving the way public money is spent on looking after England’s elderly,” says Care Industry News.

Indeed, 2015 I believe will be make or break for social care and council leaders are saying the same.

Quoted din the online article, LGA Chairman Sir Merrick Cockell says: ”In recent years, local government has worked tirelessly to save billions while protecting services for those who need them most. But the scale of the challenge facing local authorities next year is stark. Council finances are on a knife-edge and the old way of doing things – including the way we care for our elderly population – just won’t work anymore.

“Next year will be a make or break moment for adult social care, for local services provided by councils and for the NHS.”

Central to the rescue mission is the introduction of the Better Care Fund (BCF).

“Neither councils, the NHS or England’s elderly can afford for this not to work,” he adds.

And I have just returned from a meeting about the Better Caring Fund. Interesting – it seems the Government is still “deciding and discussing,” while local authorities and CCG’s are now too far down the line to stop in what seems a perfectly reasonable use of money. Spend the money to help people stay healthy in their own homes or care homes and spend a whole load less on acute hospital admissions.

More cuts to an already financially struggling industry or cutting back on the BCF would be catastrophic.  The challenge ahead is enormous and I for one have everything crossed that all will be well.


Extra £2bn ‘needed to integrate NHS and social care’

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The chairman of the Local Government Association has warned that the NHS needs an extra £2bn to help integrate its services with social care.

Sir Merrick Cockell says the money is needed on top of Better Care Fund – the £3.8bn project to make this difficult union happen.

And, with what I believe is good insight, he’s also demanding that the fund gets five-year commitment, rather than the year it is officially scheduled to last.

He believes the money would “ease the short term disruption to residents and to patients.”

Speaking at conference organised by the King’s Fund thinktank in London, and reported in The Guardian, he does add that the Better Care Fund is “our best answer to the questions asked of us in these testing times”.

The Better Care Fund relies on pooled funding from local authorities and the NHS, with the intention of reducing pressure on hospitals by providing more care and support in people’s homes.

Not wishing to dampen enthusiasm here, but on weekly basis I seem to hear or read that local authorities have no spare cash.

The fund launches next April, and Cockell is reported as saying that the coming year is “the crunch year in all respects … we simply can’t fall apart in that year.”

I agree with Mr Cockell that we are, indeed, in “testing times” but I feel I’m missing something here. Local authorities throughout the UK have decimated social care budgets, closed care homes, day centres and libraries as central government finances have been revised downwards,

Can someone tell me please, just where is this extra money coming from? I’m fully supportive of an integrated NHS and social care system and the West Midlands Care Association has excellent working relationships with both of these care streams. I fear, however, the financial juggling is already beginning to unravel as the austerity measures deepen.

Care providers are struggling with unrealistic fees and my NHS colleagues are wincing as their budgets shrink. Too much hard work has gone into this for it to fail.

I have seen first hand some of the effort that the NHS and local authorities have put into getting this to work in the West Midlands as everyone sees the benefits of not dragging people into hospital when they can be better helped where they are.

Dudley have some very exciting ideas emerging, including a Community Rapid Response Team that will help people in their own home and care homes to be treated ‘locally’ if possible.

Do we need a rethink, Mr Cameron, on this pressing matter of funding? I think so.

‘Zombie’ comment on care plans reveal true divide

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Care minister Norman Lamb is not happy. Indeed he appears to be furious after his £5bn plan to join up social care and NHS funding was likened by a doctor to “zombie” that needed putting out of its misery.

The care and support chief was speaking at the School for Social Care Research conference and had told delegates that “great chunks” of NHS cash was going over to personal health budgets for people living with long-term conditions.

A question from the floor reminded him that at another event a show of hands revealed that overwhelmingly most health professionals were against the idea, with one medic likening the plan to an “intellectual zombie”, an “ideologically-driven dead idea still moving” that needed putting out of its misery.

Lamb’s response was brisk: “It demonstrates the cultural change that’s needed,” he snapped. “The idea that the clinician knows best has to be stopped.”

It’s a brave stance by anyone’s reckoning and though I welcome the promise of more funds, we must find a common ground with the NHS and be able to work together.

And may I add that all NHS staff are not the same. With West Midlands Care Association I have fostered some great working relationships with NHS-led care colleagues.

Lamb’s angry retort reveals the real tension over his plans, something I have mentioned many times in my blogs. If I’m honest, I can really see any movement to scrap the plan.

The coalition’s Better Care Fund (BCF) will mark a significant step forward.

According to the national media: “Lamb has confirmed that the fund, set up with a pooled £3.8bn of existing funding, mostly from the NHS, will in fact kick off next year with at least £5bn available to develop integrated care services, thanks to more than 50 local areas electing to chip in extra to that required.”

Sadly, there has always been a chasm between health and social care and the enthusiasm to join the two together I fear is only skin deep.

I quote yesterday’s Guardian: “A few months ago, when there were fears of a winter crisis in the NHS, Care England, representing private care providers, approached Downing Street to offer help. Encouraged by officials, it emailed health trusts and CCGs, among others, to make beds available in care homes for less acutely ill patients so that pressure on hospital wards might be eased.

“According to Care England, barely 10 per cent of its emails were even opened. Still fewer prompted any response. As long as such narrow thinking persists, the health and care system is doomed to remain disunited – and to fail.”

I’m afraid Mr Lamb will need more than a sticking plaster approach to fix this problem.

Bed block figures shame the social care cuts policy

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NHS figures released in the New Year show that almost 18,500 patients spent the festive period in hospital even though they were fit to go home.

Why? Because there was just not a big enough social care pool of community providers for support care package to be put in place. Bed blocking is back in the news – in reality, it probably has never gone away.

More than 18,490 “delayed transfers of care” were logged between 19 December and New Year’s Day at the cost a whopping £4.8m. Just how much social care would that buy?

The cost of this restriction on hospitals functioning normally surely must be a strong lever in the government’s budget setting for social care. It costs the NHS about £260 a day to keep someone in hospital and the 18,490 beds occupied by those safe to discharge is thought to be the highest total ever.

Here we have elderly people trapped in hospital and frankly, the blame must lie with government. The coalition has restricted business development in the care sector with its fiscal stranglehold on funding and its attempts to make access to care so much harder.

It is cabinet that have decided to trounce social care, squeezing its budget unmercifully and the bed blocking is yet another symptom of chronic underfunding failure.

Andy Burnham, the shadow health secretary, was quoted in The Guardian as saying: “Rather than rising to the challenge of the ageing society, we are going backwards, and care of older people is getting worse.”

I’m sure Ministers would not agree that their actions have cause such a distressing figure but I know plenty of people who do.

Caroline Abrahams, director with charity Age UK condemned the fact that high quality social care was “being stripped to the bone.”

Research at the tail end of last year by the London School of Economics found 483,000 people had either lost their home care support or were no longer eligible to claim it, compared with 2008.

The solution to this mess, according to a Department of Health spokesman quoted in The Guardian online, is “joined-up services” so that “more people can be treated closer to home.”

“We are transforming out-of-hospital care by bringing back the link between GPs and their older patients and investing £3.8bn to join up health and social-care services,” the newspaper reported.

Hmm . . . £3.8bn: Has anyone at the sharp end of social care seen any sight of this to help streamline, expand our services and develop future-proof business?

I thought not.