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By Debbie le Quesne

Posts Tagged ‘norman lamb

‘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.

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U-turn on plans to fund care: What a mess we’re in

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Writing in the Daily Mail, columnist Simon Heffer, addresses the apparent U-turn on government care policy.

He points out that Care Minister Norman Lamb announced last July that people would no longer be forced to sell their homes to pay for long-term care in old age. And it seemed to be a policy, and a promise, set in stone.

Guess what – now it appears to be nothing of the sort.

Heffer claims “there has been no great Government announcement – in fact, the U-turn has been slipped out in virtual secrecy. “

The devil, as always is in the detail, with the latest consultation proposals making provisions for means testing “that would penalise tens of thousands of hard-working, thrifty people each year.”

Heffer adds: “Essentially, it would force many members of the middle class to spend their assets on care or face having to sell their homes — as 40,000 a year do now.

“In doing so, it would make a mockery of their efforts to scrimp and save for their retirement — often at a cost to their quality of life in middle age — in the hope that financial rectitude would bring its own rewards.”

I have prided myself for years in not ever letting politics jaundice my views on care, but this coalition is something else when it comes to offering defined leadership – and not least, information – to the care sector.

Indeed, Heffer is correct when he writes the change would be “shocking breach of promise.”

To recap, Mr Lamb had pledged to ring-fence people’s homes by offering a deferred payment scheme that would allow the state to recover the cost of care (up to a capped level of £72,000) from estates after death.

Succinctly, Heffer rightly adds: “However, this may not now be so. The promise of a universal scheme of deferred payments for care, whether residential or in the elderly person’s own home, may be diluted so that homeowners with assets (excluding their house) over £23,500 would be forced to run them down to that level before qualifying for help.”

Well, Mr Cameron, where do we go from here?

Clearly there needs to be a major overhaul of care funding and the problem is not going to go away. How much worse can this all get? My care provider members are essential to the wellbeing of our elderly, frail and chronically sick. Frankly, the government’s commitment to them as they have effectively help roll out its modernisation policies is shameful. We are on the cusp of major social care crisis and we’re looking for a lead.

Things must be bad when the Mail, of all newspapers, criticises these new Government proposals, agreeing with Labour’s shadow care minister that it’s  “an attempt to ‘pull the wool over the eyes’ of the elderly.”

Heffer concludes his well-structured rant by writing: “Much as I am always loath to agree with the present Opposition, in this case they are absolutely right.”

Back to the drawing board (does anyone use that expression any more?). . .

Cheer up the elderly and we’ll save a fortune: I don’t think so

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Cheer up elderly and ease pressure on NHS, so says the headline in the Telegraph online.

Inspired by Norman Lamb, the minister for care and support, it’s certainly an eye-catcher – well done that sub-editor.

The Lib Dem MP maintains that taking elderly neighbours to church or a football match will reduce pressure on the NHS by giving pensioners a “reason to live” and stopping their “dependency” on care services.

Is that right?

The article says that Mr Lamb wants people to offer their elderly neighbours “companionship” because those who are ageing are living “miserable lives”.

He adds, according to the Telegraph, that such action could be enough to stop them relying on professional carers.

Earlier this year I blogged a piece about Mr Lamb suggesting that Neighbourhood Watch groups could be responsible for providing care to pensioners. I was not impressed with his proposal then and neither am I heartened by his latest idea.

Where does he get the idea that the elderly, per se, are miserable and need reasons to live? This is hardly an evidenced-based generalism, Mr Lamb.

Yes, some are lonely, some are miserable – but so are a lot of young and middle-aged people.

Why do I find Mr Lamb’s comments so insulting? Am I now old?

According to the Telegraph he told a fringe meeting at the Lib Dem conference in Glasgow: “If you are on your own and you never see anyone from day to day and week to week other than a formal care worker perhaps only for a 15-minute visit in the morning and afternoon, your life is pretty miserable.

“If you start to get a visit from someone who says, ‘Let’s go out, let’s take you to church, let’s take you to [a football match]’ you give people their lives back. You give them a reason to live again.”

His comments are certainly partially true, I guess a little like politics. Did I read he’s a lawyer and wouldn’t his courtroom experience serve him well for the ‘whole truth’?

Ultimately the Telegraph article reveals the driving force behind Mr Lamb’s comments and I quote directly from the piece . . . “Mr Lamb said local authority finances are under huge pressure because of the growing elderly population. “As people get their lives back they are less dependent on statutory services to deliver support to them. And so the cost to the local authority starts to reduce.”

Is this the best he can offer in creative management of grossly inadequate social care budgets?

Come on, our elderly really deserve much better than this. Not least, they deserve properly funded care from paid professionals.

Care minister seeks help from frontline workers

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When you don’t know the way ahead, ask a care worker on the frontline.

Well, at least that seems exactly what the government is doing at present.

Care minister Norman Lamb has called for everyone in the care mix – service users, carers, managers and directors to submit ideas on how to make the home care system work.

Earlier this month Mr Lamb held a crisis summit with home care providers on how to improve standards.

Simultaneously, business secretary Vince Cable told us that he is undertaking a fact-finding review of zero hours contracts – and some, if not an awful lot, of domiciliary staff have them.

The care minister’s crisis meeting followed a Beeb story showing video footage of neglect by a community provider.

Reported in the online CommunityCare, Colin Angel of the UK Home Care Association, who attended the summit, said the meeting recognised there was little new money available to help the cause.

“It was about how we can harness what good practice and innovation there already is across the country to improve the situation,” he was quoted as saying.

Mr Cable has stated that over last ten years there had been a rise in the use of zero hour contracts. True, but inevitable given the financial stranglehold of the economy and government.

With claims of abuse in the air over such working practices, Mr Cable was quoted as saying in the CommunityCare article: “Whilst it’s important our workforce remains flexible, it is equally important that it is treated fairly. This is why I have asked my officials to undertake some work to better understand how this type of contract is working in practice.”

As far as I understand there’s no timescale involved in this review and it’s all about “understanding” the working arrangements.

I know only too well the financial rigours care businesses face and news of no more financial help is not good. Many can only stay in business by offering zero hour contracts. It’s simple economics – no work, no pay.

Other issues in focus are unpaid travel times, shorter calls to clients and compliance with the national minimum wage. The waters get very muddied here.

I am heartened that Mr Lamb wants our views, though I doubt the care sector will be very responsive. Everyone is just too busy trying to survive, Mr Lamb!

I’m also ever so slightly worried that the call for help smacks of desperation. Truth is, care workers aplenty would probably have some excellent best practice to share and not least a few politically uncomfortable home truths.

Integration – it’s here, but will it really work?

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There’s a new buzzword being banded about in the NHS and social care – integration.

It’s the pioneering programme devised by health minister Norman Lamb. Already columnists and health worker have hit the public forums with the integration solution being couched in comic book hero terms.

But we do need a solution. After all, integration of streams of care on paper seems a good idea.

I’m not an expert, but some aspects are innovative. Not least is the prospect of new payment flexibilities – a shift away from paying hospitals for discrete activities towards rewarding them for developing integrated care pathways back into the community.

My abiding concern in the ‘real world’ of caring is that there are huge divides still between social care and the NHS – not an easy fix; inadequate funding – CCGs are being asked to give two per cent of their budgeting to this cause and already cash is tight; there’s the political issue of who gets priority; and frankly, I don’t believe the initiative will fix the billions of pounds shortfall politicians are speaking of.

I do, however, praise the bravery of this plan. No doubt those selling tickets for events which explore the reality of integration are doing a roaring trade.

One thing that I would hope emerges is that our members are, indeed, seen as part of a solution.

The debate will run and run  . . .

Funding for the future: A new collaboration

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Just when I think I’m getting a respite from the issues in the great funding debate the BBC go and spoil it – well, not really.

Wading into the Beeb’s headlines yesterday was Chris Ham from the King’s Fund, who said there should be a pooled resource for health and social care budgets as an ageing population meant more people had needs that spanned the two services.

The current system established after the Second World War has two distinct streams of care: Social care which is means tested and NHS care which is free at the point of use. It also has two funding streams.

We have head too many times that increased pressure on local authorities to make even more savings, couple with the prospect that central government will also cut their allocations, will eventually hit at our most vulnerable.

In 2016 we will see the cost of social care capped at £72,000 in an attempt to bring some limit to the public obligation to care, but I do not believe is will solve any of the fundamental problems of delivering sustainable, good quality care and financing it.

Now the King’s Fund is calling for a fundamental review to look at what was set in motion with the NHS in 1948 and how this great institution can work hand-in-glove alongside social care in the future.

Successive governments have failed to get this debate airborne but now says Lamb “the planets are aligned” for change.

To this end the Fund wants a radical single budget. But according to Minister Norman Lamb this is already being made to happen locally.

Where? I ask. What local authority is getting NHS ‘ring fenced’ cash to boulster social care?

Clearly closer integration is needed between NHS and social care as we address the demographic changes, but as ever, the devil will be in the detail.

Lamb said on the BBC interview said there should be a “fully-integrated system by 2018” and the government is to make announcements in September that would “really push the boundaries”.

We don’t know what’s coming next, but I bet it’s not going to be an easy pill to swallow.

Means testing for the NHS? Please help!

New champion for care, but what about the children?

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It seems timely that adult social care users and practitioners will have a new champion following the appointment of Lyn Romeo as Chief Social Worker for Adults.

Minister for Care and Support, Norman Lamb, made the appointment last week – about the same time that it emerged that more and more of more of our children are taking care duties.

Interestingly, in a government press statement, it says the new post “will work closely with a Chief Social Worker for Children to be announced shortly.”

Hmm . . . The new Chief Social Worker for Adults will help to improve the quality of care across adult services and act as a champion for those who receive services and the professionals who work in the sector, the press release adds.

These roles will lead social workers in protecting the “safety and welfare of the most vulnerable in society and make sure the views of social workers are heard at the highest levels of Government.”

They will advise Health and Education ministers on how best to improve standards in social work, looking at areas like training and professional development. They will also explore how social workers can best work with leaders of other professions to give the best possible services.

Lyn Romero is currently Assistant Director of Adult Social Care and Joint Commissioning at the London Borough of Camden. She has more than 35 years experience of social work practice.

Care and Support Minister, Norman Lamb, said: “I am delighted that Lyn has accepted this new and exciting role

“Her expertise will make her a strong and effective advocate for people who use services, their carers and social work practitioners working with adults.”

Lyn will take up her role in late summer/autumn.

But what will she and Chief Social Worker for Children do to address the news which broke from the Children’s Society last week?

More of our children are caring for us than ever before and the challenges that they face have been shown in sharp relief by the charity.

Post-school they are twice as likely to be not in education or employment. One in 12 are caring for someone more than 15 hours per week. Around one in 20 misses school because of caring. These young people often say they’ve been bullied or have developed their own physical and emotional health problems.

The scale of the issue is huge. The 2011 census shows 178,000 young people under 18 looking after a friend or family member, but this is not the whole picture.

When filling in the census, many parents simply don’t recognise or want to say that their child is caring for them.

BBC research in 2010 put the figure at 700,000 at that time.

At one end there is the five- to seven-year-old age group, where the census shows 10,000 little boys and girls caring for parents or siblings.

This can mean emotional support when they’re depressed, helping them put their clothes on because they can’t manage themselves or getting meals ready for the family.

At the other, there are 60,000 16 and 17-year-olds looking after households and paying bills, making sure people get to their medical appointments, giving people their injections, carrying out personal care such as bathing disabled relatives and supporting parents even when their mental health is at its worst.

These are hugely complex roles and between the caring they are juggling school demands.

The Carers Trust supports over 24,000 young carers, and they are constantly trying to reach more.

The government has the chance to ensure that the right support is provided for these  special youngsters.

Two pieces of legislation currently before parliament present a historic opportunity to improve young carers’ lives. The children and families bill, currently in the House of Commons, could be used to ensure that young carers who need support get a proper assessment and support to ensure their development isn’t put at risk.

But getting support for young carers themselves isn’t enough.

We need to make sure that adults who have care needs are also properly supported so that children are not relied upon to look after their families.

The care bill, before the House of Lords, is exactly where that can happen. If the government doesn’t amend it, the bill should acknowledge that it is relying on our children to pick up the care when no one else will.

I find it hard to believe that we potentially have legislation that actually underpins government failure to provide support and care.

The facts are all so sanitised, but the truth is we have grown a society, just like those in less enlightened times, where children have been given responsibilities for ‘providing’ things they never should.