Squeeze on social care intensifies pressure on NHS: emergency admissions at record high (19 December)

NHS England have today (19 December) released their weekly ‘winter health check’, the last of 2014, further revealing the  pressure that the NHS is currently under.

Emergency admissions in the last week are at their highest number since records began over a decade ago, with 111,062 patients being admitted to A&E. The NHS also experienced very high levels of attendance this week, with 440,428 patients attending A&E – up more than 24,000 on the same week last year.

For the full statistics: http://www.england.nhs.uk/2014/12/19/winter-health-chck-19-12/

Responding to the latest figures Richard Hawkes, Chair of the Care & Support Alliance, said:

“The pressure on our health system is being intensified by the squeeze on council-funded local care.

“Chronic underfunding has left hundreds of thousands of older and disabled people, who need support to do the basics, like getting up or out of the house, cut out of the care system. The impact is now being felt throughout the health and care system, and the health service is forced to pick up the pieces when people become isolated, can’t live on their own and slip into crisis.

“Every day, our organisations hear horror stories of people who struggle to get the support they need. This also has a huge impact on carers, who we know are struggling right now. Chronic underfunding has seen dramatic year-on-year rationing of social care support for older and disabled people and their carers, excluding thousands from the support they desperately need.

“As more and more of us need care, and fewer and fewer of us get it, the Government needs to fund care properly, as well as the health system. As health experts argue, anything else is a false economy.”

The Telegraph launches Justice for the Elderly campaign: CSA response (13 December 2014)

On 13 December, the Telegraph newspaper launched their Justice for the Elderly campaign, demanding ‘radical reforms to ensure that elderly and disabled people are treated with dignity in a care system the public can trust’.

The campaign is calling for:

  • Proper training for care workers
  • Properly licensed and paid care workers
  • Better regulation of care services
  • A new, national, highly publicised care advice service

Find out more about the campaign here: http://www.telegraph.co.uk/health/elderhealth/11292329/Justice-for-the-Elderly-The-Telegraphs-goals.html

In response, Richard Hawkes, Chair of the Care & Support Alliance said:

“The care system is on its knees.

“One-in-three people have experience of care – but polling shows that the public has no confidence in the system.

“Standards in the care system are a serious issue, but only one part of the problem.

“The bigger issue is that chronic underfunding has seen dramatic year-on-year rationing of social care support for older and disabled people.

“Every day, our organisations hear horror stories of people who struggle to get the support they need to simply to get up, get dressed and get out of the house. This has a huge impact on carers, who we know are struggling right now.

“The health service picks up the pieces when people become isolated, can’t live on their own and slip into crisis.

“As more and more of us need care, and fewer and fewer of us get it, the Government needs to fund care properly, as well as the health system. As health experts argue, anything else is a false economy.”

CSA response to Autumn Statement commitment to extra NHS funding (3 December 2014)

Today the Chancellor, George Osborne, confirmed £2bn of extra annual funding for the national health service in his Autumn Statement.

The £2bn, to be introduced from April 2015, includes:

  • £300m new funding for GPs to invest in their facilities and develop a wider range of care and treatment outside hospitals.
  • £1bn from underspending by other Whitehall departments.
  • £700m to be allocated to NHS England for frontline services, from the existing Department of Health budget,

Responding to the announcement, Richard Hawkes, Chair of the Care & Support Alliance, said:

“The Autumn Statement brings another pre-election promise on NHS spending.

“But as health experts argue, it’s a false economy without investment in care.

“Chronic underfunding has seen dramatic year-on-year rationing of social care support for older and disabled people.

“Every day, our organisations hear horror stories of people who struggle to get the support they need to simply get up, get dressed and get out of the house. This has a huge impact on carers, who we know are struggling right now.

“The health service picks up the pieces when people become isolated, can’t live on their own and slip into crisis.

“One-in-three people have experience of care – but polling shows the public has no confidence in the system. Along with health, it’s voters’ top priority for investment.

“The Health Secretary underlined its importance on Monday, but care was conspicuous by its absence in the Autumn Statement.

“As more and more of us need care, and fewer and fewer of us get it, the Government needs to fund care properly, as well the health system.”

Careweneed.com: See the facts and compare your views on care

cropped-csa_large_roundel_v02.jpgPanels V2

The Care & Support Alliance has developed an online tool which reveals key statistics about social care in each constituency in England.

Simply type in your postcode and find out how many older people, disabled people and carers live in your area to gain an idea of how crucial social care is to so many people.

We commissioned a YouGov survey which asked over 4,500 people across England what they thought about the state of care services for older and disabled people and how such support should be funded. You can take the survey and compare your results to other people in your area, of your age, or voting intention: www.careweneed.com

We launched the site at the political party conferences this autumn, where hundreds of MPs and other visitors engaged with the data on interactive screens at our exhibition stand.

The findings of our polling demonstrate that care is not just of crucial importance to hundreds of thousands of people, but a real election issue.

Chronic under-funding of social care over the last five years has led to a tightening of eligibility, which has seen fewer and fewer people getting the support they desperately need. Councils report that some £3.5bn has come out of the care system. In October, the Government published new national eligibility criteria for care under the Care Act reforms, which come into effect in April 2015. Research by the London School of Economics indicates that 340,000 people – who struggle to live independently – could be locked out of the new care system as a result of the changes.

Our polling
The YouGov poll we commissioned in September this year was one largest independent surveys of public attitudes to social care to date. The message from the public was loud and unanimous: people are not confident they will receive the care they might need and increased government expenditure on social care is their top priority along with health services. Check out the full findings here.

CSA response to Better Care Fund announcement (30 October 2014)

Today (30 October), the Department of Communities and Local Government, and the Department of Health, approved local plans for Better Care Fund (BCF) spending and announced further money for the scheme following increased investment from local authorities.

https://www.gov.uk/government/news/better-care-plans-to-help-elderly-and-reduce-hospital-visits#

The Secretary of State for Health, Jeremy Hunt MP, wrote in the Telegraph yesterday that the £5.3 billion – an increase from the initial £3.8bn – will be invested in 151 plans across the country to help keep elderly people healthy at home, and avoid needless admissions to hospitals and care homes.

http://www.telegraph.co.uk/health/healthnews/11196762/NHS-basic-model-to-change-pledges-Jeremy-Hunt.html 

Responding to this announcement, Richard Hawkes, Chair of the Care & Support Alliance, said:

“The Better Care Fund is a bold and ambitious bid to address the crisis in care and move us closer to a preventive, more integrated, system that keeps people out of A&E and living independently.

“But the real issue is that chronic underfunding has seen a year-on-year rationing of support, which will not be addressed by this fund.

“The only long-term solution to the care crisis is a longer term investment in the overall funding for adult social care.

“The Barker Commission experts argue that as a country we can afford it.

“In fact we can’t afford not to. Every day, our 76 organisations hear horror stories of older and disabled people who struggle to get the support they need to simply get up, get dressed and get out of the house. This has a huge impact on carers, who we know are struggling right now.

“Care – along with the NHS – is now undoubtedly an election issue. Our recent survey shows the public has lost confidence in the current system. It shows care, along with health, is where the public want the Government to invest more.”

For more information, please visit http://careandsupportalliance.com/

CSA members respond to the Government’s new national eligibility criteria for care (23 Oct 2014)

Age UK

Caroline Abrahams, Charity Director at Age UK, said:

“It is hugely disappointing that the new national eligibility criteria fail to give more people access to care. The care system is in a desperate place with funding failing to keep pace with rising demand. As a result, care is now restricted to only those in the greatest need. The situation is bleak for those older people who need help with everyday tasks –they are being denied their dignity and peace of mind when they are most vulnerable but without help could well end up in hospital. .

“Everyday day there is another horror story of an older person failed by the system and sadly things will not improve until the social care funding gap is filled. Politicians in every party need to recognise this and commit to action as an urgent priority.”

Alzheimer’s Society

Responding to the new national eligibility framework, Jeremy Hughes, Chief Executive at Alzheimer’s Society said:

‘In setting the eligibility criteria for council-funded social care so high thousands of people with dementia will be cut off from the vital support they need and deserve. It is absurd logic that services which help prevent people from reaching crisis point are given such low priority. People with dementia shouldn’t be waiting for an emergency until someone steps in – our care services should be working to prevent that crisis from happening.

‘Without hard cash the black hole in social care finances will suck the potential out of this opportunity for transformative change and we will continue to see people with dementia struggling to live from day-to-day.’

Independent Age

Care Act 2014 (part 1): In response to today’s publication of statutory guidance and response to consultation, Janet Morrison, Chief Executive of Independent Age said:

“We welcome the new rules to support the Care Act, in particular the strengthening of protection for families from having to pay unfair top-up fees for relatives’ care home costs. We also welcome the requirement for councils to improve information and advice services on care issues. However we think the government has missed an opportunity to liberalise the rules on who is eligible for social care, meaning that an estimated 235,000 older people will continue to be outside the system and need to either pay for care themselves, receive it from friends and families – or go without. This is shortsighted because many of those outside the care systems may as a result need to draw on health and other services earlier as a result”

Midland Heart

Ruth Cooke, CEO Midland Heart, in support of the Care & Support Alliance, said:

“We know that increasing demand and falling resources will together unhinge the aspirations of the new care reforms.  This pressure means that the bar to accessing services is being raised.

“We are a provider of early intervention services for many vulnerable people and see the very positive difference preventative services can make.  Its about helping an individual live with dignity and independence in their own home.

“With more people excluded from the care system, we will see countless older and disabled customers unable to get the vital services they need and they will simply hit crisis point.

“We need a bigger, honest whole system debate on making prevention truly work – it’s a debate about funding, eligibility, integration and wellbeing.”

Mind

Paul Farmer, Chief Executive of Mind, the mental health charity, said: “Social care isn’t just for older people or those with physical disabilities. It can play a vital role in keeping people with mental health problems well and able to cope.

“We welcome some of the provisions in the guidance and regulations, in particular the inclusion of support for people to maintain and stay in their home. This will particularly help people with mental health problems and was something we have been campaigning for.

“However, without more funding in the system many people with mental health problems will be denied access to the care and support they need. A very low level of relatively inexpensive support with managing bills, doing the weekly food shop or getting out and socialising with others can make sure someone stays on their feet and manages their mental health problems well. Take that away and people can descend into illness, unable to get out of bed, wash, dress, get to work or maintain relationships. This has serious implications for other parts of the system such the NHS, as people reach crisis point and need much more intensive and expensive hospital or home-based health care.

“As NHS England today highlights, our NHS is straining at the seams. Mental health services in particular are struggling to cope with the numbers of people seeking support and the government would be well-advised to consider the long-term implications of denying thousands of people the basic social care support they need. A little initial investment will not only save money in the long run – it will save lives.”

Sense

Threshold for social care “far too high”

National deafblind charity Sense today (23 October) warned that many disabled and older people will miss out on services they desperately need following the Government’s publication of the regulations that set out who is eligible for social care from 2015 under the new Care Act.

Sue Brown, Head of Campaigns and Public Policy at Sense, said:

“The Care Act is an incredible opportunity for politicians to finally get social care right in the UK. However under the regulations released today the threshold for people to become eligible for social care is set far too high. As a result, many disabled and older people will miss out on the services they desperately need for day-to-day life. It is also vital that the Government releases enough funds for local authorities to provide the right level of support for what is currently a chronically underfunded system. Otherwise the Care Act will be built on sand.

“Inadequate social care has a knock on effect and results in further demands on the NHS. For example, the deafblind people we support can become more susceptible to falls or require hospital treatment because they didn’t get the support they needed from social care. The Government must act and provide the funding that will allow disabled people to receive adequate care.”

New care overhaul leaves 300k older and disabled people struggling to live on their own (23 Oct 2014)

Care & Support Alliance Press Release: New care overhaul leaves 300k older and disabled people struggling to live on their own (23rd October 2014)

Following a crucial Government announcement on its flagship care reforms, a coalition of more than 75 charities is calling on the Government to urgently reconsider plans that risk leaving more than 300,000 older and disabled people without support to things as basic as getting up, getting washed and getting out of the house.

With parties pledging support for the NHS, the Care and Support Alliance joins experts in arguing that an effective, preventative care system is the only way to ease the admissions crisis.

The CSA says that the care system is on its knees, with demand going up but fewer and fewer people getting support.

The Government brought in sweeping reform of the care system in May – ending the postcode lottery, backing carers and capping catastrophic costs.

The Government today publishes a final version of its new national criteria for social care eligibility – in other words, it reveals who will and who will not get care from April 2015.

Chronic underfunding of the care system has seen councils increasingly ration access to care to only those with the highest needs.

But the Government now confirms that it doesn’t plan to reverse the trend.

Research by London School of Economics shows this means 340,000 people – who struggle to live on their own – will be locked out of the new care system.

The Care Minister, Norman Lamb, has previously said his intention is to set the level at the equivalent of ‘substantial’ in the current system. This formally excludes people who are misleadingly described as having moderate needs, but who actually struggle to do basic tasks without support.

The CSA argues that sitting behind this issue is a tale of chronic underfunding.

Councils report that some £3.5bn has come out of the care system in the last five years.

The Alliance is campaigning for a properly funded care system. The call to action follows YouGov polling which shows that the public have lost confidence in the current care system and that care – along with health – is the place they’d most like to see greater investment.

Richard Hawkes, Chair of the Care and Support Alliance, said:
“The Care Act is a ground-breaking piece of legislation – capping catastrophic care costs and ending the postcode lottery.

“But it will only live up to its promise of a genuinely preventative system that promotes wellbeing, if the Government re-thinks its plans to exclude so many older and disabled people from the system.

“Setting a high threshold for the care system is a bit like going to the doctor with a chest infection and being told to come back with pneumonia.

“Every day, our 76 organisations hear horror stories of older and disabled people who struggle to get the support they need to simply get up, get dressed and get out of the house.

“Care – along with the NHS – is now undoubtedly an election issue. Population changes mean more and more people need care. Yet fewer and fewer people get it, as chronic underfunding has seen a year-on-year rationing of support.

“Our survey shows the public has lost confidence in the current system. It shows care, along with health, is where the public want the Government to invest more.

“The only long-term solution to the care crisis is an increase in funding, and – as the Barker Commission experts rightly argue – as a country we can afford it. In fact we can’t afford not to.”

The CSA is on-hand for interviews, case studies and background information.

Contact Warren Kirwan in the Scope press office on 02076197200 or warren.kirwan@scope.org.uk.

The Care and Support Alliance was set up in July 2009. It is a consortium of over 75 organisations that represent and support older and disabled people, including disabled children, those with long-term conditions and their families, and campaigns to keep adult care funding and reform on the political agenda. For more information go to www.careandsupportalliance.com  

Who are the “340,000”…

According to the research conducted by London School of Economics setting a high bar on eligibly (equivalent to substantial) would see the following people ineligible for council care:

  • 69,000 working age disabled people with moderate needs not in the system
  • 36,000 working age disabled people with moderate needs currently in the system
  • 170,000 older people (over 65s) with moderate needs not currently in the system
  • 65,000 older with moderate needs currently in the system

= 340,000

(From Fernández JL et al. (2013) Implications of setting eligibility criteria for adult social care services in England at the moderate needs level. London: PSSRU, LSE, http://www.pssru.ac.uk/archive/pdf/dp2851.pdf)

Care facts and figures

  • The care crisis is well documented. Age UK are reporting that almost 900,000 older people in England and Wales who struggle with such basic tasks as washing and dressing are being left to fend for themselves.
  • Councils report that some £3.5bn has come out of the care system in the last five years. Of the 152 councils in England responsible for care, government figures show nearly 90% now offer care only to those with the highest level of needs. In those areas this means older and disabled people who are unable to undertake several aspects of personal care, or of work, education or training are no longer eligible for council-funded care.
  • When it comes to just older people the figures are even starker. Two thirds of people aged 60+ believe the Government should be doing more on social care. Around seven in 10 are not confident they will receive good care. After the NHS, social care is the biggest priority for voters when it comes to government spending.
  • The most important decision for older and disabled people will be whether they are entitled to care in the new system, due to come in in 2015. The proposals were published for public consultation in the summer 2014 and the Government published its final version on 23rd October 2014. Eligibility will also be used to determine who benefits from the ‘cap on costs’.
  • The Barker Commission recently released its report on how we create a system fit for the 21st Century and proposals for how we can afford it.