Adult Care Blog: January 2011 Archives

Health reforms will not lead to patient care improvements, say GPs.

By Jeremy Dunning, senior adult beat journalist on January 31, 2011 5:10 PM | No Comments

More than half of GPs responding to a snapshot survey carried out by the Royal College of GPs are concerned that the proposed health reforms will not lead to improvements in care for patients.

And one of the key concerns remains opening up the NHS to more competition.

This finding comes on top of a poll by YouGov, showing that less than one third support allowing private companies to provide more NHS services, as my colleague Mithran mentioned in his blog earlier today on the second reading of the Health and Social Care Bill, the vehicle for health secretary Andrew Lansley's overhaul of the NHS.

The GPs' poll, conducted via online tool SurveyMonkey, shows that GPs are yet to be convinced that the reforms will improve patient care, enhance the relationship between GPs and consultants, or reduce bureaucracy in the NHS.

This is surprising considering Lansley has consistently claimed that GPs are beginning to show more interest and enthusiasm for the reforms.

The poll attracted more than 1,800 responses. More than 50% disagreed that the proposed model of GP commissioning would create a patient-led NHS. More than 70% of respondents said they disagreed- or strongly-disagreed that the concept of 'Any Willing Provider' would either achieve a patient-led NHS, or improve healthcare outcomes.

RCGP Chair Clare Gerada said: "The RCGP is not opposed to NHS reform; we want to improve the NHS for our patients, and GPs want to see a clinician-led NHS that places patients at its very centre.

"However, these results highlight the continuing concerns many of our members have about the proposals outlined in the Health Bill.

"This is a snapshot of what our members are thinking at the moment. These results show that a significant number of our members are keen to support GP-led commissioning; it is something the College, and GPs, have wanted for many years.

"However, our members are telling us that they are worried about the pace at which these reforms are being implemented, the danger of fragmentation of services, and the emphasis on competition, and they are not sure whether the proposals really will have the positive impact on patient care that is intended.

"Our members are also worried that time which could be spent caring for patients will be taken away to deal with budgeting and administration and that this will impact negatively on the quality and continuity of care our patients receive".

"They worry about the financial pressures, and the competition culture of 'Any Willing Provider'; and they fear that these reforms could cause irreparable and irreversible damage to the NHS."

Will Lansley listen and slow the pace? On current form it appears unlikely.

£400m for mental health strategy - is this new money?

By Mithran Samuel, adults' editor, on January 31, 2011 12:48 PM | 2 Comments

Deputy prime minister Nick Clegg is apparently due to unveil the government's mental health strategy in the next few days, reports The Telegraph (not sure why it's him rather than either care services minister Paul Burstow or health secretary Andrew Lansley - maybe it's that they're busy with the tricky business of the Health and Social Care Bill).

As we have reported, there are big questions for the strategy to answer on how mental health services deal with rising demand and falling resources.
Last year, Paul Burstow was good enough to set out his vision for the strategy in Community Care, and The Telegraph story indicates that this vision is still on track.

It reports that £400m will be made available over the next four years to support the strategy's aim of increasing access to talking therapies and other forms of support. The story quotes some ambitious sounding figures of "curing" up to one million people with mental health problems and getting 70,000 into work by 2015.

We will have to see the detail to see whether this is realistic and also whether this £400m is new money or a recycling of money already allocated to the Department of Health - I would presume it is the latter, in which case where will it come from?

(Picture on Flickr from Liberal Democrats)

A message to adult care directors: Protect HIV/AIDS funding

By Mithran Samuel, adults' editor, on January 31, 2011 12:14 PM | No Comments

Deborah Jack, chief executive, National AIDS Trust, has sent the letter below to every director of adult social services, calling on them to protect social funding for people with HIV/AIDS. As we have reported, there are longstanding concerns about the future of this funding.

Dear Director

Re: The importance of social care for people with HIV

Our chair, Dame Denise Platt, has asked me to write to you, in your capacity as director of adult social services, to highlight the vital importance of continuing to fund social care services for people living with HIV over the next year.

As you will know, the Aids Support Grant, which funded social care for people with HIV, is now part of councils' overall formula grant. However, AIDS support remains an identifiable allocation specifically calculated to enable you to meet the needs of people with HIV in your area. I am sure you will be aware how much your council has been allocated for 2011-12, We firmly believe that spending this allocation on services that meet the specific needs of people living with HIV will deliver value for money and be a cost-effective investment in the long term.

Social care for people with HIV provides a lifeline for many vulnerable people, enabling them to retain their independence and have as normal as possible life. The government has clearly identified this as a primary aim and has acknowledged the continuing need for HIV social care and the necessity to protect these services through the continued existence of a specific and distinct amount of money with its own allocation formula.

Investing in HIV social care services has long-term benefits both in terms of the council's finances, but also for the health of your local population. Good-quality social care is an essential part of keeping people well and avoiding expensive hospital in-patient care and more complex and costly community support. The closer liaison between yourselves and the local NHS as we go forwards only goes to further increase the benefits of the continued funding of HIV social care.

A reduction in HIV social care services will also have public health implications which, with the council's forthcoming public health role, should be taken into consideration when determining funding now. Research shows that when people with HIV are suffering from depression and other forms of psychological distress they are less likely to adhere to their HIV treatment. Non-adherence not only impacts on the individual's own health but also on the health of others, as they become more infectious and therefore there is a greater risk they will pass the virus on, creating further demands for local health and social care services.

HIV social care provides a wide range of services including counselling, peer support, support for carers, respite care and support for children and young people affected by HIV. Many of these services are provided by small community-based voluntary organisations who deliver value above and beyond the direct cost of the services. As well as delivering support these organisations often provide a voice for people living with HIV at a local level, but a reduction in short-term funding for HIV social care services by the council may well threaten their future viability.

I hope that the issues I have highlighted above will serve to convince you of the importance of using the money allocated to 'HIV/AIDS support' within the formula grant to continue to fund essential social care support for people living with HIV. If you would like to discuss any of these matters further please do not hesitate to get in touch.

Yours sincerely,

Deborah Jack

Care home residents killed by thirst

By Vern Pitt, journalist, on January 31, 2011 11:09 AM | No Comments

The Telegraph reports today that nearly 700 care home residents died of dehydration in care homes between 2005 and 2009.

"The figures mean that, on average, 133 people died from dehydration each year - which is more than double the 66 deaths in 1997," the paper reports.

The figures do not include those that are admitted to hospital and die there, which I think we can probably assume will be sizable number.

Disability benefit cuts to hit up to 12,000 blind people

By Vern Pitt, journalist, on January 31, 2011 10:57 AM | No Comments

Cuts to disability benefits and social care will move partially sighted people further away from work and restrict their income, a report published today concludes.

The report by the Royal National Institute of Blind People (RNIB) calculated up to 12,000 blind or partially sighted people could lose their disability living allowance under proposed reforms.

Steve Winyard, head of policy at RNIB, said the government had failed its own test of fairness with the proposals. "Blind and partially sighted people need support to secure employment and to manage the extra costs of living with a disability, not the threat of losing their benefits.

"Yet like a perfect storm, the Welfare Reform Bill will pass through Parliament at precisely the same time as local authorities make swingeing cuts," he said.

D-day for Lansley as controversial NHS overhaul hits Parliament

By Mithran Samuel, adults' editor, on January 31, 2011 12:00 AM | No Comments

Today sees the second reading of the Health and Social Care Bill, the vehicle for health secretary Andrew Lansley's overhaul of the NHS.
This means the principles of the reforms will be debated and voted on, ahead of more detailed debate on the bill.
As I have mentioned already, these reforms have massive implications for social care.
One of the key concerns for health professionals is the plan to open up the NHS to significantly more competition from the private sector.
And it seems the public are also concerned, with a poll by YouGov showing that less than one third support allowing private companies to provide more NHS services.
The government's argument is that competition drives up quality in service industries more generally, and this applies to health as it does to any other.
Their critics - including practically all health unions and professional bodies - disagree, and see in these reforms a recipe for the fragmentation of the NHS and a race to the bottom on the price of services, at the expense of quality.
And they are taking this message to MPs today.
In a parliamentary briefing, the Royal College of Nursing said it wanted to see amendments to the bill to ensure that care is not fragmented or damaged by competition. Unite, one of the most vociferous opponents of the bill, is also briefing MPs today on why it is so wrong.
Given the coalition's healthy majority I think the bill will pass, but in amended form. Lansley and his colleagues will come under significant pressure to make some concessions, with the threat of Liberal Democrat, and possibly even Tory rebellion, hanging over the legislation.
It's worth getting a ringside seat for this one.

Picture courtesy of the NHS Confederation on Flickr

Solving the care funding crisis - responses to the Dilnot review

By Mithran Samuel, adults' editor, on January 28, 2011 4:00 PM | No Comments

Amid the misery of countless social care cuts stories, it is easy to forget that a commission is at work trying to find a long-term, sustainable solution to funding adult social care. Today sees the end of the Dilnot commission's call for evidence and responses are flooding in (I exaggerate slightly) from interested parties. (The man on our left is Andrew Dilnot, the economist tasked with heading the review).
Well, what are they saying?

There is widespread consensus that the "postcode lottery" in adult social care needs to end in England, through a national system of assessments and eligibility, with people able to retain eligibility if they move areas. This message is coming loud and clear from the voluntary sector (Mencap and Leonard Cheshire Disability), local government (the Local Government Association) and the private sector (insurance company Partnership).

No one is particularly clear where the threshold for such a system should lie (particularly with planned eligibility threshold rises happening across the country), while any new settlement will have to thrash out how much flexibility to give local authorities to respond to different local circumstances, markets and costs (unsurprisingly, the LGA is keen on there being maximum flexibility).

There is far less consensus how a reformed care system should be funded - in terms of the respective contributions of state, individual and families, and the respective roles of general taxation, private insurance and new funding mechanisms (such as a compulsory levy on estates).

The LGA - a cross-party body - has declined to come out in favour of a particular system because of the "inherent politics involved". Fair enough, given the Labour-Tory war over this issue before the 2010 election (Remember that?).

What is clear is that people want those in poverty and those with lifelong conditions who are unable to build up savings and assets to have their costs broadly covered by the state. Mencap has made this point particularly strongly as has Leonard Cheshire Disability.

But the key debate is over how people contribute to the costs of any care needs they acquire later in life after having built up savings and assets.

Free personal care for all, funded out of general taxation, seems out of the question on cost grounds and because of the argument that this will burden working-age people with funding the care of older people. But what solutions are open to the commission?

Two issues stand out.

1) Whether contributions should be extracted from people voluntarily or compulsorily (back to that Labour-Tory war: Labour favoured the latter, the Tories the former, broadly, before the last election).
2) Whether there should be different funding systems for different generations - whether the relative wealth of the Baby Boomer generation should be tapped to pay for their care, while those currently of working age should be asked to build up modest contributions for the rest of their working lives.

Respondents still seem to be wrestling with these questions and there is no clear direction being given to the commission from what I've read (still early days on that so far).

Observers of such things will recognise a number of these points - it is less than two years since we consulted on the Labour government's green paper on the same issue.

Let's hope that these responses - and many others - help the commission, which also includes ex social services directors Jo Williams and Norman Warner, come to a sustainable set of conclusions in its final report, due in July.

This will form the basis of a government White Paper in the autumn and legislation next year. As the axe falls on social care around the country we need something to make us optimistic about the future for older and disabled people.

Government decides to keep care home capital limits at current levels

By Vern Pitt, journalist, on January 28, 2011 2:22 PM | No Comments

Among the cuts there is a little ray of sunshine. The Department of Health has decided to keep the capital limits for council help with residential care at current levels.

The lower limit will remain at £14,250 and the upper limit will remain at £23,250.

In a letter to councils the Department said: "The intention is to help protect the level and quality of social care services by enabling local authorities to raise additional revenue to pay for these services, from residential care charges. This extra revenue should help ensure local authorities can maintain the existing quality and quantity of social care."

I guess it's quite something when not getting worse seems like a positive but at least social workers won't have to learn a whole bunch of new numbers for capital limits now.

Why I hope social care isn't like dentistry

By Vern Pitt, journalist, on January 28, 2011 10:26 AM | No Comments

I have a tooth ache. It's not an emergency but it is annoying and I want to get it fixed.

In dentistry, like in social care, I should have a choice of providers according to government policy. There are indeed two dentists very close to my house but despite moving to the area a year ago I am yet to register with either. Needless to say the pain in my face has prompted me to investigate doing so.

Unfortunately despite customers being given a 'choice' of dentists for years the NHS were unable to provide me with any information on which to compare the two practices beyond the waiting time for registration, which tells me nothing about the quality of care.

Why is this relevant to social care? Read on after the jump...

Continue reading Why I hope social care isn't like dentistry.

Government spending cuts get personal

By Vern Pitt, journalist, on January 28, 2011 10:20 AM | 1 Comment

Fighting monsters has an excellent post today which nicely illustrates something I hear said a lot - cuts put immense pressure on social workers who have to deliver the news.

CB, the author of Fighting Monsters, puts this much more eloquently than I could when she talks about having to deny one of her clients and increase in their personal budget, despite increased care needs.

She writes:

"I had to tell them and negotiate with them about what to cut from their own package of care.

"Not the Prime Minister. Not the Millionaires in the cabinet. Not any elected politician or Council Chief Executive. No councillor had to sit in that room with me and look the service user and carer in the face and ask them what they would prefer to give up from their package of care."

Legal action looms over service cuts to vulnerable people

By Jeremy Dunning, senior adult beat journalist on January 28, 2011 10:10 AM | No Comments

Communities secretary Eric Pickles and housing minister Grant Shapps are being threatened with a judicial review over Nottingham's Council's plans to cut 45% from its Supporting People budget next year.

Nottingham-based Framework Housing Association is arguing that the city council's decision is based on information on the department for communities and local government's website that officers used to make calculations for the coming year.

Last year the city council received £22.3m of Supporting People grant, but has said it believed that its SP budget for 2011 to 2012 had fallen to £12.4m - a cut of 45%. Framework has said these cuts, which would take effect from 1 April, will affect 3,000 of its own clients.

The city council's SP consultation finishes in February.

The government however rolled SP into the overall formula grant and has said it is impossible to identify any authority's allocation.

In a letter to DCLG, lawyers acting for Framework said: "It is unreasonable for the Secretary of State to fail to provide the appropriate calculations and formulae to establish clearly the accurate amount of SP allocation for NCC.

"This renders the failure to do so unlawful and susceptible to challenge by way of judicial review."

A Communities and Local Government spokesman declined to comment on the specifics of the threatened action but added: "Ministers are clear that spending decisions are a matter for councils themselves, but they should look to ensure that the most vulnerable in their communities continue to be protected."

Framework is also contemplating action against the city council based on the speed of the decision; that there was no proper consultation and that it was based on misleading information.

A spokesman stressed that no decision had been taken on SP funding, but added that the council was basing its decision upon information on the DCLG website.

He said the city council was looking at providing £2m extra into its SP pot for one year only.

The threat comes as the row over Supporting People cuts intensifying as councils struggle to find ways of maintaining their statutory services.

The outcome of a judicial review is expected today into the legality of London Councils' decision to pull out 12 months early from agreements funding services to the most vulnerable communities across London and to repatriate funds for other services to the 33 London boroughs. The plan would save £3.2m a year.

At the same time the Bishop of Truro, the Rt Revd Tim Thornton, has entered the row in Cornwall where the county council has announced cuts of 40% over three years to its Supporting People programme.

In a letter to Cornwall council leader, Cllr Alec Robertson, Thornton wrote: "I am acutely aware of the problems of homelessness in Cornwall and the precarious funding for many of the voluntary organisations that provide practical help for such people in a variety of ways.

"I do of course understand the pressures on you and the cuts that have to be made but I do urge you to ensure the cuts to the Supporting People funds are proportionate and are aimed to ensure as little direct affect as possible on the most vulnerable in our society."

Housing minister Grant Shapps recently expressed disappointment that several councils are indicating significant cuts in SP services despite the government largely protecting its £400m budget.

This funding is not ring-fenced but is rolled into councils' overall formula grant, which the government acknowledges is tight but it believes is enough for councils to carry out their responsibilities.

Homelessness umbrella body Homeless Link however found that English councils plan to cut their Supporting People programmes by between 26% and 37% over the next three years.

Last year the National Housing Federation warned that 400,000 people could lose vital support under projected cuts by councils to Supporting People.

Image on Flickr from Department for Communities and Local Government

Recession leads to reduced drink and drug use

By Jeremy Dunning, senior adult beat journalist on January 28, 2011 9:14 AM | No Comments

beer by Tim Pearce, Los Gatos (Flickr).JPG

Two interesting statistics have been published showing reduced alcohol consumption and reduced illegal drug use.

The decline in alcohol consumption appears related to the recession with people having less disposable income, although those that did enjoy a tipple increasingly came from the middle classes, according to the Office for National Statistics (ONS) General Lifestyle survey.

This showed that men in the UK drank 16.3 units of alcohol a week on average in 2009, down from 17.4 in 2008, while women drank eight units a week on average, down from 9.4 in the previous year.

The number of alcohol-related deaths in the UK fell by nearly 13% in 2009 to 8,664, but these were still more than double the figure of the early 1990s.

However as Don Shenker, chief executive of Alcohol Concern, said it is likely that "It is very likely that alcohol consumption will rise again once the economy picks up."

Clearly though this is a national picture and there are regional spikes. The Eastern Daily Press reported that drink-related hospital admissions for both NHS Norfolk and NHS Great Yarmouth and Waveney primary care trusts are increasing.

In the year to April 2010 there were a total of 20,633 admissions to hospitals in Norfolk and Waveney, up from 9,815 in 2002/03.

Meanwhile the recession may be partly a cause behind the decline in popularity of illegal substances among all age groups.

The NHS Information Centre's annual survey of drugs misuse in England found that fewer people in England and Wales are taking drugs such as cannabis, cocaine or heroin.

Twenty percent of 16- to 25-year-olds used illegal drugs in 2009-10, down from 22.6% the year before, and well below the 29.7% recorded in 1996.

The survey found 8.6% of those aged 16 to 59, or 2.8 million people, were using illicit substances in 2009-10 - the lowest ever figure since drug-taking trends were first monitored in 1996, down from 10.1% in 2008-09, 11.1% in 1996 and the record 12.3% in 2003-04.

The proportion using class A drugs such as heroin or crack also fell year-on-year (3.7% to 3.1%), as did those taking cannabis (7.9% to 6.6%).

Today has also brought further controversy over the reasons behind the Health and Social Care Bill.

Prime minister David Cameron and health secretary Andrew Lansley cited poor outcomes to justify a £1.4bn restructuring of the NHS that will pass control of budgets from managers to GPs.

But today the King's Fund's chief economist John Appleby had said that deaths from heart attacks and cancer are falling despite lower spending on health than in countries such as France.

Appleby said: "These trends must challenge one of the government's key justifications for reforming the NHS."

The article, which is published online for the British Medical Journal shows that Britain had the largest fall in death rates from heart attacks of any European country between 1980 and 2006.

Finally nearly all of Leicester's day care centres for some of the city's most vulnerable people face closure.

Leicester City Council is looking at shutting all four centres for people with physical disabilities and for older people with mental health difficulties.

The Leicester Mercury said that if approved new admissions to the centres will end this year. Services would then be run down.

Picture courtesy of Tim Pearce, Los Gatos on Flickr.com

Stephen Fry joins campaign to save mental health crisis centre

By Vern Pitt, journalist, on January 27, 2011 1:29 PM | No Comments

Stephen Fry has joined the campaign to save a mental health centre in Leeds from funding cuts.

Fry Tweeted his support to his 2.2m followers encouraging to get involved via the campaign's website. Within a hour the site had nearly doubled it's hits.

The Leeds Crisis Centre provides instant access counselling for people in mental health crisis. Leeds council feels the service is a duplication of services available elsewhere and is subject to closure under council plans to reorganise its mental health provision.

Campaigners are calling for a full consultation with service users, consideration of cost cutting measures which would retain some crisis provision and attempts to secure NHS funding.

Fry has previously spoken out about his experiences dealing with bipolar disorder.

Personalisation's growing pains

By Jeremy Dunning, senior adult beat journalist on January 27, 2011 12:28 PM | No Comments

Serious questions are being asked about how well personalisation is working on the ground with Carespace comments pointing to personal budgets in some areas being restricted to personal and practical care only with "imaginative" solutions to complex problems being ruled out.

Some of the problems appear to be connected to choice and control issues, which is something we've raised before.

Other problems appear related to budget cuts.

What do you think? Have your say on Carespace

Mental health discrimination still rife, finds report

By Jeremy Dunning, senior adult beat journalist on January 27, 2011 12:06 PM | No Comments

A report from the the charity Shaw Trust has found that endemic levels of discrimination still exist for workers with mental health problems.

The report: Mental Health, Still the last workplace taboo? found that:

·         40% of employers view workers with mental health issues as a 'significant risk'

·         8 in 10 companies have no mental health policy

·         1 in 4 employers could not name any mental health disorders

·         Mismanagement of mental health cost British business 70 million sick days and £26bn a year

The report was based on a poll of 500 business leaders, commissioned by Shaw Trust and funded by Time to Change reveals that while there has been improvement, mental health discrimination and prejudice are still rife within the workplace.

Chief executive Sally Burton said: :Our poll, reveals British business is continuing to fail employees with mental health conditions.

"Levels of prejudice and misunderstanding are alarmingly high, yet emotional and practical support remains low or often non-existent. Working for a supportive employer can make all the difference. But it's not just about social justice; it also makes real business sense. In this age of austerity, companies can ill afford to ignore mental health in the workplace. It is time to break this last workplace taboo once and for all."

Carers in Scotland suffer more illness and disability finds study

By Jeremy Dunning, senior adult beat journalist on January 27, 2011 11:17 AM | No Comments

There are a couple of articles on The Guardian that I want to draw readers' attention to.

The first is a report from Carers Scotland that has found that carers suffer more illness and disability.

The study found that carers are twice as likely to be hit by illness and disability as the rest of the population.

This chimes with a survey carried out by the Princess Royal Trust for Carers, which pointed towards a growing financial hardship for carers.

There's also a really interesting feature about older drug addicts and asks whether the system is prepared to deal with the rising numbers.

Disability benefit complaints against Daily Mail and government

By Mithran Samuel, adults' editor, on January 27, 2011 10:58 AM | No Comments

Just a bit more on this. We understand from the Press Complaints Commission that there has been five complaints about the Daily Mail article on the number of employment and support allowance claimants found fit for work.
We have also contacted the UK Statistics Authority, which regulates the use of official statistics, to see if they have anything to say about the Department for Work and Pensions press release that has triggered complaints about accuracy from disability campaigners.

War of words builds up over council cuts to services

By Jeremy Dunning, senior adult beat journalist on January 27, 2011 10:40 AM | No Comments

Margaret Eaton must have been angry to have used the phrase "Detached from the reality" in a response to the government's stance that local councils could do more to produce savings.

Eaton, who is the chair of the Local Government Association, was giving a withering response in The Guardian over Eric Pickles' claim that big government was partly to blame for unsustainable growth as much as the banks.

Pickles, who is the communities and local government secretary, has said he does not believe that the scale of the funding cuts will mean big cutbacks to services.

However Eaton stepped into the public row and dismissed this with a few well-chosen words.

She said: "Councils, already the most efficient part of the public sector - a point recognised by the Audit Commission, the Treasury and the prime minister - have been leading the way in trimming the fat over the past few years by sharing services, reducing costs and making the money they do get from government go much further.

"But we cannot escape the reality that back-office efficiencies alone will not be enough to cope with the cuts.

"Pickles says he does not "believe for one moment" that the scale of spending cuts will mean big cutbacks. But some authorities have seen a reduction in the grant they receive from government of 17% next year.

"To suggest this will not have any impact on services is detached from the reality councils are dealing with as they set their budgets."

It all adds up to a row that is nicely simmering away with regard to cuts by councils to the Supporting People programme.

The government protected from this from cuts but it is not ring-fenced and has been rolled into councils' overall formula grant. Many have therefore been raiding it to pay for their statutory responsibilities and therefore cutting their own programmes.

Earlier this week Cllr David Rogers, chairman of the LGA's community wellbeing board, said on this blog that even taking taking into account efficiency drives councils were facing a huge funding shortfall at a time when there were increasing pressures on areas like adult social care and child protection.

Therefore he said cuts to services on which vulnerable and homeless people relied are "inevitable".

Disability campaigners take fight to Tories and Daily Mail

By Mithran Samuel, adults' editor, on January 27, 2011 8:55 AM | 4 Comments

You've got to admire the gumption of disability campaign the Broken of Britain. Yesterday they decided to take their fight against disability benefit cuts - and what they see as a wider anti-disability agenda - to two of the country's most powerful institutions: The Daily Mail and the government, specifically Conservative employment minister Chris Grayling.
Both stand accused of being somewhat liberal with the truth, to put it mildly, about the proportion of sickness benefit applicants who are fit for work.

Their target was a press release put out by the Department for Work and Pensions on Tuesday headlined: "Majority of people found fit for work as government presses ahead with reforms".
This was followed up the following day by The Mail in a story headlined: 400,000 were 'trying it on to get sickness benefits: 94% of incapacity benefit claimants can work".

Broken of Britain has now referred the Mail to the Press Complaints Commission and Grayling to the Cabinet Office for breaching the ministerial code of conduct.

The Cabinet Office says it hasn't received the complaint yet but will look at it when it does. We are waiting to hear from the PCC on whether they have received it.

So why the fuss?

Here's an explanation that is far better than I can muster from the very reliable Full Fact (an organisation that scrutinises political and media statements for accuracy).

The gist is that the government's statement that a majority of people who apply for employment and support allowance is dubious, to put it politely. It involves the adding the proportion found fit to work between October 2008 and May 2010 (39%) to the proportion who drop out of the application process before receiving a medical assessment (also, 39%). But, as Broken of Britain points out, there is no evidence equating dropping out of the assessment to fitness to work. And of those who are found fit to work, many successfully appeal.

The Daily Mail's 94% figure is even more of a stretch. It adds in the 16% who are found eligible for ESA and placed in the so-called work-related activity group. This means that they are not fit to work but could work with some specialist support.

My - based on nothing but hunch - sense is that these complaints will not be upheld but it is a reflection of the vigour of the new online disability movement that Broken of Britain is posing these questions of those in power in politics and the media.

Sleep disorders rise in the UK, warns mental health charity

By Jeremy Dunning, senior adult beat journalist on January 27, 2011 12:00 AM | No Comments

A third of the UK population suffers from insomnia or another sleep disorder, according to a new report by the Mental Health Foundation.

The report - "Sleep Matters" - is being published today to launch a major awareness campaign on the importance of sleep for mental and physical health.

It details how, far from being a minor irritation, sleep disorders put sufferers at significantly greater risk of health problems ranging from depression, anxiety and bipolar disorder to immune deficiency and heart disease.

Data from The Great British Sleep Survey, the largest ever survey of the nation's sleep, show that, compared to people who sleep well, people with insomnia are:

·         Four times as likely to have relationship problems (reported amongst 55% of survey respondents with mild, moderate or severe insomnia, compared to 13% of respondents who slept well)

·         Three times as likely to experience low mood (83% compared to 27%)

·         Three times as likely to lack concentration during the day (78% compared to 26%)

·         Three times as likely to struggle to 'get things done' at work or elsewhere in their lives (68% compared to 23%)

·         Over twice as likely to suffer from energy deficiency (94% compared to 42%)

MHF chief executive Dr Andrew McCulloch, said: "Up to a third of the population currently suffers from insomnia, and with stress and longer working hours on the rise in the current economic climate, it is crucial that we now treat the issue of sleep problems as the major public health concern it is."

The report makes a series of recommendations:

·         Local and national public health campaigns should be organised for schools, workplaces and other public arenas, to highlight the importance of sleep and advise on evidence-based good sleep practice and therapies (as detailed in the report)

·         GPs should be provided with up-to-date information and training about the importance of sleep and evidence-based sleep therapies

·         The government's new Public Health Outcomes Framework should include specific outcomes on reducing sleep problems

·         NICE should develop guidance on the management of insomnia using evidence-based non-pharmaceutical therapies, such as Cognitive Behavioural Therapy (CBT) (the best proven therapy for persistent insomnia)

·         People with sleep problems should be recognised in the government's Improving Access to Psychological Therapies (IAPT) programme, especially regarding access to CBT.

·         Further research into low cost CBT-based interventions for sleep problems, such as self-help books and online courses, should be carried out.

MHF has also produced a pocket guide to achieving better sleep called Sleep Well and a new website: www.HowDidYouSleep.org, where people can access advice and information about sleep.

Mind warns of increased pull on mental health services

By Jeremy Dunning, senior adult beat journalist on January 26, 2011 3:33 PM | No Comments

Mental health charity Mind has expressed concern about the numbers of people not receiving appropriate treatment for one of the nation's most common mental health problems - generalised anxiety disorder.

The charity sounded the warning on the day that the National Institute for Clinical Excellence (NICE) released updated guidelines for the management of the condition. Key among these is that GPs should not offer benzodiazepines or antipsychotics.

The notice from NICE makes the point that GP rates of diagnosis and treatment of anxiety disorders are much lower than expected, which it ascribes to difficulties in recognising anxiety disorders and a reluctance among patients to discuss their symptoms with their GP.

Since GPs are meant to take the lead in commissioning in the new health world, this is a worrying finding.

And as Paul Farmer, chief executive of Mind, pointed out people presenting with mental health problems is likely to increase in the current climate due to increased job insecurity and money worries.

He said: "It's vital that people feel able to speak out about their distress without fear of stigma or discrimination.

"They also need to feel confident that their GP is equipped to identify symptoms, some of which may be physical. If anxiety is diagnosed, then a range of support should be offered, giving people the best chance of recovery and the opportunity to play an active role in society.

"This updated guidance also highlights the importance of a choice of treatments such as talking therapies, as it's shown that these can play a pivotal role in an individual's recovery.

"Further investment in mental health is needed to ensure that everyone has access to a range of psychological therapies within 28 days."

Gok Wan turns social workers into socialites

By Vern Pitt, journalist, on January 26, 2011 11:47 AM | No Comments

Last night Gok Wan took four adult social workers and turned them into socialites (his words not mine) with just a few sequins and some stilettos.

The outfits look fabulous, darling.

But you might be left wondering, as I was, whether stilettos are appropriate work wear for a social worker, but Gok reliably informs us that it's fine.

If you "spend loads of time on other people, but not on yourself" then it might be worth a watch.

Image by Rex Features

Norfolk gives ground on cuts but big reductions loom for the county's adult service users

By Jeremy Dunning, senior adult beat journalist on January 26, 2011 10:55 AM | No Comments

Norfolk County Council has been trumpeting about some "significantly revised savings proposals" it has offered to adult social care users who were faced with a £52.6m cuts package.

The initial three-year plans involved slashing preventive services, mental health spending and day care, squeezing care providers, raising eligibility thresholds to critical only and increasing care charges to cope with reduced government funding.

The "significantly revised" plans involve cutting £50.6m over three years, which I fear we will see more of over as more councils finalise their spending plans.

The council stresses this is not the final figure because it does not take account of additional NHS funding that will also be available in 2012/13.

However it makes it clear that the extra government funds for rehabilitation announced by health secretary Andrew Lansley allowed the council to reduce some of the cuts.

So by my rough calculations that amounts to a £2m difference between the two plans with the key difference a decision not to tighten eligibility. It comes to something when a council says £2m is a significant revision.

These are recommendations by the cabinet and will still have to be voted through by the full council when it meets on 14 February, though I suspect there will be no more changes.

The changes to the adult social care plans for 2011/12 include:

*The proposal to change eligibility criteria from critical and substantial to critical is removed.

*The authority will continue to invest £600,000 a year in sensory support in a reshaped service.

*£5m of the proposed £6m reduction in prevention services spending is removed while the council works with the NHS and partners on the creation of a prevention fund. The remaining £1m saving to be found through efficiency savings.

*Plans to remove the community meals subsidy will be phased in over two years.

*The proposed reduction in the social care equipment service will be scaled back.

*The planned £1.6m reduction in mental health services will be phased in over two years.

However the council still intends to cease providing day centres by 2012, saving £7.7m, cut transport funding for social care users (£6.7m) and squeeze providers (£6.3m) by limiting the inflation uplift to the independent and third sector.

Norfolk also plans to save £1.5m by promoting self-assessments by service users, which would "prioritise social work need on people in greatest need".

In the report to cabinet council leader Derrick Murphy said that reductions in services are unavoidable in the light of the country's financial crisis.

He also warned that 750 full time equivalent posts are set to disappear in the coming financial year - some through compulsory redundancy.

He said: "There can be no avoiding what must, inevitably, be felt by many residents and staff as painful decisions.

"But this is an extremely well-run council and by using our limited flexibility wisely, among the general austerity there is also some very good news for some of our most vulnerable residents in particular."

Council chiefs hit back in row over cuts to services for vulnerable people

By Jeremy Dunning, senior adult beat journalist on January 25, 2011 5:35 PM | No Comments

The war of words over cuts in services for the most vulnerable intensifed today after local government chiefs said they had no choice but to go ahead with them, despite government backing for the Supporting People programme.

Cllr David Rogers, chairman of the Local Government Association's community wellbeing board, said even taking taking into account efficiency drives, such as shared services, councils were facing a huge funding shortfall at a time when there are increasing pressures on areas like adult social care and child protection.

Therefore he said cuts to services on which vulnerable and homeless people relied are "inevitable".

He said: "Councils know how vital it is to invest in housing support for vulnerable people, and will do all they can to help those in the greatest need.

"But the ability of local authorities to pay for these services on the scale they would like to is inevitably being constrained by what they can afford in the current climate."

Rogers' comments were made after housing minister Grant Shapps expressed "disappointment" at the scale of cuts by some councils to the £400m Supporting People programme.

In an open letter to the LGA, Shapps urged councils to do all they could to maintain services for the most vulnerable and invited chairman Margaret Eaton to send representatives to a ministerial working group on preventing and tackling homelessness in order to build a "shared sense of direction".

However it continues to insist that councils are free to spend their money as they want according to local priorities.

In the letter Shapps said: "It is disappointing to see several councils are indicating significant cuts in Supporting People services, particularly for the homeless.

"It is difficult to understand why some councils appear to be targeting any disproportionate spending reductions on programmes that support the most vulnerable people in their communities."

The government has projected that councils will see their budgets cut by 4.4% on average in 2011-12, with Supporting People funding receiving a notional cut from government of only 0.9%.

This funding is not ring-fenced but is rolled into councils' overall formula grant, which the government acknowledges is tight but is enough for councils to carry out their responsibilities.

Homelessness umbrella body Homeless Link however found that English councils plan to cut their Supporting People programmes by between 26% and 37% over the next three years.

Among planned cuts, Somerset has approved a £3m cut in its Supporting People programme from April 2011, representing an 18% reduction on its £16.5m budget allocation for 2010-11.

Meanwhile a survey for the National Housing Federation of 136 Supporting People providers in England shows a similarly dismal picture.

In some circumstances it found that whole services face closure as cash strapped town halls look to make massive savings over the next four years.

The survey found:

    * Nearly three quarters of respondents (73%) said local authorities they work in had already indicated cuts of greater than 12%. 41% of respondents expected cuts over 20% in their area, and 18% of respondents expecting cuts over 30%.
    * 60% of respondents said their organisation would be forced to reduce the level of service they offered
    * The top five client groups most at risk of cuts are: Single homeless people, older people in need of support, people with drug and alcohol problems, ex-offenders, people with mental health problems.
    * There's still considerable uncertainty, with 42% of respondents saying one or more of the areas they work in were yet to announce cuts.

Last year it warned that 400,000 people could lose vital support under projected cuts by councils to Supporting People.

Federation chief executive David Orr said: "Services which provide a lifeline to thousands of vulnerable people are being hit disproportionately by councils - with the first to declare their hands indicating they intend to cut back their funding by up to 67%.

"Raiding these budgets to pay for other spending priorities runs contrary to what ministers want, what the public wants and most importantly what the vulnerable who rely upon them want to see happen.

"Councils must now be completely transparent with their local communities and account for where they plan to spend their Supporting People cash."

In a recent letter to councils, the Department for Communities and Local Government acknowledged that councils were free to decide how Supporting People should be spent.

It added that ministers did not expect authorities to respond to reductions in their budgets by passing on disproportionate cuts to other service providers, particularly the voluntary sector.

This row over Supporting People brings into sharp focus the doctrine of localism, which has been coming under some strain of late as the cuts begin to hit. Last year communities secretary Eric Pickles said he was "happy to offer a degree of guided localism".

Only recently the Prime Minister was dragged into the Riven Vincent affair, amid similar fears over funding for short respite breaks for carers. This was allocated £800m over four years but is also not ring-fenced.

Vincent, from Bristol, told the online forum Mumsnet that she could no longer cope with the day-to-day care of Celyn, six, who is blind, quadriplegic and has cerebral palsy and epilepsy.

In her message, she wrote that her local authority, South Gloucestershire Council, had refused to provide her with extra respite support to help with her daughter's care.

Picture courtesy of Ed Yourdon on Flickr.com

Housing benefit cuts to be reviewed

By Jeremy Dunning, senior adult beat journalist on January 25, 2011 4:41 PM | No Comments

Welfare minister Lord Freud has conceded some ground over the government's housing benefit cuts with the announcement of an independent review on the impacts.

Speaking in the House of Lords, Freud said the government intended to "commission independent, external research" and ultimately report to both houses.

He promised it will cover a wide variety of areas including homelessness and whether this is increasing or reducing; the shared room rate and houses in multiple occupation; the impact on Greater London; as well as the impacts on rural communities, black and minority ethnic households, large families, older people, people with disabilities and working claimants.

The report will be ready in early 2013, with initial findings available in spring 2012 and an interim report that same summer.

The concession was made in response to a motion laid by cross-bench peer Lord Best who said he shared the concerns of charities that several thousand tenants were facing homelessness as a result of the changes.

Measures include capping payments so claimants can only afford to live in the 30% cheapest properties in their local area, down from 50%, increasing local housing allowance in line with the consumer price index measure of inflation, rather than the higher retail price index, and chopping the benefit by 10% for those who have been on jobseeker's allowance for more than a year.

The aim is to cut the housing benefit bill by £2bn by 2015. The belief is rents will reduce in line with the reduced benefit levels, though many believe this unlikely given the acute housing shortage.

Considering the government largely rejected advice from its own social security advisory committee late last year over the likely impacts of the reforms it is uncertain whether this concession will amount to much.

Then the only ground it gave was to delay the new cap on housing benefit by nine months to give those affected more time to negotiate a cheaper rent or find a new home.

However ministers brought forward from October to April next year its plan to peg welfare payments to 30% of market rents rather than half.

The Chartered Institute of Housing (CIH) welcomed the review. Chief executive Sarah Webb said: "The promise of a review demonstrates that the government has listened to some of the concerns voiced by professionals around the impact of housing benefit reforms on low income households."

Could 128,000 more disabled people lose benefits under reform plans than expected?

By Vern Pitt, journalist, on January 25, 2011 11:58 AM | No Comments

Could the number of people at risk of losing their disability living allowance (DLA) be growing?

The government's plans include introducing a two tier system for the care component of DLA, there are currently three tiers. But the latest figures from the Department for Work and Pensions show there are 235,000 more people claiming lower rate DLA care component than previous estimates.

In response to a parliamentary question the DWP revealed 878,000 people are on the lowest care rate of DLA as at May last year.

Now here comes the maths.

Disability Alliance, one of the largest disability benefits campaign groups, has previously said 750,000 could lose their benefit.

Based on there being 643,000 on the lowest rate (previous government figures) the charity worked out cutting these people's benefit entirely would save the government £635m. However, the government has said it wants to save about £1bn from the DLA bill, so Disability Alliance up-scaled the number effected accordingly, arriving at 750,000 people.

But if the government wanted a simple solution it would cut the entire lowest tier of 877,900 giving it a little more money to a) pay for its proposed reassessment regime and b) give those that are eligible for the two higher tiers a bit more cash than they get now. That would also fit with the government rhetoric of "targeting the benefit" for those that need it most.

This is, of course, idle speculation at this point and the numbers of people who lose out could be significantly less, but the government has remained staunchly tight lipped about its estimates for this.

Your guess is as good as mine at this point. Let me know what you think in the comments below or on email.

Image by John C Abell on Flickr

"Don't cut services for vulnerable people", government tells local councils

By Jeremy Dunning, senior adult beat journalist on January 25, 2011 9:30 AM | No Comments

"I am proud to be part of a government that, despite tight public finances, has committed to support the most vulnerable in this country.

"We've entirely protected homelessness funding at £400m in the spending review, and took deliberate steps to protect this central funding so that the impact of cuts do not fall on those most in need."

These are the words of housing minister Grant Shapps and there is no doubt that the Supporting People programme, which helps groups such as the homeless, has been protected to the tune of £400m.

And he adds: "Local authorities on average will only receive a reduction in their overall spending power of 4.4% this year, and we have taken steps to cap the maximum reduction for any individual council at 8.9% to protect those dependent on government grants."

However his problem is that with cuts to local government on top of year-on-year efficiencies and with Supporting People not being ring-fenced, councils, such as Cornwall County Council which is cutting 40% off its Supporting People budget, are raiding it to spend on other statutory priorities.

This is creating the beginnings of a row between local government and central government, which saw Shapps fire off an angry letter to local government chiefs.

In an open letter to the Local Government Association, Shapps expressed his disappointment at the actions of these councils and urged all authorities to do as much as they can to maintain services in these "economically challenging times.

He said: "We know the damage that can result both for individuals and communities if needs are not addressed, and we can not see a return to the levels of homelessness and rough sleeping seen in the past."

So he adds: "It is disappointing to see several councils are indicating significant cuts in Supporting People services, particularly for the homeless. It is difficult to understand why some councils appear to be targeting any disproportionate spending reductions on programmes that support the most vulnerable people in their communities."

However with the adherence to localism in its purest form, it is difficult to see what else he can do and combined with the level of cuts to local government there is also a degree of cynicism here by saying 'Don't blame us; blame them'.

Local authorities will say they are trying to make the best of a bad deal and I suspect we will see more examples of "disproportionate spending reductions on programmes that support the most vulnerable".

The theme of the most vulnerable being hurt through the cuts and the reforms is revisited in two other Guardian stories today.

Laurence Buckman, chair of the BMA's GP committee, is warning that the proposed health reforms would see the poor, elderly, infirm and terminally ill in large parts of the country losing out to richer patients who can shop around and demand the "right" to see a doctor.

The department of health, of course, maintains that the reforms will drive out inequalities in the health system. All we can do is wait and see.

Finally on this theme the respected United Nations body, the International Labour Organisation published a high-level report criticising western governments for embarking on austerity measures without offering sufficient support for programmes to spur growth.

Coming on top of the attack on the government from the outgoing director general of the CBI, Sir Richard Lambert, who criticised a lack of strategy for economic growth these will not make pleasant reading for ministers.

This matters because it suggests it could be a while before we see an end to this diet of cuts.

On to mental health and the Irish Times has an interesting comparison on mental health spend compared to the UK. If mental health workers think the service is the poor relation compared to acute services over here, spare a thought for those in such services in the Irish Republic.

According to the paper, the percentage of the health budget spent on mental health in the Republic, at just over 5 per cent, was significantly less than that of the UK and the US, where mental health spending accounts for around 7.5 per cent of the health budget.

Finally and this is not for everyone but a medical team at Frenchay Hospital in Bristol is pioneering a new form of surgery to treat long term depression.

The technique is called deep brain stimulation and involves the use of electrodes which are implanted into the brain through holes drilled in the skull.

Picture courtesy of fotografar on Flickr.com

Is personalisation really efficient?

By Vern Pitt, journalist, on January 25, 2011 12:00 AM | 1 Comment

The Social Care Institute for Excellence has launched a guide to how personalisation might deliver efficiency savings today.

However, top of it's list of key messages is this: "It is too early to make conclusive decisions on whether or how personalisation has delivered efficiency savings but there is emerging evidence of factors which may increase productivity and efficiency."

Although personalisation was never going to be a quick fix for delivering great efficiency in social care, as we approach three years of roll-out of the strategy shouldn't we have seen more evidence that it works than this indicates?

Tory MP lashes out at council's care charge hikes

By Vern Pitt, journalist, on January 24, 2011 4:53 PM | No Comments

Peterborough MP Stewart Jackson has slammed the local council for putting forward plans to raise charges for adult social care, the Peterborough Telegraph reports.

"The council should be ashamed of itself for such proposals," he tells the paper. "The cabinet needs to be held accountable for these decisions. How can cabinet members justify cuts while spending £170,000 on translation and interpretation?

"Front-line care should not be cut when so much money is spent on non-essential projects," he adds.

That's all well and good but most commentators (except the government themselves) would say that these cuts are a direct result of councils having to make savings because of reductions in central government funding. As a MP of the government Mr Jackson is at least partially responsible for that.

Jackson may also like to know that Peterborough is far from out on a limb with this. Community Care reported today that the swarm of councils approving such plans is in rude health. Peterborough is just the latest entry on a growing list.

When commenting on this trend Ruth Cartwright, joint manager for England at the British Association of Social Workers, said she felt an awareness of the effects of cuts was more common in local government than central government. Jackson's shocked and angered reaction would lead me to conclude that she is right.

Image by Tambako the Jaguar on Flickr

Tory thinktank set to criticise government for making cuts based on "hunches".

By Jeremy Dunning, senior adult beat journalist on January 24, 2011 10:01 AM | No Comments

Coalition cuts are being made on the basis of hunches and not on evidence a report from a Tory-backed thinktank will argue tomorrow.

The Centre for Social Justice, which was set up by the work and pensions secretary Iain Duncan-Smith, says Whitehall appears to not be planning cuts properly and that instead services are sacrificed unnecessarily.

I've heard a similar argument before with critics arguing that departments are taking arbitrary decisions in order to cut a sum of money and the report makes it clear that this is an historic problem.

However its key point is that with less money around there has to be a better link to outcomes.

As The Guardian says: "That conclusion will be particularly controversial as the coalition government has scrapped Labour's outcome-based targets and introduced 'business plans' for each department, setting out what ministers must ensure their departments do by when."

In a follow-up to the Health and Social Care Bill, the Western Mail has a good article on the Bill's impact upon Wales. Economic pressures on the English NHS could benefit retention and recruitment in Wales, where there have been problems in the past, it argued and pointed also to the dangers of a postcode lottery appearing.

Finally the Mirror warns that 10 UK troops a day are now being treated for psychological problems as a result of the bitter fight with the Taliban.

Why people are protesting against disability benefit assessors and are they right?

By Vern Pitt, journalist, on January 24, 2011 9:30 AM | 1 Comment

Today will see protests up and down the country directed at the low quality of the assessment for access to employment and support allowance (ESA).

The work capability assessment is conducted by a company called ATOS' who will today see the protests take place outside their head offices in London, Scotland, Leeds, Burnley and Tyneside.

The system has been controversial and multiple studies have found it to be recommending people as fit for work when they are not. Figures from the DWP have shown that 36% of applicants fro ESA were found fit to work while on 17% were put into this group under the incapacity benefit regime.

The assessment formed the focus of several recommendations by Professor Malcolm Harrington, who reviewed the whole ESA system, at the end of last year. Many of his reforms (all of which were accepted by the government) are due to be implemented before the government rolls out the assessment to 1.5m people on incapacity benefit, which was replaced by ESA in 2008.

However, critics of the process fear that those changes will not be in place in time and the result of incorrectly shifting a significant portion of 1.5m people onto a lower rate benefit will cause chaos in those people's lives. Others simply fear the changes are inadequate anyway.

It may also end up costing the government a whole heap of cash in appeals. Currently 70% of appeals are successful, which could be fixed if the assessment works better.

To ATOS' credit whenever I've heard them speak they seem more than willing to sort out the problems in the assessment which by it's very nature is difficult to get right.

ATOS have previously attributed the consistent failings in assessment to a lack of information available to assessors when making their assessment. Most of this crops up at the appeal stage, hence the high rate of appeals success.

A more pro-active way of gathering this information forms part of the reworked assessments which will form the basis for wider roll-out to incapacity benefit in the summer. These are currently being trialled in Aberdeen and Burnley.

I understand that interim figures from the pilots show the percentages of people allocated into ESA's different groups is far closer to those that were envisaged when the system was introduced. ie. closer to the numbers of those deemed fit for work under the incapacity benefit system.

Today's protests will be hoping this is the case or there will probably be further protests demanding the brakes be applied to the roll-out of the assessment.

Flagship government disability equipment scheme slammed

By Mithran Samuel, adults' editor, on January 21, 2011 5:03 PM | No Comments

Observers of the disability equipment world will be familiar with the Transforming Community Equipment Services scheme. This is a "retail" system promoted by the Department of Health since 2006 in which disabled people can get prescriptions from OTs following assessment, which they can then take to accredited private retailers to exchange for equipment. This is opposed to the standard system of accessing equipment from local authority-NHS stores.
The model is designed to improve efficiency, ensure disabled people can access equipment more quickly and allow flexibility by enabling service users to "top up" their prescriptions with their own resources to pay for enhanced products.
There is evidence of the TCES scheme achieving efficiencies for councils and NHS partners that use it.
However, there are some who are concerned - as this report shows. It is written by Brian Donnelly, a former adviser to the Welsh government on equipment and chair of the UK Community Equipment Standards Adoption Group - a coalition set up to develop national minimum standards for equipment services and lobby for their adoption by the country's government.
His paper argues that a lack of standards is blighting the TCES model. I'm sure many in the Department of Health would disagree but it is worth having a look at his arguments.
His group is developing best practice guidelines for use in England, which should be available this spring, even though they will not be endorsed by the DH.
By contrast, as we reported a little while ago, national minimum standards have been adopted in Wales. (Yet more evidence of England's continued divergence from our Celtic neighbours on public sector regulation).

(Image by Marshall Astor on Flickr)

Common sense guide to dealing offender mental health issues published online

By Jeremy Dunning, senior adult beat journalist on January 21, 2011 4:35 PM | No Comments

Mental health charity Together has put online its common sense guide to working with defendants and offenders with mental health problems.

I've blogged on the guide's launch previously but it's worth outlining what it is again. In simple terms it provides guidance to professionals on how to work effectively with the disproportionate number of people with mental health problems who find themselves in contact with the criminal justice system.

It also includes information and advice on working with people who have substance misuse issues, alcohol problems and learning difficulties.

I recommend anyone who works in this field to download the guide.

Is increasing reablement care really a good thing?

By Vern Pitt, journalist, on January 21, 2011 11:08 AM | No Comments

The generally accepted wisdom is that getting people into reablement packages of care is positive. Council's save money, service users get to live more independently and it frees-up staff to look after the people with higher care needs.

Everyone's a winner, right?

We'll it seems a group in Cambridge doesn't quite agree. Cambridge News reports that the Cambridge Older People's Enterprise (Cope) are concerned about the council's plans to increase the use of reablement.

Spokesperson Robert Boorman told the News that he isn't convinced the right safeguards are in place and that people will get the support they need.

He is quoted as says: "We know things can go wrong in the health service or in social service and the problem with cuts like this is that there is less room for mistakes - there may be some people who get missed out."

The government is yet to publish its guidance for how to safeguard adults. No Secrets remains the primary guidance in doing this and it has long be crying out for revision in the era of personal budgets. I understand the government are looking at this and will be revising safeguarding adults procedures in the light of a modernised care system, if not before.

But a lot of the changes to how care is provided will happen before then and Cope are right to be concerned.

Social worker's should be too because they may find themselves in the firing line if gaps in policy leave them exposed.

Image by Jenny Downing on Flickr

Costs to rise under planned health reform, warns report

By Jeremy Dunning, senior adult beat journalist on January 21, 2011 10:41 AM | No Comments

The proposed health reforms will mean extra costs in the short term to the NHS and risks to service quality as the new structure beds in, the National Audit Office warned today.

The spending watchdog warned that unless the transition is handled carefully the change could overwhelm the NHS.

The report's purpose is to inform the Public Accounts Committee so that it can take stock of the proposals, which include cutting 24,000 management jobs and axing England's 152 primary care trusts, with GPs to take the lead in commissioning services.

As my colleague Mithran pointed out yesterday the Health and Social Care Bill also means big changes for social care.

Its careful warnings add to a chorus of criticisms from every single health body and will surely add to the pressure on prime minister David Cameron and his health secretary Andrew Lansley.

The NAO's report makes the key point that: "Our work has identified a number of
undesirable results which follow from poor risk management: poorly thought-through
plans, unrealistic timetables, weak controls, delays in delivery and wasted money."

Although carefully worded, this seems to say the NAO has its doubts.

Among areas for discussion are:

*The extent to which sound programme and project management principles are
being applied to the reorganisation.
*The robustness of the cost and benefi ts estimates currently being used by the
*Department and the length of time until cost certainty is achieved.
*How the Department and the NHS will minimise the transitional costs.
*How the Department and the NHS are maintaining quality of service and fi nancial
performance during transition.
*Commissioning effectively during the transition.
*The development of a regulated market of healthcare providers.

Interestingly last night former Tory minister Michael Portillo said the Tories did not spell out their plans for the NHS during the election because they feared they would not win.

Appearing on the BBC's This Week programme he agreed the proposed reforms were risky for the coalition and specifically for the Tories if it goes badly wrong as Cameron said the NHS was safe with his party. He acknowledged voters regard the NHS highly.

Mumsnet's campaign against abolition of disability benefit gains support

By Vern Pitt, journalist, on January 21, 2011 9:50 AM | 1 Comment

Mumsnet joined the campaign to stop the cuts to disability living allowance (DLA) last weekend and it seems to be gaining traction.

A campaign thread call for a stop to the government's proposed changes to DLA has reached nearly 300 posts.

Given the way the forum has thrust the issue of social care for disabled children into the limelight over the last couple of days it may well have an important effect on the government's final decisions.

The forum has wielded a fairly large amount of political power in the past. The leaders of the main parties all appeared to answer members questions during the general election last year and Gordon Brown's reticence to name his favorite biscuit resulted in much criticism in the mainstream press.

Community Care took part in a blogswarm last weekend to raise awareness of the consultation on the future of DLA, which ends on February 14.

Mencap probes housing conditions of people with learning disabilities

By Mithran Samuel, adults' editor, on January 20, 2011 8:35 PM | No Comments

Mencap is looking to find out more about the housing situation of people with learning disabilities, through a survey. It is looking at the type of housing people are living in, their access to benefits (particularly with housing benefit being reformed) and experiences with hate crime. Maybe one to mention to your clients.

How social care can manage on less money?

By Mithran Samuel, adults' editor, on January 20, 2011 8:13 PM | No Comments

That really is the million (or should I say the several billion) pound question.
The Joseph Rowntree Foundation has come up with some answers in a paper this week. Worth a look.

Mental health sector backs apparent restriction in patient safeguards

By Mithran Samuel, adults' editor, on January 20, 2011 7:45 PM | No Comments

(Blog updated 21 Jan)

The Health and Social Care Bill is apparently five times the size of any previous piece of health legislation so unsurprisingly details are emerging slowly. One thing that I spotted today that slightly concerned me (see page 120 of this tome) was a plan to remove the right of some patients on community treatment orders to have their treatment approved by a second psychiatrist (a second opinion appointed doctor or SOAD). CTOs impose conditions on treatment that patients must comply with or face possible recall to hospital. SOADs are there to provide a safeguard to ensure such patients are being treated appropriately.

The bill would remove the right to a SOAD from patients who consent to their CTO treatment plan and have mental capacity (about 2,700 patients a year). While this reduces patients' rights, it seems the mental health sector agree that, on balance, it is a good thing.

This is because there has been severe pressures on the SOAD service - run by the Care Quality Commission - ever since CTOs were introduced in November 2008.

This has meant patients have been stuck waiting to start CTOs pending a second opinion, preventing some from starting treatment plans that would help them recover.

It seems discussions have been going on behind the scenes between the Department of Health, the CQC and mental health charities and professional groups. While initial reactions to the proposal from the sector were sceptical, campaigners and practitioners have now come round to the idea on the basis that it will make the CTO system more efficient, helping patients.

Tony Zigmond, who leads on mental health law for the Royal College of Psychiatrists, told us it will improve safeguards by ensuring that people who lack capacity or those who do not consent to treatment have the benefit of a SOAD.

The CQC pointed out to us that this measure would bring CTOs in line with sections under the Mental Health Act (where patients who consent to treatment and possess capacity do not receive a second opinion). Its head of mental health, Anthony Deer, told that many patients resent having a second examination when they have consented to treatment.

Care regulator forces closure of Southern Cross care home

By Vern Pitt, journalist, on January 20, 2011 3:01 PM | No Comments

The Care Quality Commission (CQC) has closed the Griffin Care Centre in Luton, run by Southern Cross Ltd.

The inspectors had concerns about the management of medication at the care home.

Would you move to Scotland to escape privatisation?

By Mithran Samuel, adults' editor, on January 20, 2011 11:35 AM | No Comments

This is my second post based on Fighting Monsters' blog today so apologies to her for that (but isn't that what the internet is all about?) but I was taken by this comment she made at the end:

I'm not joking when I write this but I am considering moving to Scotland where at least I have family links. I wonder how easy it would be to pick up the Scottish legislation and switch my English registration for a Scottish one.. seriously, if anyone does know the answer to that, let me know!

This is all about the Health and Social Care Bill published yesterday and particularly its provisions to increase the level of competition between providers for NHS-funded services and the expected rise in the number of private companies delivering them. (See our story yesterday for health professionals' concerns about the same).

The proposed reforms will widen an already large chasm between the nature of the NHS in Scotland and Wales, and that in England. In the former, integrated health boards, responsible for planning and providing services, run the show; in the latter, purchasers (currently PCTs, soon to be GP consortia) are separated from providers (NHS trusts and providers from other sectors - whose share of the market is expected to increase significantly under the bill).

That got us thinking about whether there is something special about working in the public sector - or about having public sector delivered services - as opposed to the private (or voluntary sectors). We've kicked off a debate on this on CareSpace if you want to add your twopenneth.

(Photo from the Laird of Oldham on Flickr)

Correction: GP consortia to take responsibility for mental health aftercare

By Mithran Samuel, adults' editor, on January 20, 2011 11:11 AM | No Comments

Apologies but I've had to update this blog as what I wrote initially was entirely wrong. Sorry about that.

The Health and Social Care Bill did not include plans for councils to take on responsibility from PCTs for providing aftercare for people who have been detained under the Mental Health Act. This responsibility will pass from PCTs to GP consortia.

Councils will be taking responsibility for the independent mental health advocates service - and I understand from the Department of Health that this will be taken into account in local authorities' funding formula (it currently is taken into account in PCTs' funding formula).

Again apologies for the error!

Home care charging postcode lottery unveiled

By Vern Pitt, journalist, on January 20, 2011 9:42 AM | No Comments

Home care charges vary from £20 an hour to nothing research from Which? reveals today.

It also unveils the scale of variation on charging caps which range from £60 in Barnsley to £850 in Brighton.

Which? go their information from freedom of information requests to 154 councils and it backs up a lot of what we have heard about this issue.

Last autumn Community Care pointed out that charges were on the increase in many councils' plans.

The Which? data is a snapshot of the current situation. It says that Derbyshire don't currently charge for home care, next week they will decide whether to continue with that policy or not.

Many other councils are in a similar situation raising or introducing charges, by April the picture could be significantly bleaker than the one Which? paints this morning.

Wordle created for health and social care bill

By Jeremy Dunning, senior adult beat journalist on January 19, 2011 2:31 PM | No Comments

It didn't take long but already someone has developed a wordle of the Health and Social Care Bill, which is published today.

It made me laugh and it's far more digestible than the Bill itself!

See how small the word social is compared to health.

Health and Social Care Bill published

By Mithran Samuel, adults' editor, on January 19, 2011 2:09 PM | No Comments

The Health and Social Care Bill has been published. This is the full text - all 367 pages of it.
We don't have the explanatory notes - the plain English version of the bill - yet so can't work out if there are any surprises. It all looks to be as has been proposed.

Adult safeguarding guidance published

By Mithran Samuel, adults' editor, on January 19, 2011 1:14 PM | No Comments

Guidance on adult safeguarding has been published today for social care professionals and their colleagues in health, police and other agencies.
The policies and procedures for London have been developed by the Social Care Institute for Excellence, directors of adult social services in London and chairs of local safeguarding adult boards.
Though targeted at the capital the guidance may well form the basis of procedures developed elsewhere.
They cover information sharing, handling referrals, conducting and closing investigations and roles and responsibilities. Worth a read if you get time.

Vulnerable people at risk of being forced back on to the streets.

By Jeremy Dunning, senior adult beat journalist on January 19, 2011 10:34 AM | No Comments

I have reported on the threat to the Supporting People programme many times before, but the latest study by leading homeless charities suggests that a quarter of the hostel beds available to homeless people could vanish within months.

This is of course because of the cuts agenda and the result could see tens of thousands of vulnerable people forced back on to the streets.

The charities warn the problem of so-called "visible homelessness" will resurface as councils prepare to make savings of up to 65% to budgets that provide key services for mentally ill people, ex-offenders, drug addicts, refugees, care leavers and teenage parents.

The government insists it wants to protect services for vulnerable people and has left the £1.6bn Supporting People programme largely untouched.

But it is no longer ring-fenced and councils have raided it to support their own statutory services.

NHS reform plans set to be outlined this afternoon

By Jeremy Dunning, senior adult beat journalist on January 19, 2011 9:41 AM | No Comments

As my colleague Mithran has said today is the publication of the Health and Social Care Bill.

It's probably worth linking to a few other stories on this subject. One thing to note is the opposition to the root and branch reform from within and without many parts of the health and social care sector.

The Tory-Lib Dem Coalition is clearly committed to it, but coming amid many other controversial measures I can't help thinking it is going to have to compromise if this is to make its way through the legislative process unscathed.

NHS bill to detail major overhaul in England

NHS reforms 'will mean fewer hospital beds'.

NHS cuts: Scale of shakeup took No 10 by surprise

NHS reform proposals under fire

Government takes first steps towards NHS reform

Daily Mail - Depressed? Get a grip!

By Vern Pitt, journalist, on January 19, 2011 9:40 AM | No Comments

This was the very sensitive and enlightened headline (below) which appeared in the Daily Mail yesterday. I'm frankly lost for words.

You can read the whole article on their website. It's written by Angela Patmore who has a new book out called, Challenging depression and despair: A medication-free self-help programme that will change your life.

Will you be recommending it to any of your clients? Join the debate on CareSpace or in the comments below.

Daily Mail Depressions.jpg

(Image by Huw Davies)

What the NHS shake-up means for social care

By Mithran Samuel, adults' editor, on January 19, 2011 12:00 AM | No Comments

(To update this blog - the Health and Social Care Bill has, of course, been published. We've done a couple of stories on the main points and concerns about the impact of increased competition - see below. Think the points below still hold!).

Though this is fundamentally a health bill, its title is indicative of its importance to social care.
Here are a few things to look out for:-

Joint working 1: The death of the PCT

Councils have built up relationships with primary care trusts over many years, often including formally pooled budgets and integrated structures, but this bill will abolish PCTs by 2013. In their place will come GP consortia - statutory bodies with responsibility for commissioning, made up of GP practices. Key issues to consider here are:-
•    What will happen to existing, legally-based joint arrangements between PCTs and councils, such as care trusts, pooled budgets, integrated teams or joint commissioning arrangements?
•    What will be the boundaries of GP consortia? Most PCTs share boundaries with a single council. However, GP practices will be largely free to determine the boundaries of the consortia they form. The latest thinking is that there will be a bias towards sharing boundaries with councils but there are no guarantees on this.
•    What will happen to existing working relationships between council and PCT colleagues?

Joint working 2: The rise of the GP consortia

GP consortia are an unknown quantity and councils are having to develop relationships with GPs where none existed (beyond the links between GPs and frontline social care colleagues). The bill will provide help in cementing this relationship through health and well-being boards - new statutory partnerships, based within local authorities, that will be responsible for setting and aligning priorities for health and social care. Helpfully, GP consortia will have to be members. However, the boards will not be able to impose commissioning strategies on GPs.

(Picture from The Health Hotel on Flickr)

Continue reading What the NHS shake-up means for social care .

CQC probe exposes mental health failings at acute trust

By Mithran Samuel, adults' editor, on January 18, 2011 4:09 PM | No Comments

Meant to blog this earlier but didn't get time.
A Care Quality Commission report today has illustrated the importance of mental health or mental health liaison services within acute hospitals.
Failings identified at Southend University Hospital NHS Foundation Trust include:-

"Unacceptable" delays in providing psychiatric assessments for people in A&E and in moving them on to specialist services.
Lack of staff training in mental health.
Support from specialist staff employed by the local mental health trust is only available between 2pm and 10pm.

CQC has said the trust is addressing these issues but must take more formal steps to improve its partnership working with mental health trusts.

Baby boomers sell homes to pay for care but it's not enough

By Vern Pitt, journalist, on January 18, 2011 9:50 AM | No Comments

The numbers of people selling their homes to pay for care has risen 17% in the last five years, a report published today shows.

The Express reports that 20,000 people sold their home to meet care fees last year, according to a report by law firm Dickinson Dees.

If you work in the social care sector this is unlikely to come as a surprise to you, the care sector has been straining to support an ever growing population for years.

But this story, rather unfortunately, coincides with a slew of stories today about the state of the care home sector, which paints an even less pretty picture. You could be forgiven for thinking that the injection of cash from people's homes is still nowhere near enough.

In Liverpool one home has been fined for dropping a elderly resident from a sling, she later died; in Kent the council is pressing ahead with home closure plans, despite vocal opposition and in Flintshire a care worker has been caught drink driving.

This morning it's more clear than ever that the government's social care bill in the autumn will need to be robust.

Image by TheTruthAbout on Flickr

NHS reform plans are risky and expensive, warn MPs.

By Jeremy Dunning, senior adult beat journalist on January 18, 2011 9:32 AM | No Comments

MPs have today warned that the government's plans for rapid reform of the NHS could have far-reaching and expensive consequences for health and social care.

Reporting ahead of tomorrow's health and social care bill, the health select committee said it shared the policy objectives of the government but added that the means adopted were inefficient.

This would make it difficult for the NHS to meet the challenge laid down in 2009 by the NHS chief executive, Sir David Nicholson, to make efficiency savings of 4% per year from 2011 to 2012.

In its critique, the committee said: "It does not believe however that the approach adopted by the Government represents the most efficient way of delivering those objectives.

"The failure to plan for the transition is a particular concern in the current financial context. The Nicholson Challenge was already a high-risk strategy and the White Paper increased the level of risk considerably without setting out a credible plan for mitigating that risk."

Chair Stephen Dorrell, the former Tory health secretary who chairs the committee, also criticised the "surprise" proposal to scrap primary care trusts (PCTs) and hand commissioning to GP consortiums.

Although the report said little about social care, it does refer to the interface with social care and points out the importance of joint working arrangements between the NHS and local councils.

The report said it will review the effectiveness of the structures proposed in the bill which are designed to safeguard such arrangements and promote the development of new ones.

Among comments on the committee's report Mind's chief executive Paul Farmer said: "There is a real risk that valuable mental health knowledge and skills could be lost in the transition process and that some mental health services will be vulnerable to closure or disruption.

"We know from past experience that mental health services often bear the brunt of health budget cuts and we can not allow history to repeat itself."

"GPs have limited specialist knowledge on mental health and we're worried that this lack of understanding will affect commissioning choices."

More small enterprises are expecting to get smaller

By Vern Pitt, journalist, on January 18, 2011 9:31 AM | No Comments

One in eight small firms plan to axe staff next year, according to report by the Federation of Small Businesses said yesterday.

I've not seen the report myself and although there is no specific mention of the social care sector in the Daily Mail's reporting, linked to above, I see no reason to suspect that it won't be equally effected unless, of course, there is an influx of self-funders propping up the sector.

The news is eerily reminiscent of the report we did last week showing that voluntary organisations, and particularly small ones, have similar redundancy plans.

If the independent sector is hit as badly as the voluntary sector and the public sector is subject to funding cuts it makes you wonder who will be around to cater for the rising demand we know is inevitable. Answers on a postcard please, or in the comments below.

Come clean about the cuts

By Vern Pitt, journalist, on January 18, 2011 9:25 AM | No Comments

Come clean about the cuts, says John Tizard, director of the Centre for Public Service Partnerships, in an excellent blog on the Public Finance website.

He very neatly and coherently sums up how local authorities are being forced to take the blame for the government's slashing of public sector spending and the disastrous impact it will have.

He concludes: "Local authorities need to rise above the insults and attacks and robustly defend local communities where making hard spending choices will too often result not in the best but in the least worst outcome for individuals and communities."

Thoroughly recommended reading.

MPs: 'Social care cuts will endanger NHS reform savings'

By Vern Pitt, journalist, on January 18, 2011 12:01 AM | No Comments

Cuts in social care will have a knock on effect on the ability of the NHS to meet rising demand and savings targets, a report by MPs concludes today.

Last year the government published its health white paper outlining it's plans for wide scale NHS reform. In addition the comprehensive spending review set the NHS targets to save 4% each year through efficiency.

The report by the Health Select Committee, said: "There are likely to be knock-on effects upon NHS demand from likely changes in levels of local authority social care provision."

Social care leaders have expressed concern about the effect of the proposed reforms on joint commissioning arrangements.

The committee reflected this in its report saying it would examine how the Health bill, due to be published tomorrow, would encourage and protect NHS and local authority joint commissioning of services. The committee said it would be reviewing the arrangements for this proposed by the government after the bills publication.

The committee report, which focused on NHS commissioning, also said GPs needed to listen to experts if they were to be effective commissioners.

Knitters save older people

By Vern Pitt, journalist, on January 17, 2011 4:09 PM | No Comments

Every once in a while a press release drops into my inbox with just great photos. This is one:

Full press release after the jump...

Continue reading Knitters save older people.

My passion for public services, says Cameron

By Jeremy Dunning, senior adult beat journalist on January 17, 2011 11:49 AM | No Comments

I've just received a copy of the Prime Minister's speech and there's not one mention of social care.

However because the health and social care bill will impact upon the readership it's worth considering his words.

That he feels it is so important for him to speak on public service reform and to defend the NHS reforms suggest he is aware they are in trouble with the public not buying in yet. Therefore he has been forced to go on the offensive. Clearly his own health secretary has not been able to win the argument.

In the speech he talks of his "passion" to modernise public services to ensure they in his words excellent.

He says the changes are not ideological but are based upon a desire to improve service quality and to reduce micro-management and bureaucracy and here I sympathise.

I know there are professionals in social care, for instance, who argue they are stifled by bureaucracy.

Cameron says in his speech that it is untrue that the government is turning off the spending tap and that "when we're done with these cuts, spending on public services will actually still be at the same level as it was in 2006."

However I'm not sure people on the ground would notice these nuances. All that we see are cuts.

Cameron is correct to say that the costs of our public services will escalate through demand rises, rising costs and growing bureaucracy.

However a reform as large as this will also cost huge amounts as things settle down.

Like every government Cameron also believes that this government will succeed in reform where others have failed, partly because it is a coalition but also because "we have tried really hard to learn the lessons of the past."

Instead he blamed the previous Labour government for understating the role of the voluntary sector and for surrendering to vested interests. However, this seems to ignore the widespread opposition to the health plans.

He also speaks of his desire for professionals to take ownership of their organisations and to see payment by results introduced in areas like drug rehabilitation.

He says that GPs like the proposed health reforms with over 140 GP-led consortia having come forward to test new GP commissioning arrangements.

He also addresses the why now? Cameron claims that: "The longer you leave things, the greater the institutional inertia against change becomes." I'm not sure this is a strong argument to explain the rush.

Finally on the cuts, Cameron blames the previous government for allowing "spending to run out of control."

He uses the old line of taking tough but necessary steps to deal with the deficit but frontline services will be protected.

He warns however: "We won't be able to avoid job losses entirely. That would be unrealistic."

NHS reform necessary to bring UK up to European standards, says PM

By Jeremy Dunning, senior adult beat journalist on January 17, 2011 9:34 AM | No Comments

David Cameron has defended the proposed NHS reform, arguing that "fundamental changes" are required for the UK to catch up with European health care standards.

Speaking ahead of a major policy speech in which he will set out his passion and reasons for reforming the public sector and the need for urgency, Cameron said on Radio 4's Today programme today that the reforms were necessary to ensure the UK did not fall behind the rest of Europe.

He claimed the reforms were not being rushed out and would bring real power to patients and practitioners.

It's interesting he felt the need to pin his colours firmly to the mast and is an attempt to combat the backlash that has built up against health secretary Andrew Lansley's plans.

These plans will be unveiled on Wednesday with the government's publication of its flagship health and social care bill, which will hand to GPs the power to commission services, and which has been criticised by health bosses and medical leaders.

These plans have seen the NHS Confederation issue a strong warning that healthcare would suffer as a result of the reforms.

Also in a letter to the Times the heads of six health unions, including the British Medical Association and the Royal College of Nursing, warned of their concerns.

For a bit a light relief this is worth looking at. It gave me a laugh on how some opponents view Cameron's words.

Picture courtesy of World Economic Forum on Flickr.com

Social workers share disabled people's concerns on disability benefit reform #ombh

By Vern Pitt, journalist, on January 14, 2011 4:17 PM | No Comments

By Joe Godden, Policy Officer at the British Association of Social Workers (BASW) and Allan Orrick, a BASW member working in welfare rights

The proposals on disability living allowance (DLA) are creating a lot of concern among people with disabilities and their carers.

The benefits system is very complex and unsurprisingly social workers report fears among service users that may confuse one set of changes or proposed changes with another. Social workers and social care professionals working in a mental health resource centre report that this has had significant impact on people they work with.

One client, John*, has really been set back by being removed from incapacity benefit. His attendance at the resource centre dropped off significantly - he couldn't afford the bus fares for one, he couldn't afford to eat properly, which affected his health. Workers are very concerned for him and there is a real risk that he may end up back in hospital, which is very costly.

More after the jump...

Continue reading Social workers share disabled people's concerns on disability benefit reform #ombh.

Health reforms could "destabilise" the NHS, says GP body

By Jeremy Dunning, senior adult beat journalist on January 14, 2011 2:30 PM | No Comments

The Royal College of General Practitioners (RCGP) is warning that some Government suggestions on providing more choice in the NHS will cause long-term harm to patients and the NHS, particularly for vulnerable adults and at-risk children.

The RCGP made the comments in its response to the Department of Health's consultation Liberating the NHS: Greater Choice and Control, which closes today and it adds to the criticism health secretary Andrew Lansley's (pictured) proposed reforms have been facing.

In its response the RCGP said it welcomed the concept of patient choice but warns that some of the suggestions laid out in the consultation are misguided such as the abolition of practice boundaries and is concerned that the suggestion of 'any willing provider' 'runs a severe risk of 'destabilising the NHS in England and causing long-term harm to patient outcomes'.

It also warned that continuity of care could suffer.

It said: "There are potential consequences for the protection of children and vulnerable adults, where parents/carers are able to register out of the area."

It also warns that some rural practices may become 'unsustainable' and raises concerns regarding potential for easier abuse of prescribing and other services'

Dr Clare Gerada, RCGP Chair, said: "Patients do value more choice and they trust GPs to help them make the right choices.

"We do feel that the choices outlined in this consultation are misguided. GPs and their teams play an essential role in the lives of a great many of their patients such as in safeguarding the health of at-risk children and vulnerable adults.

"The Government's suggestions could severely affect continuity of care and end up costing much more than they have bargained for."

Picture courtesy of NHS Confederation on Flickr.com

Providers: 'Cuts to disabled mobility benefit will leave people with £14 a week' #ombh

By Vern Pitt, journalist, on January 14, 2011 12:01 AM | No Comments

By Steve Scown, chief executive at Dimensions UK a learning disability support provider

Plans to change and improve systems would normally be fully welcomed. However, we have to strongly oppose the recent proposals made for cuts to the Disability Living Allowance (DLA).

Yes, the system can be improved but these planned reforms will seriously impact on the quality of life for many. The proposal to take away the mobility element of the allowance is not going to improve anybody's life. In fact, having listened to many of the people we support and their families, there is a real danger that people with disabilities will become prisoners in their own home.

heartbreak badge.jpg

It may sound dramatic but sometimes reality is just that. The allowance is essential, for many people living in residential homes. This cut to their income, combined with the reductions in basic funding we are beginning to experience, will leave many with no means to get out and about in the community. They won't be able to afford to pay for transport and do the kind of things most of us take for granted such as attending appointments, visiting family and friends, or even something as basic as shopping for their own food.

This proposal to cut is made on the belief that local authorities are already meeting those travel costs but they aren't; many stopped funding that years ago. Without this benefit, people are left with an average personal allowance of just £14 a week to pay for anything beyond their bed and board.

More after the jump...

Continue reading Providers: 'Cuts to disabled mobility benefit will leave people with £14 a week' #ombh.

Labour: 'Government isn't honest on disability benefit reform' #ombh

By Vern Pitt, journalist, on January 14, 2011 12:01 AM | No Comments

"I don't think the government have been that honest," said shadow minister for disabled people Margaret Curran (pictured). "The changes to disability living allowance's mobility component are driven solely by economic factors; their whole approach to welfare reform is driven too much by economic factors."

Opposition to the government's Disability Living Allowance (DLA) reform proposals has been mounting since before the proposals were even announced. When George Osborne announced the mobility component of DLA would be cut for those in state funded residential care, he shook-up a hornets' nest of opposition.

The government argues that mobility is paid for both by DLA and council residential care contracts, making it reasonable to withdraw this component for those in receipt of both. However, earlier this week a report by 27 charities and endorsed by local authorities concluded this was false.

The Department for Work and Pensions spokesperson responded by saying: "The government is committed to protecting DLA for the future and ensuring that the £12bn spent on it every year goes where it is needed the most."

Meanwhile, Curran has been fronting the opposition to the changes in Parliament.

It was Curran's parliamentary question which unveiled revised government estimates increasing the number of people who will be affected by the cut to DLA's mobility component by 20,000, in December.

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Speaking earlier this week Curran was even more critical of the policy process on the opposite side of the house.

"Someone inside government probably thought it was simple easy cut," she said. "In terms of government spending it's a very small percentage. They are taking every opportunity they can to cut welfare spending irrespective of the consequences and that is driven more by George Osborne than it is by the Department for Work and Pensions."

More after the jump....

Continue reading Labour: 'Government isn't honest on disability benefit reform' #ombh.

Your top ten disability cuts #ombh

By Mithran Samuel, adults' editor, on January 14, 2011 12:00 AM | 8 Comments

[Blog updated 6 March 2012]

Online disability campaign group The Broken of Britain is today calling on bloggers to demonstrate online against the impending cuts to public spending facing disabled people in its blogswarm. heartbreak badge.jpg

But what exactly are those cuts? Here's a rundown of ten of the worst; no wonder disabled people feel this government has got something against them.

1) Scrapping disability living allowance and replacing it with the personal independence payment from 2013 for working-age adults. This reform, which will include a new assessment system, is designed to cut the number of claimants by 20%, meaning 360,000 people will lose out on support, saving the government £360m in 2013-14 and £1.075bn in 2014-15.

2) Scrapping the mobility component of disability living allowance - worth up to £50 a week - for publicly-funded care home residents and children in residential special schools. This money pays for transport for residents to leisure activities or to visit friends. It will affect 80,000 people, saving the government £135m a year. [Update - thanks to pressure from campaigners this cut was dropped in November 2011].

3) Cutting social care support for severely disabled people through the Independent Living Fund. The ILF is now closed permanently to new clients. This means that people who would previously have had their council social care packages topped up by the ILF will have this no longer. The ILF itself will be scrapped from 2015 onwards, raising questions about the future funding of existing claimants.

4) Social care cuts. Councils with social services responsibilities in England face average cuts in their budgets of 4.7% next year on the government's figures. Many are increasing eligibility thresholds or means-tested charges, both of which will hit disabled people's access to care and income levels.

5) Supporting People cuts. Councils are planning average cuts next year of 17% from their funding of supported housing schemes for groups including people with learning disabilities or mental health or substance misuse problems, a survey has found.

6) Welfare cuts for incapacity benefit claimants following reassessment. 1.5m incapacity benefit claimants will be reassessed on their fitness to work from 2011-14, using the controversial work capability assessment. The government expects 23% to be deemed fit for work, meaning they will be transferred to jobseeker's allowance, meaning they will lose £25 a week or more.

7) Cuts for employment and support allowance (ESA) claimants. This is a big one. The government expects to save £2bn in 2014-15 by time limiting ESA (the successor benefit to incapacity benefit) for some claimants to one year. Those losing out will be those found to have some future prospect of working, with support, who claim ESA on the basis of national insurance contributions not on the basis of their low incomes. This comes in from 2012.

8) Cutting the rate at which benefits increase each year. This apparently technical change - it means the value of benefits will increase in line with the consumer price index rather than the typically higher retail index - will net the government almost £6bn a year. This will affect DLA, attendance allowance, carer's allowance and employment and support allowance and make many disabled people and their carers poorer than they would otherwise have been.

9) Cutting mortgage interest relief. The National Housing Federation has estimated that 64,000 disabled homeowners could be at risk of losing their homes due to the government's decision to reduce support with mortgage interest payments for them by cutting the interest rate at which support is given.

10) Housing benefit. Many disabled people will be affected by the cuts to housing benefit, and there have been warnings that many will be driven into further poverty and possible homelessness. An estimated two million disabled people live in the private rented sector and many will be affected to the cuts to the benefit, which include capping payments and cutting housing benefit levels by 10% for those who have been on jobseeker's allowance (and many more disabled people will be on JSA due to point 6 above).

(Image by TheGiantVermin from Flickr)

Unison warns of social worker burnout on Climbie anniversary

By Mithran Samuel, adults' editor, on January 12, 2011 12:01 PM | No Comments

Unison today warned that social workers were facing burnout due to high caseloads and lack of management support as it launched a campaign urging government to meet the demands of the Social Work Contract - the trade union and Community Care's blueprint for fair working conditions for the profession.
Today's intervention is timed to coincide with the 10th anniversary of the sentencing of Victoria Climbie's killers - and Unison warned that the problems revealed by the Climbie case - high caseloads, recruitment and retention problems, lack of management support, over-reliance on agency staff - are still with us.
If you haven't signed our petition in support of the Social Work Contract, then please do. We want to put as much pressure on government as possible.

Government claims over disability living allowance dismissed as a myth

By Mithran Samuel, adults' editor, on January 12, 2011 9:38 AM | No Comments

Disability charities are stepping up their war against the government's plan to cut the mobility component of disability living allowance for 80,000 care homes residents and children in residential special schools. Here's some background on the issue. The money essentially funds mobility vehicles or taxi journeys for people so they can visit friends and family and get out and about.
If you remember, the government has claimed that these DLA payments - worth up to £50 a week - essentially duplicate money that councils provide - or should provide - for transport services in disabled people's care packages.
In a report today, a coalition of 27 disability bodies have said that this claim is a myth - it surveyed national disability car providers, none of whom said they received a payment from councils to fund mobility for residents.
They are calling on government to reverse the policy, which would save £135.5m a year.

Drugs services invited to be paid by results

By Mithran Samuel, adults' editor, on January 11, 2011 8:36 PM | No Comments

This is something we missed just before Christmas (apologies!). The National Treatment Agency has issued an invitation to local drugs partnerships to bid to pilot payment by results. This follows the drugs strategy, which set out the government's aim to pay drugs services on their success in helping users recover and become drugs free. This is controversial, both because of doubts over how you can define a "result" in drugs services and concerns over the focus on abstinence.
The results in question will cover reduced offending, employment, health and well-being and drug users not representing for drug treatment within 12 months of being discharged, free of dependence.

Legal aid cuts to hit poor - not fat cat lawyers

By Mithran Samuel, adults' editor, on January 11, 2011 2:16 PM | 1 Comment

Really good piece from George Monbiot in The Guardian about how the government's legal aid cuts will not hit fat-cat lawyers (as has been presented) but the poorest and most vulnerable: people wrongly sacked from their jobs; people unfairly evicted from their homes etc.
The government intends to shave £350m from the £2bn a year legal aid budget by removing eligibility for immigration, benefits, employment, contact and residence, debt and housing cases that do not involve domestic violence or potential homelessness.
A campaign is due to be launched tomorrow against the changes under the banner Justice for All.

Birmingham creates action plan to combat high rates of delayed discharges

By Jeremy Dunning, senior adult beat journalist on January 11, 2011 1:08 PM | No Comments

Birmingham City Council has around 150 delayed-discharge cases in an average week, according to a new report.

This found the biggest single cause is the availability of nursing-home placements, which was responsible for 19% of delayed discharges in the 28 months up to the end of July last year.

The authority's health overview and scrutiny committee, which published a review of the extent of the city's ongoing problems with delayed discharges, found that in joint second place - both responsible for 17% of delays - were patients awaiting care packages that would allow them to return to their own homes and patients awaiting placement in a care home.

The review is accompanied by a 12-point plan for improving the situation. Among the recommendations, is for a single director or senior manager in the council, one in each PCT and one in each Hospital Trust be given specific authority and responsibility to resolve and decide inter-budgetary or other disputes quickly where these are causing or contributing to a delayed transfer of care.

Debt charity launches new service for vulnerable people

By Jeremy Dunning, senior adult beat journalist on January 11, 2011 11:12 AM | No Comments

Consumer Credit Counselling Service (CCCS) has launched a new service providing additional assistance to vulnerable people who are struggling with debt.

People identified as vulnerable will be offered extra support such as help with completing forms and undertaking welfare benefits checks.
Picture courtesy of alancleaver_2000 on Flickr.com

Common sense approach to dealing with offenders with mental health problems launched

By Jeremy Dunning, senior adult beat journalist on January 11, 2011 11:05 AM | No Comments

Practitioners at the mental health charity Together have joined forces with criminal justice and health agencies to produce a new mental health guide targeted at frontline criminal justice agency staff.

'A common sense approach to working with defendants and offenders with mental health problems' is being launched today by Prof Louis Appleby, National Clinical Director for Health and Criminal Justice.

It offers guidance to professionals such as police officers, probation officers, security and court staff on how to work effectively with the disproportionate number of people with mental health problems who find themselves in contact with the criminal justice system.

It also includes information and advice on working with people who have substance misuse issues, alcohol problems and learning difficulties.

Voluntary organisations speak out against cuts

By Vern Pitt, journalist, on January 11, 2011 10:57 AM | No Comments

Voluntary organisations in Nottinghamshire have complained that the council's plans to cut funding will strip the sector of capacity to fulfil the government's Big Society plans, the Nottingham Post reports.

The council is currently consulting on detailed plans to cut spending in all departments including the provision of adult social care.

In a letter to the council, 21 groups which are members of Notts Infrastructure Consortium said: "We believe the scale of the proposed Notts County Council cuts and the indecent haste in implementation will cause lasting damage to all those groups out there working to help those who need it most; the elderly, disabled, children, and young people.

"From luncheon clubs to Citizens' Advice Bureaux, from pensioners to post natal support, we are there supporting people.

"The proposed cuts to the sector will strip it of much of its potential to help ease the impact of the public sector cuts and will also greatly damage the 'Big Society' we have spent years working to create."

I doubt that the situation in Nottinghamshire is different from the rest of the county and it is likely that the third sector will be hit hard by funding cuts putting David Cameron's Big Society plan in jeopardy.

Mental health and gender: problems for men and women

By Mithran Samuel, adults' editor, on January 11, 2011 9:33 AM | No Comments

Two reports today illustrate the gender dimension to mental illness and mental health care.
Mind and the Men's Health Forum have launched the first guidelines on the mental health needs of men and boys.

In 2009, Mind warned that the economic downturn was putting men's mental health at risk but put statistical flesh on the bones of the widespread belief that men are less likely than women to seek help: 14% said they would seek help from a GP if they felt low, compared with 37% of women.
Today's guidelines stresses that while men and women experience mental ill-health in equal numbers, men are much less likely to be diagnosed and treated for it. As a result 75% of suicides are by men. Besides the stigma of seeking help, other problems identified in the guidelines include the fact that men often don't display the traditional symptoms of depression and are more likely to respond with aggression or self-medication (i.e. drink and drugs).
They call for more mental health advertising to be targeted at men and for male-friendly treatments.

However, a separate report today highlights the specific mental health problems facing women today. Platform 51 (formerly the YWCA) found that three in five girls and women have experienced low-level mental health problems. Its survey found that this triggered problems such as drink, drugs, losing friends, taking time off work, drug taking and promiscuity.
These findings occasioned this jolly headline from the Daily Telegraph -"Women in crisis as depression fuels binge drinking and sex - research"). Nice.

Platform 51 also highlighted the effect of women's mental health on families, given their greater caring responsibilities.

And it's not just men who are not getting the help they need. Platform 51 found 30% of those affected by low-level mental health problems have never sought help.

All of which means that services will need to be vigilant about the differing needs of differing groups of service users.

However, social worker blogger Fighting Monsters - an approved mental health professional - issued a warning about the Platform 51 research, saying there is a danger in classifying issues such as low self-esteem as a mental health problem.

"I wonder if this is an implicit desire to classify some of a woman's experiences as 'mental health problems'," she says. "I'm not saying that these matters cannot have a significant effect on mental wellbeing but is there a difference between having a less than positive and secure mental well-being and having a mental health problem?"

(Photo from Flickr from KellyB)

Doctors call for more debate on health reforms

By Jeremy Dunning, senior adult beat journalist on January 10, 2011 12:57 PM | No Comments

According to the doctor's magazine Pulse, the BMA council is set to hold a vote on whether to hold an emergency meeting on its stance on the goverment's health white paper, after almost a dozen regional branches backed a debate on the issue.

Rebels want the BMA to end its policy of 'critical engagement' with health secretary Andrew Lansley.

It all adds to more difficulties for the government.

Social care and benefit cuts slash incomes for disabled

By Mithran Samuel, adults' editor, on January 10, 2011 11:24 AM | No Comments

Cuts to disability benefits and social care look set - surprise surprise - to devastate the living standards of disabled people, a report out today shows.
Norfolk Coalition of Disabled People, which is campaigning against local cuts plans, commissioned the study, which found that the poorest half of disabled people in Norfolk will see their living standards fall by a third over the next four years.
This is the first report that we know of to assess the combined impact of disability benefits and social care cuts.

Kingston care protest attracts Baroness Campbell

By Vern Pitt, journalist, on January 10, 2011 10:12 AM | No Comments

Baroness Campbell Kingston 8.1.11 - web.jpg

The first protests against social care cuts in 2011 kicked off at the weekend in Kingston with the attendance of long time disability campainger Baroness Campbell.

Campaigners collected 1,000 signatures to a petition to stop proposed charge increases by the council.

Baroness Campbell said: "I was so proud to be part of this brilliant local campaign, which takes me back to the old days of direct action - not quite as exciting as being arrested on Westminster Bridge for holding up the traffic - but not far off! We mustn't let the Council get away with taking away our human rights to independent living, dignity and respect."

Details of the ongoing campaign are available here.

Disability benefit cuts may breach human rights law

By Vern Pitt, journalist, on January 10, 2011 9:45 AM | No Comments

Changes to disability living allowance could be in breach of the Human Rights Act, the BBC reported over the weekend.

The idea that benefit changes could breach one of the country's core statutes may seem incredible but given the minister has little idea of the real effect on disabled people it may just be.

The government also only recently recalculated who would lose out from the move to scrap mobility payments for those in care homes putting a further 20,000 into this group.

Reform - but don't scrap - vetting and barring scheme, says charity

By Mithran Samuel, adults' editor, on January 8, 2011 12:00 AM | No Comments

Charity Action on Elder Abuse today called for the vetting and barring scheme for staff working with vulnerable adults and children to be reformed - but not scrapped.

With the scheme under review, and the government intent on scaling it back to "common sense" levels, Action on Elder Abuse suggests a number of changes:- to restrict the scheme to a much smaller number of workers; to restrict the use of "soft intelligence" (i.e. information not related to a criminal conviction) and for the scheme to have more links with regulation of services - for instance by the Care Quality Commission - to avoid duplication.

However, AEA chief executive Gary FitzGerald said complete removal of the vetting and barring scheme would "result in increased access by abusers to vulnerable adults and a consequent increase in abuse".

Big society is rebranded Thatcherism

By Jeremy Dunning, senior adult beat journalist on January 7, 2011 2:38 PM | No Comments

Ray Jones, professor of social work at Kingston University and St George's, University of London, has written a good blog about big society.

In it Jones argues that it is simply a window-dressed version of Margaret Thatcher's government and will therefore lead to the same problems.

It's a fairly bleak vision, but there's little reason to argue against it.

Bonfire of the social care quangos slammed by MPs

By Jeremy Dunning, senior adult beat journalist on January 7, 2011 9:24 AM | No Comments

The government has "botched" its plans to axe 192 quangos, according to a highly critical report published today by a committee of MPs.

The Commons public administration select committee said the process was "rushed and poorly handled" and failed to achieve its two main aims - to improve accountability and reduce spending, meaning the reorganisation could now cost more than it will save.

A key social care quango to go was the Youth Justice Board.

Conservative MP and committee chairman Bernard Jenkin said: "The whole process was rushed and poorly handled and should have been thought through a lot more. This was a fantastic opportunity to help build the Big Society and save money at the same time, but it has been botched.

"The government needs to rethink which functions public bodies need to perform and consider transferring some of these functions over to mutuals and charities."

The union Unite repeated its call for the coalition to press the 'pause' button.

General Secretary-designate, Len McCluskey said: "It appears that the coalition is intent on pushing ahead with its plans, regardless of the stinging criticisms from this respected parliamentary committee, which means that ministers are refusing to take account of the expert advice of the professionals and the conclusions of elected MPs from across the parties.

"Unite is urging the government to stop and rethink the reasoning behind the Public Bodies (Reform) Bill which has all the hallmarks of being hastily prepared and ill-thought-out."

Senior doctors attack planned health reforms

By Jeremy Dunning, senior adult beat journalist on January 6, 2011 9:38 AM | No Comments

Rumblings over the health secretary's plans for the health service continued today as more than 100 doctors, including 20 professors, signed an open letter in the British Medical Journal, criticising the leadership of the British Medical Association, the doctors' union.

The letter, parts of which are quoted in The Guardian say the BMA should abandon its policy of "critical engagement" with ministers over plans that will "destroy" the NHS, and instead fight the reforms.

The signatories include three members of the BMA council, its 33-strong ruling body, and leading doctors in fields such as cancer, children's health and emergency medicine.

Among other stories, mental health charities have been reacting to news that a middle-aged woman who told her 1,048 Facebook "friends" that she had taken an overdose was found dead the next day after none came to her aid.

Charities said the case was a sad reflection on today's society where friends made online are not necessarily friends in real life.

How councils are coping with budget cuts

By Vern Pitt, journalist, on January 6, 2011 9:35 AM | No Comments

Multiple councils have started the new year by unveiling further charge hikes and service cuts as the full scale of the economic woes facing local government emerges.

Hull council has put forward plans to introduce charges for adult social care, the Yorkshrie Post reports.

The city joins a long list of councils which are looking at this as a way of covering reductions in funding from central government. Hull City council needs to save £40m this year.

The council also says it will need to shed 1,400 posts to make the savings.

Interestingly, the council also believes that it can save £1.5m by not providing residential care itself but rather focusing its in-house facilities on respite care only. This is a tactic which I for one have not seen before.

Here is the council's reasoning for this: "In view of the modern 21st century care homes being built in Hull and the council's inability to provide the investment that will be needed to bring our stock up to standard the council will consult on plans to stop providing residential care over the medium term. The council will use the spare capacity in its remaining three care homes for respite care."

So it's OK to have old decrepit respite homes but not residential homes? That seems a little unfair to me. Plus, I can't see family carers queuing up to check their relatives in so they can have a break if they're not desirable enough to be lived in.

Down in Kent the county council simply plans to sell three of its homes to meet budget pressures.

Meanwhile, Plymouth Council is also set to lose 90 jobs, most of which it says will be in adult social care.

I expect the residents and council workers of North Yorkshire are even more worried about their services today as the council unveils an additional £12m of savings will be needed on top of the £23m predicted by the council last year.

Funding reform needed to ensure reablement cash used well

By Vern Pitt, journalist, on January 5, 2011 10:32 AM | No Comments

Not everyone is so positive about £162m extra reablement cash, which my colleague Jeremy has already expressed scepticism about.

Jane Ashcroft, chief executive at social care and housing provider, Anchor, said:

"The coalition needs to accelerate the integration of social care and health funding if this money is going to be spent in the correct areas. Otherwise, this much-needed cash will be sucked into dealing with crises rather than preventing them from occurring in the first place.

"This money, whilst welcome, will count for little more than a token gesture if it is not backed up by radical change in the funding regime."

First care charge protests of the new year

By Vern Pitt, journalist, on January 5, 2011 9:58 AM | No Comments

Kingston will play host to the first set of protests against care charge hikes in 2011, this weekend, the Surrey Comet reports.

If there was one popular movement which dominated the headlines in 2010 it was student protesters. I suspect those in receipt of social care could be just as active, if not more so, in 2011.

However, it will most likely be action on a local level so it will be interesting to see if the issue gets the same national coverage.

Social care blamed for NHS bed blocking

By Vern Pitt, journalist, on January 5, 2011 9:14 AM | 1 Comment

Over half of hospital doctors have said bed blocking, which keeps patients in hospital is worse now than a year ago, the Guardian reports.

The survey by the Guardian report reads: "Doctors blamed local councils for making it harder for older people to access home help for vital tasks, such as eating and washing, and so forcing them to stay in hospital unnecessarily."

Doctors were said to identify increasing cuts and restrictions on eligibility for social care services as the route cause of the problem.

Yesterday the government announced an extra £163m for reablement services designed to get people back on their feet after a period in hospital However, as my colleague Jeremy pointed out yesterday this is hardly a huge sum of money. When you take into account the number of councils it will be divided by it's just over £1m each on average.

That didn't stop the Association of Directors of Adults Social Services being the first among many to welcome the cash.

The problems with reablement have been well documented. Last year Community Care uncovered how 20% of councils had been looking to charge for reablement services, something the government has since instructed them no to do.

Whether the new cash will salve the cuts, jump-start better reablement and stop the blocking of beds is unclear.

Image by YODCOX! on Flickr

Directors welcome extra social care cash but issue 'flu warning

By Mithran Samuel, adults' editor, on January 4, 2011 1:25 PM | No Comments

Following Jeremy's blog post earlier on the government providing an extra £162m for social care services to help people leaving hospital, I thought it was worth noting that the Association of Directors of Adult Social Services has given this the thumbs up.

This money, which is for this financial year, will be issued to primary care trusts to pass to local authorities, who will spend it in a way agreed with their local PCT. This is similar to money that has already been announced for future years.

There is of course only three months of this year and Adass has stressed that it is vital that PCTs and councils agree on how this money is spent quickly - particularly given what it describes as a "burgeoning 'flu crisis".

DH finds extra money for reablement services

By Jeremy Dunning, senior adult beat journalist on January 4, 2011 12:32 PM | No Comments

The department of health has today been trumpeting how it has found an extra £162m for reablement services through an efficiency drive.

The money will be allocated to primary care trusts, for them to transfer to councils to spend on social care support and hence to relieve additional pressures on hospitals over the winter period.

The extra money will be spent on helping people to leave hospital more quickly, get settled back at home with the support they need, and to prevent unnecessary admissions to hospital.

This is in addition to the previously announced £70m that the NHS will spend this year on reablement services.

It's difficult to sound churlish and of course any extra money is welcome but it sounds rather like a drop in the ocean.

Alcoholic offenders need more support, says report

By Jeremy Dunning, senior adult beat journalist on January 4, 2011 11:52 AM | No Comments

Offenders who misuse alcohol do not get enough support to turn their lives around, according to research published today by the Centre for Mental Health.

A Label for Exclusion finds that offenders who drink harmfully are not offered as much support as those who use illegal drugs even though alcohol misuse is a bigger cause of crime and ill health.

This comes despite statistics showing that six out of 10 male and four out of 10 female prisoners in England are harmful or hazardous drinkers, while almost half of probation clients have an alcohol problem.

Alcohol is also a factor in three-quarters of cases of domestic violence and more than half of assaults.

Among 10 recommendations the policy paper, which is is based on research carried out in the south west of England, calls for commissioners of health and justice services to pool resources and involve service users in planning the support they offer.

It says all front line workers, such as social workers and GPs, should have basic skills in recognising alcohol misuse and referring people on to specialist services if they need them.

It calls for good quality alcohol support to be available to people at any point in the criminal justice system, from first contact with the police to courts, prisons and probation services.

It also promotes the need for a public awareness campaign warning of the risks linked to alcohol misuse and for the cost of drink to be linked to alcohol content, though such an idea has already been dismissed by the government.

Centre for Mental Health joint chief executive Prof Sean Duggan said: "Having a diagnosis of alcohol dependency or misuse is too often a label for exclusion from both health and drug treatment services."

He added: "We hope that the government will create a more conducive environment to improve responses at all levels and for all who need more help to manage their alcohol use and offending."

Picture courtesy of Tim Dobson on Flickr.com

While we were eating mince pies...

By Vern Pitt, journalist, on January 4, 2011 10:54 AM | No Comments

You might think the world of social care would slow down a bit over Christmas and new year, but you'd be wrong.

Here are a few stories we didn't have time to report on because we were too busy stuffing turkey into our face.

Welfare bill soars as coalition counts cost of austerity drive
Local Improvement Networks delivering some service improvements but still a long way to go, says a report by the Department of Health
Dementia spending inquiry launched
Lansley faces flak over mental health funding cuts
Inquiry into respect for disabled people's human rights launched
Hull unveils deepest cuts for a generation

And finally...

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