NHS blunders and the provision of social care

NHS blunders and the provision of social care

This week, the Times published a damning report highlighting the acute waste associated with this government’s ‘streamlining’ of the NHS, as more than £90m was spent on redundancy to staff who were then immediately rehired. This does not come at a good time for the health service, which is still reeling from the press attention its reported £2.2 billion deficit attracted at the end of last year.

The Times also reveals that £150 million was spent on management consultancy designed to make the health service more efficient. Both revelations highlight the gross mismanagement and the misspending of public funds that should have gone to those who needed it most: the vulnerable and ill.

This is also not the first time that the NHS has come under scrutiny for frivolous, expensive and – in some cases – downright unnecessary recruitment costs. In one instance, an interim finance chief for one trust was paid £1m a year – highlighting the double standards at play of an organisation that claims it wants to cap the rates it pays for vital agency staff.

With so many challenges facing the wider health and social care sector, The Times is right to point out that patients will be left furious at such extreme waste when taxpayer money could be far better spent. For example, poor NHS governance has manifested itself in the ‘bed-blocking’ scandal, as covered in this recent Prestige blog. Last year alone, this problem cost the NHS £305 million, a sum the organisation can ill-afford.

Along with better financial management, bed-blocking can only be overcome if the supply of nurses and social-care workers is increased. This is a difficult task, however, and several barriers exist that perturb such a policy. One such example resides in the exponential expansion of the elderly population, the population of men aged 75 and over having increased by 149% since 1974. The immigration cap also seriously hampers the employment of nurses from overseas, further damaging the supply of care available.

The provision of trained and compassionate social-care professionals is a vital part of our healthcare system and is necessary for its continued success. With supply so low and demand so high, it is also a problem that must be combated now, before the situation grows out of control. This will be expensive but, unlike the mismanagement of NHS funds, it is also money well spent. Rather than wasting resources and money, health care leaders need to consider an over-arching approach to improve efficiency and see how health and social care can combine to alleviate the sector’s challenges.

Social care’s winter crisis and Care City

Social care’s winter crisis and Care City

The Office for National Statistics recently reported that 43,900 excess winter deaths occurred among over 65s this winter – many of which were entirely preventable. This is double that of 2013/14, and throws into sharp relief the calamitous effects the winter months can have on the nation’s elderly population. The fact this figure is rising so dramatically is totally unacceptable in an advanced country like the UK, and represents a significant failure on the part of policymakers to tackle underlying issues.

As Age UK Charity Director, Caroline Abrahams states, cold homes, high energy prices and a lack of support combine to create a ‘toxic situation’ for the elderly which is compounded by the effects of loneliness.  Furthermore, gas and electricity companies are doing little to alleviate the elderly’s winter troubles. Prices remain high, and service providers’ over-reliance on online support systems have recently been shown to leave many of the elderly population without access to vital support, also contributing to illness.

While residential care could provide a solution to this issue, care homes are expensive at over £29,000 per year, and leave many residents without independence. Family care is another option but many find the strain of caring for a family member while simultaneously pursuing a career an impossible task.

An alternative exists, however, in professional home care. Home care provides a cheaper option to residential care while also providing the elderly with important companionship and allowing greater independence. With an ever-increasing elderly population and a deficit in the number of trained social carers active in the UK, more needs to be done to ensure that the sector is capable of meeting the population’s needs.

Coupled with innovative approaches to social care, home care can play a crucial role in meeting the growing care needs of modern Britain. It is therefore encouraging to see the launch of projects like ‘Care City’, which opens this month.  Care City seeks to transform and modernise the way care and services are provided, improving life for the elderly and for the carer. Innovations include the Canary, a device that family members can use to track relative’s movements meaning they don’t have to leave work to check on them.

The success of Care City has yet to be tested but, with its strong ethos and focus on patient welfare, may just serve as a blueprint for future attempts to produce an overall approach to social care for the elderly.

Hospitals to face winter pressure: alternative solutions

Hospitals to face winter pressure: alternative solutions

As winter approaches and the chance of falling ill runs higher, elderly people who are prone to infection will increasingly be admitted to hospitals for conditions that could either be prevented or treated effectively at home.

A new report from Age UK has warned that poor community services and a lack of social care provided to the elderly by local authorities, who have had their budgets slashed in recent years, will result in a huge rise in hospital admissions. The NHS – already stretched to breaking point – cannot cope with the extra pressure and alternative ways of treating the elderly need to be made use of.

Last week, Matthew Winn, chair of the NHS Confederation Community Health Services Forum, announced that community health services should play a crucial role in reducing some of the winter pressure on hospitals. By working closely with GPs, community health staff can bring care into the local area so minor infections and ailments are treated early and effectively before they progress, and so people are supported with the day to day care they need. This would also bring complex care out of hospitals and ensure NHS money is used wisely.

Care at home is also an invaluable service. It can save people money, prevent further progression of illness and avoidable hospital admissions, and provide advice and support for patients on how to stay healthy and safe. Care is also tailored to individual needs and provided in the comfort of their own home, thus easing pressure on hospitals.

Under increased pressure, which will only worsen as the population continues to age, the NHS needs to be supported by other outlets to help meet the growing demand for care. Health services provided by the community and care at home should be used effectively to play a significant part in easing pressures not only over the winter, but for the longer term.

The NHS alone cannot meet the needs of an ageing population. More care needs to be retracted from hospitals and placed locally, taking on a more personalised approach to solve the current health care crisis. But this can only happen with adequate levels of funding in place and the government must consider this as part of an overarching approach to health and social care.

Suitable for no one

Suitable for no one

A recent letter from the County Council Network (CCN) – a constituent of the Local Government Association (LGA) – has revealed that those paying for care themselves (possessing assets below £23,500 is the current threshold for state assistance) pay a surplus of 50% on their care home costs. This is an absolutely raw deal, and is the result of a social care market that has been skewed by unacceptably low levels of central government funding.

In the CNN’s letter, Council chiefs illustrate how unsustainably low investment in the social care sector has passed fees on to vulnerable adults whose assets are above the threshold. Previous research from Prestige Nursing + Care has illustrated that councils’ ability to provide their residents with adequate social care is set to come under further pressure, following the £4.6bn in cuts care budgets have undergone in the last five years.

As a result of this, Councils have opted to work together to ensure that they get the best possible value for their money when it comes to purchasing care. With limited options available to them, this cartel-like approach means that providers have to pass their losses on to self-funding customers to ensure they can maintain standards; the Councils’ findings reveal that the weekly care bill for a self-funder (£754) is 49% above the £511 paid by a local council. This is an unacceptably large disparity.

While there is a pervasive view among some that care providers are profiting at the expense of individuals, nothing could actually be further from the truth. Margins are already alarmingly small, with many providers going under. While care is obviously a significant cost, lowering the fees – even a small amount – that councils and individuals pay would result in the lowering of standards.

The onus is therefore on government to ensure that the social care sector is both adequately and efficiently funded. The problems in the system are already acute enough to warrant increased spending, and with Britain’s population ageing, there is an imperative to increase investment before it’s too late. Furthermore, policymakers should look to the solutions that more cost effective care, such as home care and community care, can provide.