Health and social care experiences

This quarterly briefing aims to provide health and social care professionals with a summary of the issues raised with Healthwatch

Between July and September over 10,500 people shared their experiences of using health and social care with Healthwatch. This briefing looks at 128 reports published by local Healthwatch and aims to provide health and social care professionals with a summary of the issues people have raised with us.

What issues does the briefing look at?

  • Emerging themes across primary care, hospital care, social care and mental health. For example, the importance of good communication when GP services are changing and people’s mental health and physical health not being given equal consideration in A&E.
  • In focus – the support available for people with incontinence and how services can help by making sure patients can easily access the continence products they need.
  • Spotlight on experiences – the challenges people from diverse ethnic communities can face when using health and care services.

Full briefing: What have people been telling us?  A summary of our evidence – July to September 2019 | Healthwatch

The costs of smoking to the English National Health System

Ash| September 2019 | The costs of smoking to the English National Health System

Ash the smoking support charity have commissioned research to measure the impact of smoking on the need for social care. This updated  previous analyses of the cost of smoking on social care; and a multi-wave analysis of the English Longitudinal Study of Ageing (ELSA) and the Health Survey for England was undertaken. 

 

ash.org.uk
Image source: ash.org.uk

The analysis finds that 670,000 people have care needs as a result of smoking:
• 25,000 adults receive social care from their local authority because they
smoke or smoked;
• 5,000 adults receive social care they pay for themselves because they smoke
or smoked;
• 345,000 adults receive informal social care because they smoke or
smoked; and a further
• 300,000 adults have unmet care needs because they smoke or smoked

The costs of the additional care needed due to smoking are high to both local authorities
and smokers themselves:
• The cost of smoking-related social care to local authorities is £720 million
a year
• The cost of smoking-related social care to individuals who pay for their
own care is £160 million a year (Source: Ash)

The costs of smoking to the English National Health System

In the news:

OnMedica Care needs come earlier for smokers

 

Who cares? The Financialisation in social care

IPPR | September 2019 | Who cares? The Financialisation in social care

The Institute for Public Policy Research (IPPR) has published a briefing paper: Who cares? Financialisation in social care

Recent data from IPPR shows that 84 per cent of beds are now provided by the private sector, up from an estimated 82 per cent in 2015. The IPPR argues that: 

  • Social care’s reliance on private bed provision is growing
  • Larger providers – particularly those funded by private equity firms – are becoming more dominant.
  • A growing reliance on private provision could mean lower quality care

Within the paper, the IPPR calls for a bold set of policy interventions to arrest the growth of debt-fuelled private social care provision and oversee the existing sector. This should include:

  1.  the creation of a powerful national financial care regulator – OfCare – to oversee the financial regulation of systemically important care providers
  2.  a new requirement that ensures all state-funded providers of care maintain a ‘safe’ level of reserves and demonstrate they are paying their fair share of tax in the UK
  3. a commitment by government to build the 75,000 beds needed to by 2030 through
    borrowing worth £7.5 billion
  4.  the care for these homes should either be provided by the state or by innovative not-for-profit providers, building on the success of the ‘Preston Model’.

Full report available at IPPR

Social care funding and mental health

Centre for Mental Health | September 2019 | Social care funding and mental health

The latest policy briefing from the Centre for Mental Health looks at what a fair and sustainable funding settlement for social care needs to look like in order to deliver parity of esteem for mental health and sufficient funding to support people of working age as well as those in later life.

In their latest briefing, the Centre for Mental Health look at what a fair and sustainable funding settlement for social care needs to look like in order to deliver equity of esteem for mental health and sufficient funding to support people of working age as well as those in later life.

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Social care funding and mental health
 reviews the current funding and provision of mental health social work for people of working age in England. It finds that mental health social work has a vital role in helping people to live independently and to secure their rights and dignity. Local authorities also support carers and commission advocacy services, including for people subject to the Mental Health Act

The briefing concludes that the new settlement for social care must therefore:
• Provide parity of esteem for mental health with other social service functions
• Secure fair funding for people of working age
• Resolve the confusion between health, housing and social care funding for people
with ongoing care needs
• Enable local councils to invest for the future in their workforce and their community(Source: Centre for Mental Health).

Social care funding and mental health

Download the briefing here 

What should be done to fix the crisis in social care?

This ‘long read’ sets out five messages for government about priorities and options for social care reform in England, based on an assessment of the evidence and analysis of the costs of reform.  It focuses primarily on changes to the funding system rather than other policy questions such as the relationship between the NHS and social care | The Health Foundation

This analysis from the Health Foundation sets out five priorities for the new government for social care:

  • To stabilise the current social care system, which is at risk of collapse. The Health Foundation estimates this would cost £4.4bn by 2023/24. In 2020/21, this would cost £1bn.
  • To protect individuals against unfair and catastrophic care costs. A range of approaches could be used here. The Health Foundation recommends a Dilnot-style model where the government can set the maximum amount individuals would be required to pay over their life time. An approach whereby the maximum cost was capped at £46,000 would cost government an additional £3.1bn per annum by 2023/24.
  • To increase eligibility and access to social care. To reinstate levels of access to 2010 levels would cost an additional £8.1bn, according to Health Foundation analysis.
  • To see the capped cost model as a flexible approach to reform. The principle of a cap on care costs was included in the 2014 Care Act and could be put in place without new legislation.
  • To explore a range of options for raising revenue. After a decade of austerity in public finances, cutting other services to pay for social care is not feasible or desirable. Increases in tax revenue is likely to be needed, although borrowing could also play a part.

Full detail: What should be done to fix the crisis in social care? Five priorities for government

See also: Press release: New government must act to end the shameful policy failure at the heart of adult social care

King’s Fund: A short history of social care funding reform in England: 1997 to 2019

The King’s Fund | July 2019 | A short history of social care funding reform in England: 1997 to 2019

Since the 1990s, funding for social care has been widely seen to be unfair, and successive governments have attempted to reform the overall approach to funding adult social care but without success. The King’s Fund outline the history of the past 22 years of attempts to reform how social care funded (Source: The King’s Fund).

See The King’s Fund for the timeline