Better health and care for all

Better health and care for all: A 10-point plan for the 2020s. The final report of the Lord Darzi Review of Health and Care.| Institute for Public Policy Research

A previous report concluded that a bold long-term funding and reform plan is needed to secure the future of the NHS and social care. This final report of the Lord Darzi Review puts forward a ten-point plan to achieve this, as well as a ten-point offer to the public which sets out what the health and care system will be able to offer if this plan for investment and reform is adopted. 

Full report: Better health and care for all: A 10-point plan for the 2020s.

Summary available here

A fork in the road: next steps for social care funding reform

The King’s Fund | May 2018 | A fork in the road: next steps for social care funding reform The costs of social care funding options, public attitudes to them – and the implications for policy reform

The King’s Fund has published A fork in the road: next steps for social care funding reform, this paper synthesizes new financial modelling, public perceptions work and policy analysis to identify the problems with adult social care in England and outline options for its reform. It considers the relative merits and disadvantages of different options and the impact and consequences of selecting one over the other. 

The paper explores current funding pressures, alternative models, funding options, public perceptions and attitudes and policy implications.  The authors surmise that ‘England is now at a clear ‘fork in the road’ between a better means-tested system and one that is more like the NHS; free at the point of use for those who need it'(The King’s Fund).

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A fork in the road: next steps for social care funding reform The costs of social care funding options, public attitudes to them – and the implications for policy reform can be downloaded here 

What can England learn from the long-term care system in Japan?

Nuffield Trust | What can England learn from the long-term care system in Japan? | May 2018

The Nuffield Trust has released a report based on interviews and and observations conducted during a study visit to Japan in October 2017, a literature review  and insights from an earlier visit to Japan all combine to provide a snapshot of what England can learn from the Japanese system.

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Image source: nuffieldtrust.org.uk

In Japan, the Long Term Care Insurance (LTCI) system provides universal, comprehensive care to people over the age of 65 and those with a disability aged between 40 and 65.  It is partly funded by a national insurance fund that everyone aged over 40 pay into and partially from general and local taxation.

There are a number of important lessons

  • National criteria for eligibility mean that access to care is the same regardless of where a person lives. Every three years the system is reviewed and reforms made when needed. This flexibility has enabled the Japanese Government to be responsive to public concerns and to address concerns over expenditure.
  • Service users find the Japanese system easy to navigate. This is because a crucial part of the LTCI service includes having a ‘care manager’, responsible for supporting the individual to make a care plan, identifying suitable providers, coordinating between carers, the individual and the family, and overseeing the care plan in the long term. While similar roles exist in some parts of England, provision is patchy and there is no single accepted definition of such a role.
  • At the heart of the Japanese system is a strong commitment to long-term prevention of loneliness and ill health, a stark contrast to England’s short-term approach, driven by budget constraints, which is focused increasingly only on those with highest needs. Services are available both to frail or sick older people and also to healthy ones, with clubs and activities for healthy over-65s promoted as part of the system.

Source: Nuffield Trust

The full report is available from the  Nuffield Trust

Public satisfaction with the NHS and social care

Public satisfaction with the NHS and social care in 2017: results and trends from the British Social Attitudes survey | The King’s Fund | Nuffield Trust

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Image source: http://www.kingsfund.org.uk

This analysis from the British Social Attitudes survey summarises views on, and feelings towards, the NHS and health care issues. Overall NHS satisfaction levels remain higher than they were in the 1990s and early-to-mid-2000s, however, there has been a statistically significant fall in satisfaction in 2017 which took net satisfaction to its lowest level since 2007.

Key findings:

  • Public satisfaction with the NHS overall was 57% in 2017 – a 6 percentage point drop from the previous year. At the same time, dissatisfaction with the NHS overall increased by 7 percentage points to 29% – its highest level since 2007.
  • Older people were more satisfied than younger people: 64% of those aged 65 and over were satisfied with the NHS in 2017 compared to 55% of those aged 18 to 64. Between 2016 and 2017, satisfaction fell among all age groups.
  • The four main reasons people gave for being satisfied with the NHS overall were: the quality of care, the fact that the NHS is free at the point of use, the attitudes and behaviour of NHS staff, and the range of services and treatments available.
  • The four main reasons that people gave for being dissatisfied with the NHS overall were: staff shortages, long waiting times, lack of funding, and government reforms.

Full report: Public satisfaction with the NHS and social care in 2017: results and trends from the British Social Attitudes survey

Additional links:

Improving the experience of care and support for people using adult social care services

This guideline covers the care and support of adults receiving social care in their own homes, residential care and community settings | National Institute for Health and Care Excellence (NICE)

This NICE guideline aims to help people understand what care they can expect in residential and community settings, and to improve their experience by supporting them to make decisions about their care.

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The guideline has been developed by a committee of people who use services, and carers and professionals. It has used information from a review of research evidence about people’s experiences of care and support, and from expert witnesses. The committee also gave consideration to the potential resource impact of the recommendations. The recommendations are considered to be aspirational but achievable.

It includes recommendations on:

It is for:

  • Practitioners working in adult social care services in all settings.
  • Service managers and providers of adult social care services.
  • Commissioners of adult social care services.
  • People using services (including those who fund their own care) and their families, carers and advocates.

Full reference: People’s experience in adult social care services: improving the experience of care and support for people using adult social care services | NICE guideline [NG86]

See also:  NICE interactive flowchart – People’s experience in adult social care services

 

Long-term sustainability of the NHS and social care

Government response to the report on long-term sustainability of the NHS and adult social care | The Department of Health and Social Care  

This paper responds to the Lords Select Committee report stating that significant efficiencies will be needed to make the NHS and social care system sustainable for the long term.

The original report made 34 recommendations in the areas of:

  • service transformation
  • funding the NHS and adult social care
  • innovation technology and productivity
  • public health, prevention and patient responsibility
  • lasting political consensus

 

Full document: Government response to the Lords Select Committee report on Long-Term Sustainability of the NHS and Adult Social Care| The Department of Health and Social Care