Transforming care in England

One of the  challenges identified by the Kings Fund for the NHS in England is developing new and better models of care – they write:

The ageing population, changing patterns of disease – with more people living with multiple long-term conditions – and rising public and patient expectations mean that fundamental changes are required to the way in which care is delivered (see Transforming the delivery of health and social care: the case for fundamental change).

What should be done?

Realising this transformation will require a radical shift to involve individuals more fully in their own health and care. This will include making shared decision-making a reality, giving people the support and information they need for effective self-management, involving families and carers, giving people personal budgets where appropriate, and engaging people in keeping healthy. The evidence is clear: most people want to be more involved, and when they are, decisions are better, health and health outcomes improve, and resources are allocated more efficiently.

Health Care

Much greater priority should also be given to public health and prevention. Because of the complex range of influences on population health, this will require collaboration between the NHS, local government, the third sector, employers and others. It will also require action by government, as exemplified by the proposed levy on the soft drinks industry to help tackle childhood obesity. We have outlined opportunities for local authorities to use their powers to improve the health of their populations as part of a broader move towards population health systems.

The implementation of new care models should build on those outlined in the NHS five year forward view. Closer clinical and service integration is needed between hospitals, community services and general practices, health and social care, and physical and mental health. Our work has described examples of specialists working more closely with primary care teams and of general practices collaborating in federations and networks to show how new care models can contribute.

We need a workforce that is fit for purpose, able to adapt to changing demographics and aligned to the new care models outlined in the Forward View. To address this, a national workforce strategy is needed to attract, train, retain and develop the talent it requires to succeed in the long term. This strategy should include consideration of remuneration, training, culture and career development.

We also need to embrace innovations in digital and other technologies, for example, implementing an electronic care record to facilitate access to information about patients wherever they seek care.

“The challenges are immense and the outcomes could be for better or worse”

1 million elderly don’t get basic care they need !

Pensioners struggling without help from family, neighbours or state.

Further cuts to care budgets will hit ageing population.

Charlie Cooper writes in The Independent regarding the country’s leading charity representing older people stating there is an ‘unacceptable level of care for 1 million elderly’ as figures reveal they now get no help at all for basic care.

Age UK said savage cuts to social care budgets under the Coalition, combined with a growing elderly population, has led to an “exponential” increase in the number of people left struggling alone.

For the first time, Age UK said, more than a million people in England have a care need – such as getting out of bed, going to the toilet, preparing food or taking medication – but receive no help from the state, self-funded care services, or from friends or family.

Elderly ManWhile the report’s findings relate to England, all parts of the UK are struggling to cope with a growing elderly population. In Scotland, care leaders last month proposed freezing NHS funding and transferring money to home care providers.

The charity said 1,004,000 people fall into this category – an increase of more than 100,000 in the past year.

The Government plans further cuts of £1.1bn to adult social care budgets for 2015/16. Care funding has already plunged by a third to £5.46bn in the past 10 years. Care leaders say it is “almost unendurable” on the frontline, where thousands of jobs have been lost and services scaled back.

The population of over 70s is set to hit nearly 7.9 million by 2020 in England alone – one million more than today. Last week, the Health Secretary, Jeremy Hunt, called for people to take greater responsibility to combat the “national shame” that one in 10 elderly people have contact with family less than once a month.

But Caroline Abrahams, director of Age UK, said that while culture change is needed, the “immediate problem” had been caused by the Governments cuts.  “To have to  struggle alone is unfair on these older people and also unacceptable in a civilised society,” she said.

Age UK – whose analysis is based on the English Longitudinal Study of Ageing by UCL, the University of Manchester, the Institute for Fiscal Studies and NatCen Social Research – also said annual emergency admissions to hospital for over-65s have risen by 400.,000 in a decade, suggesting cuts to social care may be increasing pressure on the NHS.

“The sinister disease that is destroying the basic needs of many sectors of our society continues unchecked. With an administration unmoved by criticism and literally having blood on their hands, any improvement is unlikely. Our World, eventually, is going to be a very bad place”