“The proportion of adult social care workers in England leaving their jobs has increased 7.6% over the five years to 2017-18, according to workforce figures.
Most of those leaving were new recruits, particularly people under 30 – with a turnover rate of 42.4% in the last financial year – according to the charity Skills for Care’s annual report, published today. …”
https://www.publicfinance.co.uk/news/2018/09/social-care-staff-turnover-rises
From last month:
“If you’re one of those poor saps who just wants the NHS to keep on running and stay away from privatisation, you may be surprised to hear that this is all just a little bit too ‘political’ for the South Devon and Torbay Clinical Commissioning Group.
Commissioning Groups are ‘clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area’. They were set up by the Tories in cahoots with the Lib Dems, reneging on the promise of no reorganising of the NHS.
Meanwhile, Devon is seeing hospitals close, bed disappear and services stretched. (There may well be something like a Hospital-Air-B&B type of arrangment in the offing, too.)
The Torbay and South Devon Trades Council have arranged a meeting at The Acorn Centre on August 23rd from 6.30pm to 830pm on ‘NHS Health and Social Care Can it Survive as a Public Service’.
NHS… not for health professionals
After seeing the five-point agenda (see below, 1 is an introduction, 4 and 5 are questions) the Clinical Commissioning Group for Torbay and South Devon decided that the topics are for politicians and not for health professionals.
This is despite them being ‘clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area’.
Hey ho.”
http://www.theprsd.co.uk/2018/08/14/nhs-meeting-deemed-too-political-for-south-devon-and-torbay-ccg/
Owl says: not to worry, it is too political for the DCC Health and Wellbeing Committee too, which rushes all CCG changes through at super-fast speed and on the nod from majority Tory block-voting councillors- too much politics obviously beeing too much for their (and our) pretty little heads.
Despite Independent Councillor Claire Wright and EDA Independent Councillor Martin Shaw really, really wanting a political (and ethical) debate.
“The number of secret reviews carried out by the Department for Work and Pensions (DWP) into deaths linked to benefit claims appears to have doubled in the last two years, according to figures the information watchdog has forced the government to release.
The figures relate to the number of internal process reviews (IPRs), investigations conducted by the department into deaths and other serious and complex cases that have been linked to DWP activity.
They show that, from April 2016 to June 2018, DWP panels carried out 50 IPRs, including 33 involving the death of a benefit claimant, or roughly 1.27 death-related IPRs a month.
DWP figures previously obtained by Disability News Service (DNS) show that, between October 2014 and January 2016, there were nine IPRs involving a death, or about 0.6 a month.
These figures are only approximate, because the information about IPRs (previously known as peer reviews) provided by DWP through freedom of information responses does not provide precise dates for when each of them took place.
But they do appear to show a clear and significant increase since early 2016 in the number of IPRs carried out following deaths linked by DWP to its own activity.
They also appear to show a return to the kind of frequency of reviews related to deaths of claimants that were seen between February 2012 and October 2014, when there were 49 such reviews at a rate of about 1.5 a month, at a time when research and repeated personal testimonies showed the coalition’s social security cuts and reforms were causing severe harm and distress to claimants.
The new figures also show that 19 of the deaths in the last two years involved a claimant viewed as “vulnerable”, while six of the IPRs (and four deaths) related to a claimant of the government’s new and much-criticised universal credit (see separate story).
John McArdle, co-founder of Black Triangle, said ministers “always get up at the despatch box and say they are continually improving the system. This proves that to be false.
“Universal credit should be scrapped, sanctions should be scrapped and the government should call off the dogs, because it is leading to people’s deaths.”
McArdle said that if there was a tragedy involving the deaths of 33 people in a train crash there would be an independent inquiry into what went wrong.
But because these deaths were happening in the social security system, he said, no such public inquiry would take place.
He added: “It just shows a callous disregard for the lives of the poorest and most vulnerable people in society.”
A DWP spokeswoman declined to say whether the figures showed that DWP’s treatment of vulnerable and other benefit claimants had not improved significantly since 2012 and had worsened in the last two years.
She also declined to say if DWP was concerned that there had already been four IPRs following the death of a universal credit claimant, even though only a small number of people are currently claiming UC. … “
“Council bosses in England say the “worst is yet to come” in cuts to services, as the government further reduces local authority funding.
The County Council Network predicts “unpalatable cutbacks” next year as the councils identify at least £1bn savings to plug a £1.5bn shortfall by 2020.
It also warns the risk of some councils stripping their services back to a minimum ‘core offer’ is growing.
The government said councils will get a real term funding increase in 2018-19.
It insists its approach strikes the right balance between relieving pressure on local government and ensuring taxpayers do not face excessive bills.
‘Cost-pressures’
But town hall bosses say local government funding from central government, through the revenue support grant, will have been cut by around 60% by 2020.
Cllr Paul Carter, chairman of the County Council Network and leader of Kent County Council said: “Counties will work hard to deliver the savings required, but the scope for making deliverable savings has dramatically reduced, and decisions for next year will be truly unpalatable if we are to fulfil our statutory duties.
“Without additional resource, the worst is yet to come.”
Some councils have reached a financial crunch point, such as Northampton – where £70m of savings are required by March.
And Somerset and East Sussex have had to rubber-stamp in-year funding cuts to keep to their 2018-19 budgets.
The County Council Network, which represents 36 larger authorities, surveyed its members about their budgets and what they planned to cut next year.
All 36 responded said they faced significant cost pressures, including a growth in demand in some areas – particularly children’s and adult social care, inflation and rising costs outside of their control.
The survey revealed council bosses had already ear-marked £1bn worth of services as potential sources of savings.
Some £685m of those are to balance the books going forward.
Twenty five councils who responded to a separate survey, set out what they were planning to cut, moderately or severely:
58% said highways and transport (including road improvements, streetlights, pothole filling)
47% said libraries
45% said early years and youth clubs.
44% ear-marked public health services like smoking cessation, sexual health, substance misuse
36% said children’s services.
Councils say they are expecting to have to switch funds from non-statutory services – the ones they are not obliged to provide by law – to ensure statutory services are provided.
Councillor Nick Rushton, CCN finance spokesman and leader of Leicestershire County Council, said authorities were in a “serious and extremely challenging financial position” and further cuts and rising costs would make a “bad situation even worse”.
“County councils across the country have no choice but to find a further £1bn of savings next year,” he said.
“There is not enough money today to run vital services. Next year there is even less from the drop in government funding.”
He added that councils were again at the point where council tax rises alone would not protect services.
Councillor Martin Hill, leader of Lincolnshire County Council, said his authority had to save £25m a year since 2010.
He said it would soon come to a point where the council would have to consider whether it can operate safely with regard to its responsibilities to vulnerable children and adults.
A Ministry of Housing, Communities & Local Government spokesman said local authorities were responsible for their own funding decisions, “but over the next two years, we are providing councils with £90.7bn to help them meet the needs of their residents”.
They said local councils would have the power to retain the growth in income from business rates and develop a system for the future.”“
“Ministers should allow American healthcare companies to compete with the NHS to run hospitals as part of a free-trade pact after Brexit, a think tank recommends.
The Initiative for Free Trade (IFT) said that Britain should also end its ban on imports of products such as chlorinated chicken and accept American environmental and food safety regulations as equivalent to those in the UK.
The moves, it claimed, would help clear the way for a UK-US trade deal that would “rewrite the rules” of global commerce and allow Britain to take advantage of trade freedoms offered by Brexit. The IFT has received backing from Liam Fox, the international trade secretary, and Boris Johnson.
The report, edited by Daniel Hannan, a Tory MEP, was partly written by the trade lawyer Shanker Singham who has been consulted on free trade by Dr Fox, David Davis, Steve Baker and other ministers since the referendum.
Its conclusions will fuel suspicions that the think tank is being used as an “outrider” to align Britain with America on standards to secure a trade deal that would not be possible if the government signs a Chequers-style agreement with the EU.
The report, which was published simultaneously in London and Washington, was a collaboration between the IFT and the libertarian US think tank the Cato Institute.
It calls for Britain and the US to negotiate the most ambitious agreement ever that would allow British and American companies to compete on a level playing field in each other’s markets across both goods and services. Both countries should accept each other’s regulations on safety and environmental standards and open up all government procurement contracts to both sides.
It also suggests that any British or American citizen should be able to work in both jurisdictions if they have secured a job. It is the group’s proposals to open up the NHS to competition that is likely to prove the most contentious.
Daniel Ikenson, one of the report’s editors, described the NHS as an “incumbent” healthcare provider that should have competition. “The purpose of liberalising trade is to expose incumbent businesses to competition, including healthcare providers,” he added.
A Department for International Trade spokesman said: “We are currently seeking a wide range of views about four potential free-trade agreements, including with the USA, and we encourage all interested organisations and members of the public to make their voices heard through our online consultations.”
Source: Times (pay wall)
“… people in the UK were more likely to die from a cold home than in a road traffic accident during the cold snap last winter a report found. …
… the particularly cold spell between February 28 and March 3, dubbed the beast from the east, also left thousands of households stranded without access to support. …
We heard frequent reports of vulnerable people being discharged from hospital to homes with no light or heat. This is despite national guidance to the contrary.”
National Energy Action, as quoted in Sunday Times (pay wall)
DCC Health and Wellbeing Scrutiny Committee- and particularly its chair Sarah Randall Johnson – take note:
“NHS campaigners meeting with MPs to call for better scrutiny and review to stop damaging cuts
Defend the NHS campaign groups from across England are to lobby MPs at a meeting in the House of Commons on Monday 10th September.
They will share their experiences of the need to improve the process of scrutiny and review of substantial changes to NHS services, in order to stop damaging cuts and changes.
The meeting is hosted by Paula Sherriff, MP for Dewsbury – where the District General Hospital has lost many of its key services.
Local campaign group, North Kirklees Support the NHS, will explain the risks this has created for the Dewsbury public.
Along with six other campaigns from Lincolnshire, West Yorkshire, Devon, Northumbria, Dorset and Oxfordshire, the Dewsbury group will tell MPs that there is an urgent need to address serious flaws in the process whereby Councils’ scrutiny committees refer proposals for damaging NHS cuts and changes to the Secretary of State for Health and the Independent Reconfiguration Panel.
Christine Hyde, from North Kirklees Support the NHS, said,
“The process of referral to the Secretary of State was opaque. The Independent Reconfiguration Panel is the key body with the power to advise the Secretary of State for Health to stop and/or require changes to major NHS cuts and “reconfigurations” – but there was next to no information about how it worked.
Once we had figured that out, we naively thought public opinion would have some weight. Together with the other five local NHS protector groups, we encouraged Independent Reconfiguration Panel members to visit Dewsbury.
We were ignored.
The Independent Reconfiguration Panel’s decision that local commissioners could sort out the failings in the hospital cuts proposals has not, for the most part, been borne out.
As the hospitals reconfiguration has been implemented, it has created huge problems for the most vulnerable groups – housebound patients, infants, children with disabilities and patients with life threatening illnesses like cancer.
The hospital changes were sold as being ‘better for patients’ but it really was all about the money and even so, the savings are recorded in a response to a Freedom of Information request as ‘nominal’.”
Campaigners will also demand political impartiality in the scrutiny and referral process.
The need for this is shown by Save Our Hospitals Devon’s observation of a discussion and decision by Devon County Council’s health and adult social care scrutiny committee, that reversed an earlier vote to refer the closure of community hospital beds in Eastern Devon to the Secretary of State.
Members of Save Our Hospitals Devon Netti Pearson and Sue Matthews said,
“The feeling among observers was certainly that the decision was a political one rather than one borne of effective and satisfactory scrutiny.”
Steven Carne from 999 Call for the NHS, the national campaign group which has convened the meeting, said,
“We are very excited about the campaign groups coming together from across the country to share their experiences of wrestling with the scrutiny and referral process.
This is key to stopping damaging NHS cuts, closures and inappropriate importation of insurance-based ‘care models’ from USA’s Medicare/Medicaid system. This provides a limited range of state-funded healthcare, on the basis of financial considerations – not clinical need, to people who can’t afford private health insurance. It is not what the NHS is about.
For the first time, campaign groups across England are pooling our knowledge and experience to lobby MPs to make this scrutiny and referrals process work better, because it definitely needs to.
And also to encourage other campaigns to get more actively involved with the process, in defence of NHS and social care services in their area.
The Department of Health guidance on health scrutiny says its primary aim is to strengthen the voice of local people in the commissioning and delivery of health services.
So it needs to make sure this happens.
This meeting is just a start. We are going to pursue this goal through thick and thin.”
“Almost 1,000 elderly people a day are being admitted to hospital needlessly amid a crisis in social care, Age UK has found.
Analysis of NHS figures by the charity found that there were 341,074 avoidable emergency admissions for people aged 65 and over during the year to April 2017.
The number has risen by 107 per cent since 2003 for those aged 65 to 69, and by 119 per cent for older people aged 75-79.
Among the general population of England, the number has risen by 63 per cent.
The figures relate to admissions because of conditions such as ear, nose or throat infections, kidney and urinary tract infections, and angina, for which hospitalisation could potentially have been avoided had the person been better looked after.
Many older people rely on family and friends to help them in the absence of reliable social care, the charity warned.
One in three over-65s live alone, and one in ten have no children, and these figures are expected to rise as younger generations, who are less likely to have married or had children, reach retirement age.
Many of those who do have loved ones to care for them rely on elderly relatives who may have health problems of their own.
One case study highlighted by the charity involved a 67-year-old woman who has been a carer for 40 years, first for her parents and more recently for a younger sister who has Alzheimer’s disease.
In another case a 73-year-old woman has been the sole carer for her 75-year-old husband since he had a stroke and brain haemorrhage four years earlier. She cancelled previous at-home care because it was “unreliable and lacking in continuity”.
Its report also highlights the problem of older people stuck in hospital and unable to go home, putting more strain on the healthcare system.
Care not being in place was the main reason there were delays for older people leaving hospital in England last year, according to figures released by the NHS. …”
The current cost to park at the Royal Devon and Exeter Hospital for staff, patients and visitors:
20 Minutes free parking.
£2.50 for up to two hours.
£4.50 for up to four hours.
£8.50 for all eight hours.
£26.00 for a weekly ticket.
“Older people in England who need long-term care have to pass one of the harshest means tests in the developed world to gain state support, a study found.
Older people and their families are more likely than their counterparts in many other countries to pay large care bills because of the way social care is funded. A generation of elderly people missed out on better long-term care as successive governments ducked reform, leaving England “the poor man of Europe” for social care, it said. England also fared badly when compared with Japan.
The report by Incisive Health, a consultancy, for Age UK looked at the funding and effectiveness of social care in developed countries with similar demographic challenges to England of an ageing population and falling birth rate. The government plans to publish reforms to England’s social care this autumn, while cash-strapped councils have cut the fees they pay for care, leaving many care homes struggling.
The study concluded that England’s social care system was behind Germany, Japan and France, whose governments define national entitlements, and Spain and Italy where services vary by region. These countries each provide some basic support to elderly people regardless of wealth, use a flexible means test or limit total costs. In England care costs must be met in full by anyone with assets above £23,250.
France had the most progressive social care system, funded by national insurance, Incisive Health concluded. Payments are collected as part of income tax with top-up payments from individuals using a gradual means test or the private insurance market.
Germany’s system was judged the best funded, paid for by an income tax levy of 2.55 per cent, of which half is paid by employers.
The study praised Japan for expanding support to its ageing population, with half the funding from general taxation and a third from an additional levy on people aged between 40 and 65. People are also required to pay 10 per cent of their care costs.
The authors said that social care in Spain, which is organised and funded regionally with some national taxation, had been good until its government made cuts when the economy stalled.
Italy has a highly localised system, with many areas paying cash directly to families but the report said that in poorer parts of southern Italy these payments were often used to supplement incomes rather than for care.
Caroline Abrahams, Age UK’s charity director, said: “Sadly, this report shows that England has been left behind in the race to update the funding of care for older people, compared to some other similar nations. As a result, our older people and their families are paying more and bearing a lot more of the risk of needing expensive long-term care.”
Source: Times, pay wall
Owl says: So much work so little money.
“More than four in five MPs want extra funding to be found for social care
A survey by the LGA has found that more than four in five MPs want extra funding to be found for adult social care. The poll of 150 MPs found that 84 per cent wanted extra funds for adult social care. The extra funding was backed by 79 per cent of Conservative MPs and 95 per cent of Labour MPs, while 76 per cent of peers called for extra funds. The LGA said extra funds were needed to rescue care services for older and disabled people from collapse. It warns there is a £3.5 billion funding gap facing adult social care by 2025, just to maintain existing standards of care. Cllr Izzi Seccombe, Chairman of the LGA’s Community Wellbeing Board, said: “Councils, care workers, health professionals and now even MPs and Peers agree that social care funding to councils must be increased. Work to find a long-term funding solution for adult social care and support has been kicked into the long grass by successive governments for the past two decades and has brought these services to breaking point. The Government cannot duck this issue any longer. It must make genuinely new resources available urgently to plug the short-term funding gap of £3.5 billion as well as set out its plans to secure the longer-term future.” Cllr Seccombe also called for a nationwide public debate about the future of care for all adults ahead of the Government’s green paper.
Sunday Telegraph p8
Deferred Payment Agreements
Around 4,800 homes have been entered into Deferred Payment Agreements (DPAs) to pay for their owners’ care fees, according to a Freedom of Information Act survey. It also found 14 councils have signed more than 100 DPAs in two years. An LGA spokesperson said: “We cannot duck this issue (of how to fund adult social care) any longer, which is why, following the Government’s postponement of its long-awaited green paper on adult social care, the LGA has published its own.”
Express p2
Children’s Commissioner calls for end to ‘battery-hen’ school holidays
The Children’s Commissioner for England, Anne Longfield, says urgent action is needed to stop children leading a “battery hen existence” during the school holidays that is damaging their mental health, contributing to violence and ensuring they return to school in worse health than when they left. She called for radical measures to restore the importance of play, such as overhauling play areas and parks.
Observer p1
School cash drive saves £100m
The Department for Education’s School Resource Management Strategy will reveal £106 million was saved in 2016/17 on equipment costs in schools. In one case, savings included £40,000 worth of unused equipment in a single school, which will be sold off.
Express p2
City mayors in joint call for urgent action to tackle air pollution
A total of 17 mayors and civic leaders have signed a letter calling on Theresa May to take immediate action to fight air pollution, which scientists estimate causes at least 40,000 premature deaths a year in the UK. They say the Government should pass a stringent clean air act that will give local authorities powers to regulate emissions such as those produced by taxis in cities.
Observer p11
Cuts in projects for migrants
A new study by the Institute for Public Policy Research says cuts to key programmes have undermined efforts to help migrants settle in communities. It found funding for integration efforts, aimed at local authorities with high levels of migration, had dropped by almost a third. There was also evidence that councils with the highest levels of migration had been disadvantaged the most, as their funding had not kept pace with population growth.
Observer p20
Bus companies betray our ailing high streets
Bus operators have been accused of making the high street crisis worse by reducing services into town and city centres across the UK. Councils and private contractors have blamed gridlocked roads and a reduction in passengers heading into high streets for running fewer buses on certain routes.
Express p10
Lib Dem leader prepares to quit
Sir Vince Cable is set to stand down as the Liberal Democrat leader before the next general election. He will announce he wants a change to party rules in an attempt to create a mass membership movement and allow a non-MP to take charge.
Sunday Times p1, Mail on Sunday p2, Sky News Online
EDDC’s CEO (rapidly approaching retirement age) was once heard to call the district’s retired people “unproductive” …
“Countries could economically benefit from people living longer and should invest more in health to raise life expectancy, a think-tank has urged.
The International Longevity Centre said that as people live longer productivity also increases, in terms of ‘output’ per hour worked, per worker, boosting the economy.
Improving health and ensuring that people live longer should therefore be a key goal for governments, the analysis, based on OECD figures from 35 countries [see graph below], said.
According to the analysis, Iceland, which has one of the healthiest populations in the world, has an employment rate of 83% for 60 to 64-year-olds. This compares to the OECD average of 48.9%.
Ben Franklin, assistant director for research and policy at the think-tank, said that as raising life expectancy results in improved productivity, countries will also be able to collect more taxes from the people in work.
He said: “Public policy and economic forecasters should consider how best to take into account the potential fiscal benefit of better health and not neglect it in discussions of our long run sustainability.”
The report said that the findings are particularly important amid “many debates about long run government spending” where health spending is seen as a “drain on fiscal resources”. …”
“The Court of Appeal has issued an order granting campaign group 999 Call for the NHS permission to appeal the ruling against their Judicial Review of the proposed payment mechanism in NHS England’s Accountable Care Organisation contract.
The Accountable Care Organisation Contract (now rebranded by NHS England as the Integrated Care Provider contract) proposes that healthcare providers are not paid per treatment, but by a ‘Whole Population Annual Payment’, which is a set amount for the provision of named services during a defined period. This, 999 Call for the NHS argues, unlawfully shifts the risk of there being an underestimate of patient numbers from the commissioner to the provider, and endangers service standards.
In April, the High Court ruled against the campaign group’s legal challenge to NHS England’s Accountable Care Organisation contract – but the group and their solicitors at Leigh Day and barristers at Landmark Chambers found the ruling so flawed that they immediately applied for permission to appeal.
Although fully aware of this, on Friday 3rd August – the day Parliament and the Courts went on holiday – NHS England started a public consultation on the Accountable Care Organisation contract – now renamed the Integrated Provider Organisation contract.
The consultation document asserts that the payment mechanism in the ACO/ICP contract is lawful, because:
“The High Court has now decided the two judicial reviews in NHS England’s favour.”
Steve Carne, speaking for 999 Call for the NHS, said
“It beggars belief that NHS England is consulting on a contract that may not even be lawful. And a lot of public funds is being spent on developing the ACO model – including on the public consultation. We are very pleased that 3 judges from the Court of Appeal will have time to consider the issues properly. We shall shortly issue our stage 5 Crowd Justice appeal for £18k to cover the costs of the Appeal.
We are so grateful to all the campaigners and members of the public who have made it possible for us to challenge the lawfulness of NHS England’s attempt to shoehorn the NHS into an imitation of the USA’s Medicare/Medicaid system.
We will not see our NHS reduced to limited state-funded health care for people who can’t afford private health insurance.”
Jo Land, one of the original Darlo Mums when 999 Call for the NHS led the People’s March for the NHS from Jarrow to London, added,
“All along we have been warning about the shrinkage of the NHS into a service that betrays the core principle of #NHS4All – a health service that provides the full range of appropriate health care to everyone with a clinical need for it, free at the point of use.
Since we first started work two years ago on bringing this judicial review, there have been more and more examples of restrictions and denials of NHS care, and the consequent growth of a two tier system – private for those who can afford it, and an increasingly limited NHS for the rest of us.”
Jenny Shepherd said
“NHS England’s rebranded Accountable Care Organisation contract consultation is a specious attempt to meet the requirement to consult on a significant change to NHS and social care services.
We don’t support the marketisation of the NHS that created the purchaser/provider split and requires contracts for the purchase and provision of services.
Integration of NHS and social care services, in order to provide a more straightforward process for patients with multiple ailments, is not aided by a system that essentially continues NHS fragmentation.
This new proposed contract is a complex lead provider contract that creates confusion over the respective roles of commissioner and provider. It requires multiple subcontracts that are likely to need constant wasteful renegotiation and change over the duration of the lead provider contract. This is just another form of fragmentation, waste and dysfunctionality.
The way to integrate the NHS and social care is through legislation to abolish the purchaser/provider split and contracting; put social care on the same footing as the NHS as a fully publicly funded and provided service that is free at the point of use; and remove the market and non-NHS bodies from the NHS.
Such legislation already exists in the shape of the NHS Reinstatement Bill.”
The campaign team say they are determined in renewing the fight to stop and reverse Accountable Care. Whether rebranded as Integrated Care or not, they see evidence that it is the same attempt to shoehorn the NHS into a limited role in a two tier healthcare system that feeds the interests of profiteering private companies.
Steven Carne emphasised,
“It is vital that we defend the core NHS principle of providing the full range of appropriate treatments to everyone with a clinical need for them.”
999 Call for the NHS hope the 2 day appeal in London will happen before the end of the year. The Appeal will consider all seven grounds laid out in the campaign group’s application – with capped costs.
Details on the first instance judgment can be found here:
http://www.landmarkchambers.co.uk/news.aspx?id=5630
and the judgment itself here:
http://www.bailii.org/ew/cases/EWHC/Admin/2018/1067.html
David Lock QC and Leon Glenister represent 999 Call for the NHS, instructed by Rowan Smith and Anna Dews at Leigh Day.
Owl says: Just one problem – in the whole glowing article the cost of these homes is never mentioned! You can be quite sure these homes will be out of reach for “ordinary” (ie not rich) people – rather like all other new housing.
“Traditional care homes will be increasingly replaced by luxury developments with spas, hairdressers and beauty salons in a bid to keep pensioners independent for longer, ministers say today.
The Government plans will see £76 million invested annually for the next three years in new homes specially designed for those who are frail, elderly or suffering from disabilities.
Health officials said the plans aim to keep people independent for longer – with their own front door, but more support on hand, with use of sensors and video monitoring to track the most vulnerable.
Housing developers will be able to bid for funds, from the programme which has already seen £315 million allocated to projects which design such homes. …”
Owl wonders what EDDC and DCC (and our Local Enterprise Partnership) have arranged for us.
“Councils around the UK have begun preparing for possible repercussions of various forms of Brexit, ranging from potential difficulties with farming and delivering services to concerns about civil unrest.
Planning documents gathered by Sky News via freedom of information requests show a number of councils are finding it difficult to plan because they are not clear about the path the government in pursuing.
The responses, from 30 councils around the UK, follow the publication of details of Kent council’s no-deal planning, which suggests thatparts of the M20 might have to be used as a lorry park to deal with port queues until at least 2023.
Bristol council’s documents flag up a potential “top-line threat” from “social unrest or disillusionment during/after negotiations as neither leave nor remain voters feel their concerns are being met”.
One of the fullest responses came from Pembrokeshire council, which released a Brexit risk register detailing 19 ways it believes leaving the EU could affect the area.
Eighteen are seen as negative, of which seven are deemed potentially high impact, including the “ready availability of vital supplies” such as food and medicines.
The one positive impact was that Brexit may drive people to move away from the UK, which could reduce demand on council services.
A number of councils, including East Sussex, are worried about the provision of social care after Brexit because of the potential fall in the number of EU nationals working in the sector.
According to Sky, East Sussex’s report says: “There has already been a fall in the number of EU nationals taking jobs in the care sector and the county council has great concerns that the end of freedom of movement will put further pressure on the sector that is already stretched and struggling to deliver the level of care required for our ageing elderly population.”
A number of councils have expressed concern about the disappearance of various EU funding streams and whether thethe Treasury would step in to replace them.
The local authority in the Shetlands released a document saying that tariffs on lamb exports under a no-deal Brexit would mean 86% of sheep farms could expect to make losses. The current figure is about 50%.
One common complaint, according to Sky, was frustration at the lack of central government information about which plan might be pursued. Wirral council said: “Given the lack of detail from government about any proposed deal or arrangements, it is difficult to carry out an assessment that is not purely speculative at this time.”
Owl says: But this was always the ambition of Conservatives who much prefer “the big society” (charities and volunteers providing services) and “the small state” (councils providing minimum services). We should not be surprised at that – it is what their voters vote for. But what we SHOULD be surprised at is that it is taking MORE of our money to achieve this, not less.
Labour councils are most pessimistic (83% believe this vill happen within 5 years), as they should be, as they are generally in poorer areas and/or the North where reliance on business rates (which will be the main source of council revenue with council tax) will be tricky, particularly in a post-Brexit economy. But Tory councils, even those in business rate-rich areas are also pessimistic (63%).
A sorry state of affairs to look forward to if this government remains in power: higher taxes, lower (rock bottom) services.
“Two-thirds of councils believe they will only be able to deliver minimum services required by law within five years.
The results of a survey by the New Local Government Network (NLGN) comes as Northamptonshire County Council voted through an action plan to cut services to the bone in order to tackle a likely budget deficit for this year of up to £60m–£70m.
NLGN’s second Leadership Index survey found that councils with social care responsibilities are the most pessimistic, with 88% indicating they will be unable to deliver discretionary services by 2023.
Adam Lent, director of the NLGN, said: “This should be a sober wake-up call for a government that is overseeing a country with ever deepening social divisions and growing inequality.
“Councils are best placed to tackle these problems, and should be receiving greater investment to do this, not seeing their services stripped to the bare minimum.”
Lent said areas stripped of libraries, park maintenance, pothole repairs and advice to residents on care, or housing, were likely to see a narrowing of opportunity for residents.
The survey was carried out from 7th June to 2nd July, with 191 council leaders, chief executives and mayors replying.
Labour-run councils are the most pessimistic with 83% predicting that discretionary services will disappear by 2023, compared to 63% of Conservative-run authorities.
Northamptonshire, on Thursday afternoon, approved an action plan that agreed “spending priorities”. These include safeguarding vulnerable children and adults. Also in the plan is a review of contracts with third party suppliers. Around 70% of Northamptonshire’s services are delivered through external suppliers.
Paul Carter, County Councils Network chairman and leader of Kent County Council, said: “It is clear that unless government finds a long-term solution to council funding and a fairer distribution of resources between authorities, other well-managed county councils could find themselves unable to balance the books.
“The new secretary of state for local government recognises the situation we face, but the Treasury needs to better understand the pressures we are under and support counties with short-term resources for the next financial year, ahead of a longer-term deal in the spending review.”
Northamptonshire will also review its external contracts, including Private Finance Initiative Schemes, as well as its capital programme.
Before the meeting, Andrew Lewer, Conservative MP for Northampton South, tweeted that the county council’s “problems are national as well as local”. He revealed he has written to communities secretary James Brokenshire and health secretary Matt Hancock to request a meeting about the authority’s position.
Pressure on the government to provide further assistance to Northamptonshire also came from Anne Longfield, children’s commissioner for England, who tweeted that her organisation was “writing to ministers asking for them to also ensure no vulnerable children are put at risk by cuts to services”.
It also emerged this week that East Sussex County Council last month agreed plans to reduce services to the bare minimum required by law.
Becky Shaw, chief executive, said: “Careful planning, efficiency savings, innovation, hard work and commitment to our four key priorities have enabled us to make the best use of our dwindling resources, but the pressure created by local residents’ needs cannot be met by income raised locally.
“Having transformed our services and saved £129m since 2010, we need to be realistic about what further budget cuts will mean for the residents, communities and businesses of East Sussex.
“Our core offer paints an honest picture of the minimum that we realistically need to provide in the future and we want to use this as the basis for discussion with the government, partner organisations and residents in East Sussex.”
The Times reported this week that the chancellor, Philip Hammond, has told non-protected departments, including the Ministry for Housing, Communities and Local Government, to earmark further cuts before next year’s spending review.
Some departments believe that these budgets could be cut by as much as 5%, according to the report.”
http://www.room151.co.uk/funding/councils-anticipate-cutting-services-to-legal-minimum/
” … According to a bombshell report in the British Medical Journal last year, austerity has been linked to 120,000 extra deaths since 2010. In practice, it suggested, that could lead to 100 early deaths every single day in the coming years. The impact is, predictably enough, felt by the poorest.
Remember when Theresa May stood on the steps of Downing Street in July 2016 and delivered her first speech as prime minister, promising to correct Britain’s “burning injustices”? One of these injustices was that those born poor die nine years earlier. And yet according to David Buck – an expert in health inequalities at the King’s Fund – the gap in health outcomes and life expectancy between the most affluent and the least well-off is only widening under her abysmal premiership.
What could possibly be causing this national disaster? Rule out alcohol use: it has been steadily falling, with the ONS finding in 2016 that alcohol consumption had fallen to its lowest rate since the survey began in 2005. There are fewer smokers in England than ever. As Dorling notes, there has not been a major influenza outbreak since the increase in life expectancy ground to a halt. Neither is it credible to suggest Britain has simply reached a plateau – that life expectancy cannot keep increasing for ever. “We are a long way off that,” as Professor Martin McKee has put it, observing that life expectancy in Japan and Scandinavian nations is higher.
Given the government is refusing a national inquiry into the great standstill in life expectancy, experts are left without a credible explanation other than austerity.
Consider specific policies. The NHS has suffered the longest squeeze in its funding as a share of the economy since it was founded after the war. Its annual increase in funding in the first four years of Tory-led rule was 1.3%, despite growing patient demand and increasing healthcare costs. Then there’s social care for the elderly: a devastating £6bn less spent since David Cameron entered Downing Street. As Dorling and Basten note, since 2010, many care homes – all too often a privately run racket – have closed; and cuts to social security, not least disability benefits, have undoubtedly played a role. There are other chilling factors at play, too. Until the financial crash, Britain’s suicide rate had been falling. Since then, experts believe there could have been an extra 1,000 deaths from suicide and an additional 30 to 40,000 attempts, with austerity playing a role.
This country and its people will be paying for the Tories’ ideologically driven disaster for years to come. Those children driven into poverty will have worse health and lowered educational opportunities as a consequence, undermining their potential, and with it the potential of the whole country. As living standards stagnate, a consumer debt bubble beckons, with potentially disastrous economic consequences. Public services and infrastructure will creak. But there is far more at stake.
Austerity is literally a matter of life and death. Unless it is stopped, lives will continue to be unnecessarily shortened. That Cameron and Osborne crow over a project that has caused so much misery is grotesque. Among the many injustices they have perpetrated, history must surely record the robbing of human life for ideological means.”
“A Conservative MP has said ministers need to urgently “learn the lessons” from the financial collapse of Tory-run Northamptonshire county council if they are to prevent more councils slipping into insolvency.
Andrew Lewer, the MP for Northamptonshire South, said that while mismanagement had fuelled the Northamptonshire crisis, the council was also a victim of underlying financial pressures affecting all local authorities with social care responsibilities.
Lewer’s comments will be seen as a breaking of ranks both with the government and with his six fellow Tory MPs in the county, who have up to now sought to present the council’s problems as unrelated to wider funding issues.
His intervention came as Northamptonshire county councillors prepare to take further steps towards drawing up a drastic cuts plan that they hope will close a £70m black hole in the accounts over the next few months.
Lewer has written to the secretary of state for housing, communities and local government, James Brokenshire, and the secretary of state for health and social care, Matt Hancock, to request a meeting to discuss the council funding crisis and ensure the wider lessons of Northamptonshire are heeded.
“A culture of poor performance and decision-making in Northamptonshire county council fuelled the current crisis, but there are bigger, national drivers that also have a significant bearing on the position of not only Northamptonshire, but other local authorities too,” said Lewer.
“Adult social care demand from a rapidly increasingly elderly population is the big elephant in the room. We need to have a discussion on how future local government is structured, financed and delivered, especially for this crucial and costly sector.”
Council social care bosses in England warned earlier this year that care services for older and disabled adults were on the brink of collapse because of funding pressures. The Local Government Association (LGA) estimates that adult social care faces a £3.5bn funding gap by 2025.
Lewer, who became an MP at the last general election, is a former leader of Derbyshire county council, and a vice-president of the LGA.
Northamptonshire councillors will discuss a proposed action plan which calls for “radical service reductions and efficiencies” in areas including children and adult social care, as well as a programme of staff redundancies, at a council meeting on Thursday morning.
Although it is anticipated no precise details of the cuts will be put forward at the meeting, councillors are expected to approve a “hierarchy of priorities” approach to the cuts which will see some services restricted to the legal minimum, and non-core services eliminated altogether.
Councillors will also vote to formally accept a section 114 letter from the council’s director of finance, published last month, which sets out in humiliating detail the extent of Northamptonshire’s financial problems, and the poor decision-making that led to it being declared technically bankrupt in February.
The meeting comes amid growing concern in local government circles that more councils – many of them Conservative-run – could follow Northamptonshire into draconian cuts to try to stave off huge budget shortfalls, with Somerset and Lancashire among those reporting financial stresses.
Last week it emerged that East Sussex county council was drawing up plans to move to a bare legal minimum level of services – which it called a “core offer” – to cope with a growing budget shortfall that if not addressed would see it bankrupt within three years.
A spokesperson for the LGA said: “More and more councils are struggling to balance their books and others are considering whether they have the funding to even deliver their statutory requirements.”
Owl says: anyone recallveing consulted about this? And surely, if it is for cost-sVing, all previous financial scenarios at the two CCGs must be recalculated. And shouldn’t this be rescrutinised by DCC?
“North East and West (NEW) Devon CCG is hoping to merge with South Devon and Torbay CCG in April next year. Both CCGs have expressed an interest to NHS England to merge the organisations, in what they say is the ‘next natural step’. In May last year, NEW Devon CCG refuted claims it had ‘gone bust’ – though it did have a defecit of £42million in 2016/17.
Last year (2017/18) NEW Devon CCG had a planned defecit just shy of £50million.
It is thought the merger would help both organisations face funding challenges in the years ahead; they have already made a saving of £4million working together in the last year. This has includinged merging the two executive teams and establishing a common governing body and committees.
Executive directors now sit in Devon-wide roles working across both CCGs.
Dr Sonja Manton, director of strategy at the two CCGs in Devon, said: “We have made significant progress working as a health and care system in Devon over the past two years.
“As commissioners (buyer) of health care services for our local population, our two CCGs have worked more closely together for over a year, and this has brought many improvements and benefits such as speeding up decision making and making cost savings and efficiencies of nearly £4million on running costs.
“We have achieved much more together than we would have working separately. “A merger of our two organisations is the natural next step, and we have expressed an interest to NHS England to merge our two organisations from April 2019. “We are working with staff, clinicians, partners and stakeholders to ensure that everyone is involved in the changes as they develop. “This is an important step in our journey to better integrate health and care services to benefit our local communities.
“In Devon, we have well-established joint working arrangements with our local government partners and this will be strengthened as we design a new more integrated approach.”
https://www.northdevongazette.co.uk/news/proposals-to-merge-two-devon-ccgs-1-5642433
“Virgin has been awarded almost £2bn worth of NHS contracts over the past five years as Richard Branson’s company has quietly become one of the UK’s leading healthcare providers, Guardian analysis has found.
In one year alone, the company’s health arm, Virgin Care, won deals potentially worth £1bn to provide services around England, making it the biggest winner among private companies bidding for NHS work over the period.
The company and its subsidiaries now hold at least 400 contracts across the public sector – ranging from healthcare in prisons to school immunisation programmes and dementia care for the elderly.
This aggressive expansion into the public sector means that around a third of the turnover for Virgin’s UK companies now appear to be from government contracts. …
Sara Gorton, the head of health at the trade union Unison, said: “The company has been so keen to get a foothold in healthcare, it’s even been prepared to go to court to win contracts, moves that have cost the NHS dearly.
“While the NHS remains dangerously short of funds, taxpayers’ money shouldn’t be wasted on these dangerous experiments in privatisation.”
One former surgery manager who spoke to the Guardian said Virgin appeared to be paid more for doing less in her area, although the company said “because the contracts are generally not directly comparable, we don’t believe it to be true”.
Guardian analysis reveals the way the company that began selling records in the early 1970s has diversified in a bewildering way over recent years. …
In March 2017, it had almost 1,200 staff – a five-old increase from the year before. Over the same period, its turnover increased from £133m to £204m and its operating profit rose from £7.3m to £8m.
Though healthcare is a growing part of the group, Virgin still appears to make most of its money from transport.
Virgin UK Holdings, the UK business which holds its rail and healthcare ventures, reported revenues of £1.5bn in 2016 and paid £22m in tax.
Earlier this year, Virgin Trains had its west coast line franchise extended for another year. …
Paul Evans, the director of the campaign group NHS Support Federation, said: “Virgin Care are the biggest private sector winner to emerge out of the NHS experiment with competition and outsourcing.
“We don’t know the final shape of it, but players like Virgin and Care UK clearly see a big opportunities for business to continue to deliver clinical services for the NHS.”
East Devon Watch 