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4 Aug 2018

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Accountability, Austerity cuts, DCC, Health and Social Care (local)

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How will DCC deal with this judgment on special needs and disability funding?

Has DCC done the same as Bristol? It appears so to this layperson.

If so, what next?

“A rolled-up hearing took place on Tuesday, July 24th at Bristol Civil Justice Centre to challenge Bristol City Council’s decision to reduce special educational needs and disabilities (SEND) spending by £5m in the local area.

Represented by Simpson Millar’s Public Law and Education Team two families affected brought the legal action amidst ‘significant concerns’ that the council’s decision was unlawful. The Judgment has been handed down and the Court has concluded that the decision making process, completed by Bristol City Council was legally flawed.

Simpson Millar Partner and education law specialist, Samantha Hale commented:

“We had significant concerns that the council did not follow the appropriate procedures and legislation in making these reductions, and did not properly consult those likely to be impacted. The decision shows that the Court shared our concerns, finding in favour of the two families who brought this claim”.

“The Court concluded that the process completed by Bristol City Council before reaching its decision was flawed. Furthermore, the Court confirmed they were unable to determine what the outcome would have been in the absence of the legal errors. The Judge held that “full funding might have been allocated’”.

“Bristol City Council will now have to reconsider its funding allocation to the High Needs Block budget and to do so in a lawful way, as the Court has confirmed that the High Needs Budget will be quashed. This is a very important recognition that while Local Authorities may have to cut budgets, they may only do it, if it is done lawfully”.

“Our clients hope that Bristol City Council will recognise the serious concerns about SEN services and outcomes reflected in the Judgment when taking the new funding decision”.”

https://www.simpsonmillar.co.uk/news/decision-to-reduce-special-educational-needs-and-disabilities-send-spending-by-5m-5431

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Posted on

3 Aug 2018

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Accountability, Austerity cuts, Health and Social Care (local), Local Government Finance

Another (Tory) council bites the dust …

“Fresh evidence of the funding crisis facing local government has emerged after a second Tory-run council said it was preparing to cut back services to the bare legal minimum to cope with a cash shortfall that could leave it bankrupt within three years.

East Sussex county council said growing financial pressures and rising demand for social care were forcing it to restrict services to the most vulnerable residents only. Under this “core offer”, many of its services will be severely cut or shut down completely.

It said families and neighbourhood voluntary groups would have to take increasing responsibility for supporting those older people who would no longer qualify for social care support from the council under the new arrangements.

Northamptonshire council plans cuts to all services and workforce
East Sussex’s outline of its strategic approach, revealed in a council paper last month, appears to have been adopted wholesale by Tory-run Northamptonshire county council, which this week adopted an emergency cuts plan to reduce services to skeleton levels as it attempts to close a £70m black hole in its budget during the next few months.

Northamptonshire’s financial collapse has been portrayed by ministers as being down to chronic mismanagement rather than lack of government funding. However, East Sussex is regarded as a stable and well-run council, giving authority and credibility to its shock warnings of the consequences of underfunding.

East Sussex said that without more government funding, stripping services back to a core offer would be the best it could afford to deliver, although it added that without a sea change in local authority finances even this most basic model of municipal service might be unaffordable by 2021. …”

https://www.theguardian.com/society/2018/aug/03/local-council-funding-crisis-east-sussex-cuts-services

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Posted on

2 Aug 2018

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Accountability, Austerity cuts, Health and Social Care (local), Inequality, Local Government Finance, Scrutiny

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“Northamptonshire’s financial woes are just the tip of the iceberg”

“… All councils in Britain are required to match annual day-to-day spending with income: unlike the Treasury, local authorities cannot fund current spending from borrowing. They can, of course, borrow to spend on capital items such as land and buildings. Northamptonshire’s difficulties derive largely from a failure by councillors to address the need to match spending to income. But the wider context of relentless reductions to council spending cannot be ignored.

The Treasury has been attempting to reduce the UK government’s deficit since the coalition took office in 2010. But populist pressure to protect state pensions and the NHS, along with decisions to increase international development spending, have meant that the burden of lowering the deficit has fallen on unloved sectors and services, notably provision within the oversight of the Home Office and the Ministry of Housing, Communities and Local Government. Grants to councils in England fell by almost 50% between 2010-11 and 2017-18, and spending in real terms has tumbled by almost 30% on average.

Councils themselves, within falling budgets, have chosen to protect social care for children and adults. No chief executive or leader wants to face the dire consequences of even a single childcare failure, so money has (just about) continued to reach children’s social services. For older people’s care, the picture has been grim. Entitlements have been reduced and services cut back. Fast-rising numbers of over-75s mean that demand is growing while resources shrink.

Even the government came to realise that with rising demand and falling real resources, adult social care was unsustainable. It is a measure of overall government priorities that between 2010-11 and 2017-18 the amount spent on state pensions in the UK rose by £26bn, while spending on adult social care in England was virtually unchanged in cash terms. Only after it became clear that care homes were closing and that services were likely to fail did ministers allow councils to put up council tax and provide new grant funding via the Better Care Fund.

Other local services such as libraries, planning, highways, housing and waste management have been cut by far more than adult care. Almost by default, the way deficit reduction has been delivered has led to a retreat in the very public services that were the origins of the modern developed British state. While Victorians saw the need for clean streets, lighting, police, parks, libraries, rubbish collection and transport, the impact of post-2010 deficit reduction has been to cut such services hardest.

The abolition of the audit commission has ensured that there has been no official agency to publish embarrassing reports about the impact of cuts on councils’ financial health or, even more awkwardly for Whitehall, on the asymmetric nature of the government’s approach to achieving a zero deficit. The National Audit Office, which, crucially, reports to parliament, has undertaken noble work on the broader systemic challenge to local authorities’ financial sustainability. In a report published in March, the NAO noted that “10.6% of single-tier and county authorities would have the equivalent of less than three years’ reserves … left if they continued to use their reserves at the rate they did in 2016-17”.

In short, many of the larger councils that deliver social care are running short of resources. There have been recent press reports that in the coming spending review, covering the period 2020-21 to 2023-24, local government will again be expected to bear the brunt of deficit reduction. It is worth remembering that a zero deficit was originally planned to be achieved by 2015-16. Northamptonshire may have reached the precipice first, but if reductions in local authority budgets continue, they are unlikely to be the last. The county’s plight is evidence of a wider challenge facing the country: are we willing to put up taxes to protect provision or do we want the state to stop delivering services? A crunch point is approaching.”

https://www.theguardian.com/commentisfree/2018/aug/02/northamptonshire-finances-services-tax-rises

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1 Aug 2018

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Accountability, Austerity cuts, Health and Social Care (local), Local Government Finance

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[Tory] “Northamptonshire forced to pay the price of a reckless half-decade”

“Northamptonshire county council’s catastrophic financial collapse, and the desperate measures it now proposes to balance the books, reflect management incompetence on a grand scale as well as the punishing effects of eight years of austerity cuts.

Less than six months after it was declared technically insolvent, the Tory-run council now faces a sobering reckoning for a reckless half-decade in which it refused to raise council tax to pay for the soaring costs of social care, preferring to patch up budget holes with accounting ruses and inappropriate use of financial reserves.

Over the next few weeks the council will map out where previously unheard-of levels of cuts will fall. There are no concrete details yet, other than a promise that its future “core offer” to residents will be a bare legal minimum of service, focused only on the most vulnerable residents.

No services will go unscathed, even in priority areas like child protection that have up to now been relatively insulated. There are no easy cuts left to make: the council says hard savings must be dug out of the most essential services. What will remain is what one observer wryly called “a people-not-dying level of service”. …

… Once a low-tax Tory flagship council, touting itself as the future of local government, Northamptonshire is now bust. Its core offer warns residents, with unwitting pathos, that the most they can expect in future is “a reasonable level of customer service, within our means.”

http://flip.it/wGO8K0

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31 Jul 2018

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Accountability, Accountable Care Organisation, Health and Social Care (local), Local Government Finance, NHS (local)

Local Government Association debates tax rise to fund social care

“One of the many downsides of Brexit is that for the last two years or more it has sucked all the energy out of the Westminster policy making process, with the result that other problems are being ignored. It is a major opportunity cost. There are plenty of examples, but adult social care is probably the most glaring. Experts agree the situation is in crisis. The Conservatives floated some audacious plans in their manifesto, but they proved electorally toxic and since then they have gone silent on the topic, putting off announcements until the much-delayed green paper due later this year. Labour’s own plans are sketchy and, understandably, they are reluctant to propose reforms that will involve higher when the government won’t take the initiative itself.

So all credit to the cross-party Local Government Association that is today floating plans in a green paper (pdf) to raise taxes to put care funding on a sustainable footing. With councils in England receiving almost 5,000 new requests a day for adult social care, the LGA says this is essential.

Since 2010 councils have had to bridge a £6bn funding shortfall just to keep the adult social care system going. In addition the LGA estimates that adult social care services face a £3.5bn funding gap by 2025, just to maintain existing standards of care, while latest figures show that councils in England receive 1.8m new requests for adult social care a year – the equivalent of nearly 5,000 a day.

Decades of failures to find a sustainable solution to how to pay for adult social care for the long-term, and the Government’s recent decision to delay its long-awaited green paper on the issue until the autumn, has prompted council leaders to take action.

Short-term cash injections have not prevented care providers reluctantly closing their operations or returning contracts to councils and less choice and availability to a rising number of people with care needs. This is increasing the strain on an already-overstretched workforce and unpaid carers, and leading to more people not having their care needs met.

Increased spend on adult social care – which now accounts for nearly 40 per cent of total council budgets – is threatening the future of other vital council services, such as parks, leisure centres and libraries, which help to keep people well and from needing care and support and hospital treatment.

The LGA is publishing its green paper to start a public debate on how adult social care could be properly funded. There’s a summary here:

https://www.local.gov.uk/about/news/lga-launches-own-green-paper-adult-social-care-reaches-breaking-point

Source: https://www.theguardian.com/politics/blog/live/2018/jul/31/council-leaders-float-plans-to-raise-income-tax-or-other-taxes-to-fund-adult-social-care-politics-live

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29 Jul 2018

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Accountability, Accountable Care Organisation, Austerity cuts, Consultation, DCC, Health and Social Care (local), Integrated Care Systems, NHS (local), Transparency

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Very important case law on consultation

This has great relevance to NHS consultations, the wording of consultation comments, the treatment of those comments and the duties and respinsibility of the DCC Health and Wellbeing Scrutiny Committee to scrutinise evidence presented.

It is going to be much easier to challenge flawed consultations.

Those involved in these matters MUST read the full document (see source at end of post. Only a couple of the relevant sections are published here but should be read with the whole document.

“… “Commentary on
R (ex parte Kohler) v The Mayor’s Office for Policing and Crime
[2018] EWHC 1881

This Briefing Note considers the judgment handed down by Lord Justice Lindblom and Mr Justice Lewis on 20th July 2018. It details the circumstances of the case, its wider context and, in particular discusses practical issues which will be of concern to consultation practitioners.

Background

In common with other police forces, the Metropolitan Police has needed to make huge savings in its budget. Unsurprisingly it has led to a review of what premises they occupy and whether they still need over-the-counter services at their police stations.

In July 2017, the Mayor’s Office for Policing and Crime (MOPAC) published a Public Access and Engagement Strategy, a dual-purpose document simultaneously consulting the public about the future direction of public engagement on policing and seeking views on proposals to close or ‘swap’ 37 police counters.

The consultation was heavily criticised, and at the Institute, we published a detailed critique under the provocative title Is this the worst consultation of 2017?

https://www.consultationinstitute.org/worst-consultation-2017/

Some of the complaints were heeded and a revised set of questions emerged three weeks after its original launch.

The legal challenge

Professor Paul Kohler lives in Wimbledon and in 2014, was subjected to a serious assault. He believes his life was possibly saved only thanks to the prompt response by police from Wimbledon Police Station.

The MOPAC proposal included a provision for that facility to be transferred elsewhere in the London Borough of Merton – to Mitcham, so that the site at Wimbledon could be sold and generate capital receipts. These in turn, according to the consultation document, would help the Met Police fund technology improvements needed to support the case for changing public access and reduce the traditional reliance on police counters. …

The Kohler case spells an end to the practice of sending decision-makers a summary report (or an unreadable tome) with a message ‘Don’t worry, there’s nothing here to stop you from going ahead!’. If a failure to consider a specific argument can spell illegality following a consultation, someone somewhere has to decide what might constitute such an argument. Who can be trusted to decide?

The Consultation Institute View [on the case]

• The Kohler case is a game-changer, placing the Gunning Four Principle of ‘conscientious consideration ‘ at centre stage. There have been few comparable cases, as flawed consultations have, in the past failed the pre-determination or the sufficient information tests. It remains to be seen if the judgment opens the door to more claims that decision-makers never properly studied consultee submissions. It could happen!

• One consequence is that campaigners and other smart stakeholders will structure their comments to ensure that they cannot easily be summarised, and may specifically seek assurances that their submissions will have been read by decision-makers.

• To respond to such pressures and to safeguard themselves, consultors will need to look again at their data analysis practices, possibly strengthening the independent element both in analysis and in reporting to decision-makers. They will also need to be better at political risk assessments. Independent Quality Assurance becomes even more attractive for controversial consultations.

• The case for Public consultation hearings is further strengthened, as decision-makers will be able to prove that they heard and understood particular arguments. …”

Full document here:

Click to access briefingnote21-mopac.pdf

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22 Jul 2018

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Accountability, Accountable Care Organisation, Austerity cuts, Health and Social Care (local), NHS (local), Seaton/ Colyford / Colyton

Seaton fights for Axe Valley health care

Owl says: good to see the deprived eastern side of East Devon banding together to fight for its (similarly deprived) health services.

“Priorities identified for Axe Valley healthcare provision

“A ten point plan to safeguard healthcare provision across the Axe Valley has been drawn up.

The list of priorities has been agreed following a series of meetings between representatives from statutory and voluntary health groups along with local councillors.

Following the workshops, organised by Seaton Area Health Matters group, 10 priorities have emerged:

* To take an area approach for the Axe Valley, not just Seaton.

* Improving communication and co-ordination between voluntary organisations.

* Maintaining and extending NHS services in GP practices and at Seaton Hospital.

* The challenges in older age groups (chronic diseases, loneliness and isolation).

* The challenges in younger age groups (drug and alcohol addiction, housing, poverty).

* Mental health support.

* Transport difficulties to access services.

* Promoting health and wellbeing

* Communication on what is available.

* Co-ordination and ownership to tackle the challenges.

To look at these challenges a steering group has been established under the chairmanship of Seaton town councillor Jack Rowland.

A Terms of Reference was agreed at the last meeting on July 12 and two initial working parties have been established to work on the priorities and report back on progress at the September 6 meeting of the steering group.

A website and Facebook page will also be set up to communicate what is happening and enable people to contribute their views and receive answers, where appropriate.

Explained Cllr Rowland: “The working parties will utilise the experience and knowledge of whoever they need to as part of producing recommendations for approval by the Seaton Area Health Matters Steering Group and then potential approval and support from the Clinical Commissioning Group (CCG) and the Royal Devon and Exeter Trust (RDE).

The next meetings of the Seaton Area Health Matters group are:

Thursday, September 13, at
2pm

and

Thursday, December 13, at 2pm

both at the Marshlands Centre, Harbour Road, Seaton.

Anyone who has an interest in healthcare in the Axe Valley is welcome to attend.

Representatives from groups involved in health, care and wellbeing are actively invited to become members of Seaton Area Health Matters by attending the meetings.

Other members of the steering group are: Cllr Geoff Pook (vice chair), Cllr Marcus Hartnell, Victoria Parry (Healthy eating charity and Clinical Commissioning Group community representative), Cllr Martin Shaw, Roger Trapani (CCG community representative) Tina Trapani (Devon Senior Voice representative), Dr Mark Welland (Seaton GP and chairman of Seaton and District Hospital League of Friends).”

http://www.midweekherald.co.uk/news/group-identifies-patients-needs-1-5616100

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20 Jul 2018

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Accountability, Austerity cuts, Health and Social Care (local)

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Beware the employer suddenly interested in your “wellbeing”

Comment on Guardian article, pertinent to the current situation of less people doing more work.

“At my last job, there was a sudden uptick in the company’s interest in things like sleeping patterns and mental health. Obviously the more switched-on people reacted with mounting worry (what were they about to do to us?), but it got really sinister when we were introduced to an online system which could help us ‘keep track’ of our fitness and stress management regimes. Not, of course, compulsory (they don’t dare go that far yet) but it was framed as an amazing indication of how much the company cared about us.

I recall asking the person who was taking us through this exactly who was keeping hold of this very intimate personal data, where it went and what was done with it (some of the fine print suggested outsourcing) – they could not give me an answer to that and seemed uncomfortable that it had been asked, which was a dead giveaway. Needless to say, before I left the corporate clouds were gathering – job responsibility creep had started, people were getting looked at askance for not having picked up an email over the weekend, the cottage industry in oversight was the only one expanding…

Never, ever forget that your relationship with your employer is purely transactional. They are renting your time , labour and expertise and you owe them nothing more than what you have mutually contractually agreed to. Don’t let them put themselves in any other relationship to you than that – they are not your friend, they are not your parent and they are certainly not anyone who has any business being interested in your inner life. That’s the way to avoid job stress.”

https://www.theguardian.com/commentisfree/2018/jul/20/wellbeing-buzzword-employers-mental-health

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12 Jul 2018

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Accountability, Accountable Care Organisation, Austerity cuts, Claire Wright, DCC, Health and Social Care (local), Integrated Care Systems, NHS (local), Scrutiny

Claire Wright concerned about unpaid carers – asks for them to contact her

Could you imagine Swire being concerned about this – concerned, not just anodyne words.

“Some of Devon County Council’s Health and Adult Care Scrutiny Committee will visit Westbank League of Friends to hear from staff who support unpaid carers, later this month, following my proposal for a spotlight review into how unpaid carers who look after friends and family members are faring.

I have seen a confidential report of a focus group meeting that took place last year, which indicates that the 24 people in Devon who took part, are suffering from a lack of support, a lack of money and a lack of respite care….. many reported that their mental and physical health was suffering as a result.

I asked for the (anonymised) report to be published with the June health scrutiny papers, but this was refused as the focus group report was not ever intended to be made public and consent had not been given. Instead a rather more neutral version of the report was published, but as I told the committee, this did not reflect the original report and I don’t believe people’s voices have been heard.

The media reports today that unpaid carers save the economy a massive £60bn a year – https://www.bbc.co.uk/news/uk-40560827 – here’s the BBC story on the subject.

Anecdotally, my conversations with local people 100 per cent support the findings from Devon County Council’s focus group. Many unpaid carers are at their wits end.

I did propose a spotlight review into how unpaid carers are faring but this was not voted on unfortunately. There didn’t seem support from around the room. However, the issue will return to the agenda in September and I will pursue it then.

If you are an unpaid carer and wish to get in touch I would be very pleased to hear from you.

Email me at claire@claire-wright.org

http://www.claire-wright.org/index.php/post/unpaid_carers_are_they_getting_the_support_they_need

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9 Jul 2018

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Accountability, Accountable Care Organisation, Austerity cuts, Health and Social Care (local), Integrated Care Systems, NHS (local)

NHS bed blocking costs £550 per MINUTE says charity

“Bed blocking because of a lack of social care availability is costing the NHS an “eye-watering” £550 per minute, according to research by a charity released today. This equates to £290m a year, Age UK has estimated.

Analysis by the charity also showed that in just two years, the number of older people in England living with an unmet care need has risen by 19%, which translates to 1.4 million over 65s living with unmet care needs

More than 300,000 need help with three or more essential daily tasks like getting out of bed, going to the toilet or getting dressed, the charity found, and of this 165,000 receive no help whatsoever from paid carers, family members or friends.

Caroline Abrahams, Age UK’s charity director, said: “The numbers of delayed discharges to a lack of social care are actually going down, but a lack of social care still costs the NHS an eye-watering £500 every minute – not to mention undermining the chances of older people making a full recovery if they are unnecessarily stuck in hospital for weeks or longer.”

Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said: “People’s unmet care needs will continue to increase and deepen the crisis in adult social care unless the sector receives a long-term funding settlement, like the NHS, and further funding is made available for council’s public health and prevention services.

“To prevent crises in the NHS, government needs to plug the £3.5bn funding gap facing adult social care by 2025 and reverse the £600m in reductions to councils’ public health grants between 2015-16 and 2019-20.”

Age UK noted that between 2009-10 and 2016-17 spending on adult social care in England fell by 8% in real terms. As a result, in the same period, the average spend per adult on social care fell by 13%, from £430 to £379.

Alex Khaldi, head of social care insights at Grant Thornton, said: “Funding is not the only answer, councils need to focus on monitoring the level of unmet need in their areas more effectively. “If we are to exercise place-based leadership in social care, better data insight that allows councils to identify where and why people have fallen between the cracks is urgently needed.”

The LGA has announced that it would be publishing its own adult social care green paper, after Jeremy Hunt announced the government green paper would be delayed until autumn.

A Department of Health and Social Care spokesperson said: “We expect the NHS to work closely with local authorities to ensure people are treated in the most suitable setting and when they are discharged from hospital they have a care plan in place.”

https://www.publicfinance.co.uk/news/2018/07/bed-blocking-costing-nhs-ps550-minute

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8 Jul 2018

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Austerity cuts, Health and Social Care (local), Inequality, NHS (local)

“Fears of future strain on NHS as councils slash health programmes”

“Hospitals will bear the brunt of “incredibly shortsighted” cuts to public health initiatives that will lead to more people having a heart attack or getting cancer, experts are warning.

New research reveals that, by next year, spending per head in England on programmes to tackle smoking, poor diet and alcohol abuse will have fallen by 23.5% over five years.

Key services, including those to help people quit smoking, manage their sexual health or stay off drugs, are among those being subjected to the deepest cuts, according to analysis by the Health Foundation thinktank.

The public health grant that the Department of Health and Social Care (DHSC) gives to local councils in England, which is not covered by the cash injection, is due to fall from £2.44bn this year to £2.27bn in 2019-20. It will be the fifth year in a row it has been cut since its peak of £2.86bn in 2014-15.

By next year, councils will be spending £95m on smoking and tobacco-control services, 45% less than they were in 2014-15. The next biggest cuts over that period will have occurred in drug and alcohol services for under-18s, down by 41% to £40m, and the equivalent services for adults, which will have fallen by 26% over those five years. Sexual health services will also be getting 25% less.

“There’s a massive gap between the government’s rhetoric on public health and prevention and the reality,” said Tim Elwell-Sutton of the Health Foundation. “NHS England’s Five Year Forward View talked about ‘a radical upgrade in prevention’ while in her recent speech about the NHS the prime minister said ministers would support public health. But we are seeing significant cuts to public health budgets. It is incredibly shortsighted not to invest in keeping people well. We are storing up problems for our health and also for the NHS, which is already under huge pressure. It could become increasingly unsustainable as more and more people with preventable illnesses will need long-term healthcare.

“We’re crazy if we’re not taking seriously the underlying cause of one of the most harmful illnesses – cancer – which is also one of the most expensive to treat,” said Elwell-Sutton. Although smoking rates are falling, the habit leads to almost 500,000 hospitalisations a year and is a major cause of strokes, heart problems and life-threatening respiratory conditions.

Shirley Cramer, chief executive of the Royal Society for Public Health, accused ministers of “confused thinking” over health. “These figures demonstrate a frustrating contradiction from the government, whereby welcome extra money is given to the NHS with one hand, while the other generates more strain on NHS services by draining public health and prevention.”

Conservative-controlled Warwickshire county council is the local authority where the public health grant has been cut the most – by 39%, or £40 a head – since 2014-15. Other councils which have seen their budgets shrink by substantial amounts include Knowsley in Merseyside (38%) and Wokingham in Berkshire (38%). Five councils have seen their budget rise, including Shropshire (up 17.4%) and Warrington (up 11%).

Cramer voiced concern that two of the councils which have seen their public health grant cut the most, Knowsley and Tameside in Manchester, are also among the 10 areas with the highest rate of people being admitted to hospital because of poisoning by drugs, and three others are in the top 40.

The Department of Health and Social Care said: “We have a strong track record on public health – smoking levels are at an all-time low, rates of drug misuse are lower than 10 years ago, and drug addiction treatment services remain free for all with minimal waiting times. Local authorities are best placed to make choices for their community, which is why we are investing more than £16bn in local government public health services over the current spending period.””

https://www.theguardian.com/society/2018/jul/08/fears-of-future-strain-on-nhs-as-councils-slash-health-programmes

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3 Jul 2018

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Accountability, Asset sweating, Austerity cuts, Council tax, Health and Social Care (local)

“Council cuts are putting the vulnerable at risk, Tory peer says”

“LGA chief says austerity could damage local authorities ‘beyond recognition’

Local authorities have reached the point where relentless financial cutbacks are putting the wellbeing of vulnerable adults and children at risk, the Conservative leader of the Local Government Association (LGA) has warned.

The Tory peer Lord Porter said that after eight years of austerity during which £16bn has been stripped from municipal budgets in England, councils risked being “damaged beyond recognition” and communities depleted of vital services.

An £8bn black hole in council budgets would open up by 2023 unless ministers stepped in to close the gap between spiralling demand for adult and children’s social care services and shrinking town hall incomes, he said.

“We’ve reached a point where councils will no longer be able to support our residents as they expect, including our most vulnerable,” Porter added.

As well as problems coping with demand for services for elderly and disabled adults, the LGA says councils are struggling with an explosion in the number of children in care, and a rising bill for 80,000 homeless families placed in temporary housing.

An LGA briefing on the prospects for local government states: “The failure to properly fund these services puts the wellbeing of some of the most vulnerable residents at risk, and this cannot go on.”

Porter’s intervention, ahead of the LGA annual conference, which opens in Birmingham on Tuesday, reflects councils’ increasing concern about the precariousness of local authority finances, and frustration that ministers are ignoring the escalating crisis in social care.

While the NHS last month received a five-year £20bn cash injection, the government’s plans to overhaul the funding of adult social care services, originally due in a green paper before the summer, were delayed until the autumn. Council bosses have warned that in many areas these services are on the verge of collapse.

The fragility of many individual councils’ finances has increased speculation that more local authorities could follow Northamptonshire county council into bankruptcy. In May, Tory-controlled Somerset called for an overhaul of council funding after it was warned by auditors it could go bust.

Council leaders are also worried about the political consequences of having to sacrifice popular local services such as libraries, Sure Start centres, parks and leisure centres to divert funds into core services such as social care.

Bus services in ‘crisis’ as councils cut funding, campaigners warn
Porter said: “Councils now spend less on early intervention, support for the voluntary sector has been reduced, rural bus services have been scaled back, libraries have been closed and other services have also taken a hit. 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.

“If the government allows the funding gap facing councils and local services to reach almost £8bn by the middle of the next decade, then our councils and local services will be damaged beyond recognition.”

The LGA is calling for councils’ funding problems to be addressed through a government spending review expected in spring 2019, which is likely to set out public services funding plans over the four years to 2023.

A Ministry of Housing, Communities and Local Government spokesman said: “We recognise the pressures councils are facing, so we are working with local government to develop a funding system for the future. Over the next two years, we are providing councils with £90.7bn to help them meet the needs of their residents. On top of this, we are giving them the power to retain more of the income they get from business rates so they can use it to drive further growth in their area.”

Labour’s Andrew Gwynne, the shadow communities and local government secretary, said: “This new analysis is a damning verdict on eight years of Tory austerity. Our public services are straining at the seams, whilst the government continues to cut funding.”

https://www.theguardian.com/society/2018/jul/03/council-cuts-are-putting-the-vulnerable-at-risk-tory-peer-says

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Posted on

18 Jun 2018

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Accountability, Accountable Care Organisation, Health and Social Care (local), Integrated Care Systems, NHS (local), Post-Brexit Adjustments

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Devon Tory GP MP pours cold water on “extra” NHS funding promise

Owl says: surely “extra” money for the NHS means ALL CCG costings have to be revised? And all the arguments about WHY services have to be cut must be revisited.

“Theresa May has come under fire for promising that a Brexit windfall will provide an extra £400m a week for the NHS. May – who will pledge an extra £20bn in annual real terms from 2023-24 in a major speech – has been ridiculed for linking the money to Brexit savings. “At the moment, as a member of the European Union, every year we spend significant amounts of money on our subscription, if you like, to the EU,” she said on BBC One’s Andrew Marr show. “When we leave we won’t be doing that.”

Two senior Tory MPs, who are also doctors, took aim at May: “The Brexit dividend tosh was expected but treats the public as fools. Sad to see Govt slide to populist arguments rather than evidence on such an important issues,” tweeted Sarah Wallaston, who chairs the Commons health and social care committee. Dr Philip Lee, MP for Bracknell, tweeted: “There is no evidence yet that there will be a ‘Brexit dividend’ – so it’s tax rises, more borrowing or both.”

The PM’s decision to frame extra spending specifically as a benefit of leaving the EU has been widely seen as a sop to hardline Brexiters in her cabinet, echoing Boris Johnson’s suggestion during the EU referendum that Brexit would free up £350m a week extra for the NHS.”

https://www.theguardian.com/world/2018/jun/18/monday-briefing-nhs-windfall-is-brexit-dividend-tosh-says-tory-mp

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East Devon Watch

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12 Jun 2018

Posted under

Accountability, Accountable Care Organisation, Austerity cuts, DCC, Health and Social Care (local), Integrated Care Systems, NHS (local)

Adult social care on its last wobbly, fragile knees

“Social care services for vulnerable adults are on the verge of collapse in some areas of England, despite the provision of extra government funding, senior council officials have warned.

The fragile state of many council social care budgets – coupled with growing demand for services, increasing NHS pressure, and spiralling staff costs – is highlighted in research by the Association of Directors of Adult Social Services(Adass).

It says councils “cannot go on” without a sustainable long-term funding strategy to underpin social care and warns that continuing cuts to budgets risk leaving thousands of people who need care being left without services.

“The overall picture is of a sector struggling to meet need and maintain quality in the context of rising costs, increasingly complex care needs, a fragile provider market and pressures from an NHS which itself is in critical need of more funding,” the annual “state of the nation” survey says.

It reveals English councils plan to push through social care cuts of £700m in 2018-19, equivalent to nearly 5% of the total £14.5bn budget. Since 2010, social care spending in England has shrunk by £7bn.

A government green paper on adult social care funding is expected in the next few weeks, and while councils are hopeful this could put budgets on a firmer footing over time, they warn that extra funding is needed to shore up services in the short term.

“Social care is essentially about making sure we not only look after people with profound and increasingly complex needs, but also help many transform their lives. Sadly, however, this budget survey reveals, once again this essential care and support is just not being given the resources it needs,” said the president of Adass, Glen Garrod.

He added: “We cannot go on like this. How we help people live the life they want, how we care and support people in our families and communities, and how we ensure carers get the support they need is at stake – it’s time for us to deliver the secure future that so very many people in need of social care urgently need.”

A government spokesperson said: “We know the social care system is under pressure — that’s why we’ve provided an extra £9.4bn over three years. We will shortly set out our plans to reform the system, which will include the workforce and a sustainable funding model supported by a diverse, vibrant and stable market.”

The Adass survey says the social care market is “increasingly fragile and failing” in some parts of the country, with almost a third of councils reporting that residential and nursing home care providers have closed down or handed back contracts.

Although councils are spending an increasing proportion of their total budget on adult social care – almost 38p in every pound in 2018-19, compared with 34p in 2010 – social care directors admit they will have to continue to reduce the number of people in receipt of care packages.

The survey reveals councils are increasingly reliant on so-called “self help” or “asset-based” approaches to care – in effect using networks of family and neighbourhood groups to provide volunteer support for some social care recipients.

Half of local authorities overspent on adult social care budgets in 2017-18, the survey finds, with half of these drawing on council reserves to meet the overspend.

The National Audit Office has warned that about 10% of councils will exhaust reserves in three years at current rates of deployment, putting them at risk of insolvency.

Ministers acknowledged the financial crisis facing council adult social care services last year, when they provided £2.6 billion, enabling councils to raise extra social care funds locally through a council tax precept.

Adass says this injection of cash helped stave off financial collapse in some council areas. But it warns that the additional funding has “temporarily relieved, rather than resolved” the long-term funding needs of the sector and there is a danger council services could collapse before any new arrangements are in place.

Although councils have a legal duty to ensure there is a functioning care market in their area, nearly four in five say they are concerned that they are unable to guarantee this because of the fragility of many care firm balance sheets and rising care staff wage bills.

Councillor Izzi Seccombe, the chair of the Local Government Association’s community wellbeing board, said: “Councils and providers are doing all they can to help ensure older and disabled people receive high quality care, but unless immediate action is taken to tackle increasingly overstretched council budgets, the adult social care tipping point, which we have long warned about, will be breached and councils risk not being able to fulfil their statutory duty under the Care Act.”

Richard Murray, the director of policy at The King’s Fund, said: “This latest evidence, from every council in England, lays bare once again the need for, as the prime minister put it herself, a proper plan to pay for and provide social care.

“Older and disabled people and their families and carers continue to be let down by a system that is on its knees.”

https://www.theguardian.com/society/2018/jun/12/adult-social-care-services-collapse-survey-england-council

Posted by

East Devon Watch

Posted on

8 Jun 2018

Posted under

Health and Social Care (local), Inequality

“Ageism widespread in UK, study finds”

“Ageism is rife in Britain, with millennials holding the most negative attitudes to ageing, according to a study.

A quarter of millennials believe it is normal for older people to be unhappy and depressed, while 40% believe there is no way to escape dementia as you get older, research from the Royal Society for Public Health (RSPH) shows.

Across all age groups, almost a third of people surveyed agreed with the statement “being lonely is just something that happens when people get old”, while two thirds had no friends with an age gap of 30 years or more.

“Ageist attitudes abound in society and have a major impact on the public’s health, and yet they are rarely treated with the seriousness they deserve,” the RSPH chief executive, Shirley Cramer, said.

“Too often ageist behaviour and language is trivialised, overlooked, or even served up as the punchline to a joke – something we would rightly not tolerate with other forms of prejudice.” …

The RSPH also called for the Independent Press Standards Organisation to include age in the editors’ code of practice to prevent discrimination.

“[T]he common media portrayal of older people blocking beds could be framed instead as ‘older people trapped in hospital because they can’t afford the care they need when they go home’, states the report, About That Age Old Question, which surveyed 2,000 adults in the UK.

“[W]e need realistic portrayals of ageing that overall reflect both the challenges and opportunities in later life.”

The report recommends housing nurseries and care homes under the same roof.

“Intergenerational contact and care offer huge benefits for the groups involved, but also to the facilities operators,” it says, adding that it was an opportunity for local authorities and private providers to save costs “as well as offering genuine wellbeing benefits to ‘young’ and ‘old’ customers alike”.”

https://www.theguardian.com/society/2018/jun/08/ageism-widespread-in-uk-study-finds

Posted by

East Devon Watch

Posted on

8 Jun 2018

Posted under

Accountability, Accountable Care Organisation, Austerity cuts, DCC, Health and Social Care (local), Integrated Care Systems, Martin Shaw (Seaton), NHS (local), Transparency

Devon CCG refuses to reveal crucial figures to independent county councillor

“Beds, beds, beds – Devon’s NHS couldn’t or wouldn’t give me their overall occupancy figure for the recent winter: but they were forced to buy in more capacity and there were ’12-hour trolley breaches’

Devon NHS’s Sustainability and Transformation Partnership (STP) admitted in a report to Health Scrutiny yesterday that they had been desperately short of beds during the recent winter. They had to buy in extra beds to keep up with more patients staying longer, because of complex conditions. There were ’12-hour trolley breaches’, where patients had to wait more than 12 hours to be seen.

Despite my asking them directly, they did not give a figure for overall occupancy levels, although they did not deny my suggestion that they had been as bad as or worse than the nationally reported level of 95 per cent. (The nationally recommended safe level is 85 per cent.)

Jo Tearle, Deputy Chief Operating Officer for the Devon CCGs, rebutted my suggestion that cutting community beds had contributed to this crisis, saying that these were not the kind of beds they had needed, and that there had been capacity in community hospitals most of the time. However this suggests that there was no capacity some of the time. It is difficult not to believe that extra community beds wouldn’t have given them more leeway.

Meanwhile, Kerry Storey of Devon County Council indicated the strains that the ‘new model of care’ at home had been under. She said that maintaining personal care at home during the winter had been ‘a real challenge’, requiring ‘creativity and innovation’ – you don’t need much imagination to see that it will have been a real crisis time with frail people at home in isolated areas, care workers and nurses struggling to get through the snow, and staff themselves suffering higher levels of illness.

I and others predicted that because of the closure of community beds, there would be severe pressure on beds in a bad winter or a flu epidemic (and actually, this was not overall a bad winter and the snow episodes were late and short; despite higher levels of flu, there was no epidemic this winter).”

Beds, beds, beds – Devon’s NHS couldn’t or wouldn’t give me their overall occupancy figure for the recent winter: but they were forced to buy in more capacity and there were ’12-hour trolley breaches’

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