Relationship between the Health Service and local authorities
- Are social work values under threat?
Despite reassurances from health minister John Hutton that he wants social care staff to form a 'genuine partnership of equals' with NHS workers, many fear the profession's values are under threat. Linda Steele investigates Guardian Society
Thursday April 12, 2001
- Councils to get NHS-style performance rewards
Guardian Society
Wednesday May 9, 2001
- Nurses attack care charges
Guardian Society Wednesday May 23, 2001
- City's hospitals jammed by care crisis.
Hundreds of recovered elderly tie up beds as council cuts home support
Guardian Unlimited
Monday June 11, 2001
- Health news: Crisis point reached in Scottish care homes row
The row over care homes has reached crisis point in Aberdeen where
private owners are refusing council-funded residents.
SocietyGuardian.co.uk
14 June 2001
- Older people fit for hospital discharge are unable to leave because
social services budgets are too overstretched to give them proper
aftercare. Long Term Care, SocietyGuardian.co.uk
15 June 2001
- Senior hospital nurses are under enormous stress as they struggle to cope with shortages of staff and sometimes basic equipment while beds are occupied by patients who should not be there, according to a report which paints a bleak picture of the
NHS. Guardian Unlimited
Wednesday June 13, 2001
- Acute wards
New burdens on senior nurses are bringing many of them to breaking point. By Sarah Boseley
Guardian
Wednesday June 13, 2001
- Care crisis keeps elderly patients in hospital
Cash-strapped social services department adds to NHS waiting lists problems because it cannot cope with home needs of pensioners
Guardian Unlimited
Friday June 15, 2001
- The 10th annual report of the social services inspectorate, Modern social
services: a commitment to deliver, warns that the fast pace of NHS reform has
caused planning, management and delivery problems for social service managers
and frontline staff.
-
Progress on joint working between health and social services was also found
to be patchy, although there were isolated examples of excellence.
Guardian Society Friday
August 17, 2001
-
Scotland's first minister, Henry McLeish, has promised that new legislation will pave the way for the introduction of free personal care north of the border by next spring.
Guardian Society Thursday September 6, 2001
- Social services directors and local government chiefs warned last night that
mounting budget pressures will either force them into serious overspending
this year or to squeeze services for children, older people and other
vulnerable groups. Guardian
Wednesday September 12, 2001
- Care standards chief appointed Guardian
Society Tuesday September 11,
2001
- Councils win £300m extra for care homes Bed blocking in NHS hospitals to be
stemmed by extra grants over three years to provide alternative places for
older people. John Carvell, social affairs editor Guardian
Wednesday October 10, 2001
- New social care inspectorate to tackle thorny issue of fees. John
Carvel Guardian
Wednesday March 27, 2002
- Extra cash for social services comes with conditions. David Batty Society
Thursday April 18, 2002
- Q&A: cross-charging. David Batty and Simon Parker Society
Monday April 22, 2002
- 'More money has come, but late in the day'. It is five years since
Labour came to power. Janice Robinson of the King's Fund examines the effect
on social care. Society
Wednesday April 24, 2002
- Care in the community failing, say Tories. Guardian
Tuesday June 25, 2002
- Thousands of care places lost. John Carvel, social affairs editor Guardian
Friday July 19, 2002
- Cash fine to clear elderly from hospital beds. James Meikle, health
correspondent Guardian
Tuesday July 30, 2002
- Bedblocking exacerbated by joint working failures. David Batty
Society Thursday August 8, 2002
- Milburn retreats on care home standards. John Carvel, social affairs
editor
Tuesday August 20, 2002 The Guardian
- Exit toll on older people. Government drive to beat 'bed-blocking'
raises concerns. John Carvel
Wednesday September 18, 2002 The Guardian
- Social care reform and performance: the issue explained.
David Batty Wednesday October 2, 2002
- Social services departments will be broken up into separate units for
children and older people, under a plan for local government reform announced
yesterday by Alan Milburn, the health secretary. John Carvel, social affairs
editor
Thursday October 17, 2002 The Guardian
- Milburn plans complete social services overhaul. David Batty
Wednesday October 16, 2002
- One of the first four care trusts, which provide integrated health and
social services, has introduced rationing of care home placements in a bid to
cut a £1.9m budget deficit . David Batty
Wednesday October 23, 2002 The Guardian
- Q&A: care trusts. SocietyGuardian.co.uk has discovered that more than half
of the 11 care trusts due to launch next year have been delayed and some may
not go ahead at all. David Batty explains more about these new bodies
Friday November 1, 2002
- Integrated health and social services should not be regarded as the
miracle cure to problems over joint working faced by the two care agencies,
senior managers have warned. David Batty in Bristol
Wednesday November 6, 2002
- Charges for bed blocking to be levied. Move to speed up discharges
from hospital. James Meikle, health correspondent
Thursday November 14, 2002 The Guardian
- Bedblocking fine plan 'bizarre'/ David Batty
Friday November 29, 2002
- Health secretary Alan Milburn has promised social services in England an
extra £100m a year as a sweetener to win support for his controversial
legislation to tackle so-called bed-blocking in NHS hospitals.
Wednesday December 4, 2002 The Guardian
- Patients with mental health problems could end up on the streets because
councils are faced with diverting money into different services to avoid new
government penalties.
Sunday December 15, 2002 The Observer
- More than 4,000 older people are on any one day being held in hospital
after their doctors have declared them fit to leave, parliament's spending
watchdog warned yesterday, after an investigation of bed blocking in the NHS.
John Carvel, social affairs editor
Wednesday February 12, 2003 The Guardian
- Q&A: cross-charging. The government is proposing to fine councils if
they delay the discharge of patients into community care and so block NHS beds
unnecessarily. But will that mean one part of the NHS fining another? And how
will the plans affect patients? David Batty reports.
Wednesday February 12, 2003
- The government plans financial penalties to combat bed blocking. Critics
say this could simply lead to one part of the NHS fining another. David
Batty
Thursday February 13, 2003 The Guardian
- Bed blocking fines attribute a problem to individuals or local
organisations that lies with the entire health system, says Jon Glasby.
Thursday February 20, 2003
- Paul Dinsdale on a collaborative scheme that unblocks hospital beds and
provides a high standard of home care.
Wednesday March 19, 2003 The Guardian
- Government plans to fine councils that fail to promptly arrange the
discharge of patients from hospital are back on track after MPs yesterday
overturned four Lords amendments to curtail the controversial legislation.
David Batty
Thursday March 20, 2003
- Care trusts aim to bridge the divide between social services and health
care. David Batty reports.
Wednesday March 26, 2003 The Guardian
- A healthcare thinktank has warned that care trusts, the integrated health
and social care organisations championed by health ministers, could "wither on
the vine". David Batty
Wednesday April 2, 2003
- Q&A: care trusts. The government initially expected 11 care trusts to be
launched in England this year but now only three will be set up. A healthcare
thinktank has also warned that they could wither away. David Batty explains
more about these new bodies.
Wednesday April 2, 2003
- The government has agreed to exempt mental health services from its
controversial plans to fine councils that fail to promptly arrange the
discharge of hospital patients. David Batty and agencies
Wednesday April 2, 2003
- Q&A: cross-charging. The government is proposing to fine councils if they
delay the discharge of patients into community care and so block NHS beds
unnecessarily. But will that mean one part of the NHS fining another? And how
will the plans affect patients? David Batty reports.
Wednesday April 2, 2003
- A bill to impose fines on councils that fail to promptly arrange the
discharge of patients from hospital has passed through the final stage of the
parliamentary process and is set to become law. David Batty
Tuesday April 8, 2003
- A woman spent 10 years in hospital unnecessarily because of a series of
failures on the part of her district council which should have found her
suitable accommodation, the local government ombudsman ruled yesterday. Sarah
Boseley, health editor
Friday August 22, 2003 The Guardian
- A pioneering partnership between the NHS and local government to integrate
health and social care has been dissolved after a row between the partners
left the relationship "untenable". Barking and Dagenham council yesterday
announced that it would dismantle its joint management arrangements for local
health and social services with the local primary care trust (PCT). David
Batty
Thursday August 28, 2003
- Government plans to promote greater integration between the NHS and councils
have taken a blow with the dissolution of a pioneering partnership between a
social services department and a primary care trust (PCT) in east London. An
internal disagreement at the Barking and Dagenham partnership left the
relationship "untenable". David Batty
Wednesday September 3, 2003 The Guardian
- MPs have hit out at the "intolerable" number of elderly people who are
waiting too long to be discharged from hospital in a report published today.
Tash Shifrin and agencies
Wednesday September 17, 2003
- The government is to examine why care trusts, which bring together adult
health and social care services into a single organisation, have not been as
popular or successful as anticipated, the community care minister, Stephen
Ladyman, has revealed. David Batty
Thursday September 25, 2003
- The cost of compensating thousands of sick and elderly people who have been
denied NHS funding for their healthcare in nursing homes will reach nearly £600
million, a new survey reveals. Jo Revill, health editor
Sunday October 12, 2003 The Observer
- Bed-blocking days are numbered. Partnerships have meant fewer old people are
left languishing in hospital. Adele Waters
Wednesday October 15, 2003 The Guardian
- The government is to appoint a social care "tsar" to patrol the troubled
boundary between the NHS and social services, health secretary John Reid will
disclose today in his first address to local authority chiefs. John Carvel,
social affairs editor
Wednesday October 15, 2003 The Guardian
- Elderly and chronically sick patients could be forced into unsuitable
accommodation which does not serve their needs and may be miles from their
families under new measures designed to end hospital bed-blocking, two public
health academics said yesterday. Sarah Boseley, health editor
Friday
January 2, 2004 The Guardian
- The government this week introduced fines for social services departments
that fail to take measures to end bedblocking. But will the system work? John
Carvel, Raekha Prasad and Alison Benjamin
Wednesday January 7, 2004 The Guardian
- Long-term care: the issue explained. Care services for vulnerable
adults and older people have had a shake-up since Labour came to power. But not
all reforms have proved successful, reports David Batty.
Friday February 6, 2004
- Hospital patients must be assessed to check whether they should receive free
continuing care from the NHS before being discharged, under government
regulations unveiled today. The order issued to all NHS trusts and primary care
trusts (PCTs) in England follows months of criticism that chronically sick and
frail elderly people have been forced to pay for care that should be free. David
Batty and agencies
Friday February 27, 2004
- The NHS could save £100m a year if terminally ill cancer patients were able
to spend their last days at home, a cancer charity said today. Marie Curie
Cancer Care said the NHS would save £200m a year in hospital care if the
government made an extra £100m a year available to allow the terminally ill to
be tended at home.
Monday March 1, 2004
- The chief executive of the NHS, Sir Nigel Crisp, today announced the
appointment of a social care tsar to improve partnership between the health
service and social services. As the first national director of social care,
Kathryn Hudson will be responsible for improving joint working between the two
sectors at both the national and local level. She is also expected to take a
leading role in the Department of Health's forthcoming reform of adult social
services. David Batty
Wednesday May 19, 2004
- Q&A: The Commission for Social Care Inspection (CSCI).
Tuesday June 8, 2004
- Local authorities will struggle to meet the needs of older people due to the
growing disparity between social services and NHS funding, social services
leaders warned today. The Association of Directors of Social Services said the
annual 2.7% rise in social services spending over the next three years was
disappointing in comparison to the 7.1% increase per year for the health
service. David Batty
Monday July 12, 2004
- English councils have paid out more than £8m in fines to the NHS over the
past six months for failing to promptly arrange community care for elderly
patients well enough to leave hospital, it has emerged. David Batty
Monday October 25, 2004
- White papers urge better integration of social care and health. John Carvel
Wednesday July 27, 2005 The Guardian
- Value of volunteers.
Letters Wednesday August 3, 2005 The Guardian
- Social services
hit by PCT cuts, admits Hewitt. PCTs are 'redefining' health care needs to
pass responsibility for patients with long-term conditions to social services.
Patricia Hewitt this week admitted: "It is a real problem, it's one that we're
looking at the moment in the joint health and social care white paper."
Summary by
Keep our NHS Public
of
Public Finance 13 January 2006
- Savings plans
hit social services hard. Chief executives are withholding national
insurance contributions and delaying paying taxes, private partners and local
authorities to control debts. One in five said they had - or would - delay
payments to private sector partners. The same proportion will have done the
same to local government partners by the end of March. In areas such as
Wiltshire the NHS is accepting responsibility for less patients, particularly
the elderly in need of long-term care, and leaving them to social services.
Summary by
Keep our NHS Public
of Health Service Journal 19 January 2006
- Reality check.
The "Connected Care" initiative, a community-based program in a deprived area of
Hartlepool, aims to coordinate social and health care in the area and make them
more attuned to the community's needs. The area is one of the ten most
under-doctored places in the country - a potential target for the government's
preference for private providers to come in and offer GP services. But while the
Connected Care initiative is exactly the kind of scheme that David Miliband,
local government and communities minister, is championing, it is unclear how
coordinated and integrated community control will be squared with Hewitt's
enthusiasm for independent private providers of health services. Summary by
Keep our NHS Public
of Guardian 1 February 2006
- DoH considers
joint-working duty. The Department of Health is to consider imposing a duty
on local authorities and the NHS to work together to improve the health and
well-being of older people. The government will align the budget cycle for the
NHS and local authorities from 2007-08, making the pooling of budgets easier,
and the payment by results tariff will be unbundled in the same year so
different providers can be paid for different elements of treatment. Summary by Keep our NHS Public
of Health Service Journal 2
February 2006
- Couple's care
plight raised with minister. Mark Fisher MP is to raise the plight of a
woman suffering from a brain disease with the Department o Health. Brenda
Seckerson cannot eat, walk, dress or wash unaided. She previously received 12
hour of nursing a day from a nurse without professional training through social
services. But when her condition was deemed in need of greater attention and she
was transferred to NHS band one care from South Stoke PCT, all provision
stopped. Mark Fisher said it is an example of "what's going wrong when people
fall between the underkill of social services and overkill of the NHS." Summary by Keep our NHS Public
of Stoke Sentinel 10 February 2006
- Taxpayers 'foot
bill as health trusts cut services'. Social services and care home experts
have accused Selby and York PCT, which has a predicted £24m deficit, of making
cuts to services which must then be met by York City Council and North
Yorkshire County Council. Sue Galloway, executive member for health and social
services at York Council, said district nursing was being reduced by the PCT:
"I think it is about time now that local councils actually said, 'Sorry we
will do whatever we can, but we cannot go on at this rate picking up the
pieces.'" Ryedale Tory MP John Greenway said: "Frail, elderly people are not
being supported by Selby and York PCT. We now have a situation where there has
to be an acute need before the elderly will get nursing care. The Government
shrugs its shoulders and says, "not my problem" - but it is their problem."
Keren Wilson, development director at the Independent Care Home Group, said:
"There is a belief in nursing homes that the PCT is not assessing patients at
the right level. When they release a patient from hospital they assess them as
of low, medium or high need - high need costs the PCT the most to care for.
They are assessing people who come out of hospital in the medium band and
within four weeks these people have died, so they should have been put in the
higher band. I believe budgetary pressures are forcing the trust to take
decisions that are not in the best interests of the patient. That is a huge
problem." Summary by Keep our NHS Public
of
Yorkshire Post 15 February 2006
- Four in five local authorities are moving to tighten the eligibility rules
for services for elderly and disabled people, in response to a record £1.8bn gap
in funding for social care and the knock-on effects of the cash crisis in the
NHS. David Brindle
Thursday March 16, 2006 The Guardian
- Council fury
over £3m health cut. Several day-care centres and care homes in
Wiltshire may face financial crisis after the county's PCT withdrew £3m in
funding. Wiltshire's county council, which runs four day centres and three
respite care homes partly funded by the PCT, is outraged.
Summary by
Keep our NHS Public
of
BBC
Online 4 April 2006
- PCTs cancel £3m
in social care funding. Two deficit-ridden primary care trusts in
Wiltshire have withdrawn up to £3m of social care
funding from the local authority with just 14 hours' notice. The council
claims the move risks destabilising its finances and calls into further doubt
the viability of partnership working between health and social care. Funding for
50 older people in residential care and nursing homes was withdrawn on April 1.
Funds for respite care and day services for disabled adults have also been cut,
as the two PCTs attempt to address their estimated combined deficits of £18m.
Wiltshire council leader Jane Scott, who has complained to health minister Liam
Burn, said: "For them to renege on them is bad enough, but with such short
notice is outrageous."
Summary by
Keep our NHS Public
of
Public Finance 14 April 2006
- A patient occupied a hospital bed for more than four
years after doctors decided the person was ready to leave, it emerged
yesterday. The cost of the patient's care at an unnamed hospital in
Maidstone and Tunbridge Wells NHS trust is estimated to have been
more than
£300,000. Paul Lewis
Tuesday
May 2, 2006 The Guardian
- Pain but no
gain. According to the Guardian: "The shockwaves [of the
deficits crisis] are being felt by health service partners, notably
social services and
voluntary organisations contracted by the NHS to deliver services.
According to the Association of Chief Executives of Voluntary Organisations (Acevo),
valuable statutory funding for charities is being delayed or withdrawn in an
effort to ease NHS budgets in the short term. The result, it says, is that
many services run by voluntary groups are being left overstretched or are even
vulnerable to closure."
Summary by
Keep our NHS Public
of
Guardian 10 May 2006
- NHS debts fuel
bed-blocking surge. Bed-blocking numbers have
increased dramatically in over 10% of England's local authorities with social
service responsibilities. Senior NHS and social services sources have said that
the cause is a combination of
under-funding, primary care trust cuts, and cash-struck hospitals attempting
to move patients through their system at a faster pace. By the middle of April,
the number of acute beds still blocked by patents aged over 65 despite the NHS
declaring them fit for discharge reached two-year highs in eleven areas across
England. In each case, the increases began in September 2005 - the month the
scale of the projected NHS deficits became clear. Social services and NHS
consultant Roger Mortimore said the phenomenon was also due to the introduction
of
payment by results, as this encourages faster discharge because hospitals
are paid per patient, not by length of stay.
Summary by
Keep our NHS Public
of
Public Finance 19 May 2006
- NHS a scapegoat
for debt say Lib Dems. Liberal Democrats on
Wiltshire Council have accused its Tory chiefs of blaming the NHS for their
own mismanagement. Lib Dem opposition leaders have accused the council of
covering up a £10m black hole of their own making and blaming NHS deficits for
their errors. The claims come as NHS managers fume over being blamed for shock
budget cuts to that were announced to cover the shortfall, cuts that will hit
care for the elderly and unwell, and increase the burden on the NHS.
Summary by
Keep our NHS Public
of Western Daily Press 25 May 2006
- NHS cuts change
the definition of 'health care'.
NHS deficits are putting pressure on social care
as services try to compensate for the NHS "narrowing the definition of
healthcare", according to the Association of Directors of Social Services. In a
report the association details overspends that it says stem from a
"redefinition" of healthcare that has included earlier discharges from hospital.
The association argues that this redefinition has placed additional burden upon
social services without additional funds, causing some councils to look at
restricting services to the most vulnerable. However the concerns are not one
sided as NHS leaders have voiced similar warnings about "cost-shunting" as
social services raise their eligibility criteria.
Summary by
Keep our NHS Public
of Times
20 June 2006
- £1m tax bill.
Social Services in
Wiltshire could cost another £1m a year if plans to
close all but one of the area's community hospitals gets the go ahead. The
new trust, which results from a merger of North Wiltshire
& Kennet and West Wiltshire Primary
Care Trusts, is the biggest in the country. Cllr John Thompson, who is in charge
of Wiltshire's social services, is already facing a £7m debt partly due to cuts
in NHS services. Council accountants have worked out that if the trust goes
ahead with its Option One plan, to close all community hospitals except the
Chippenham, then Social Services will have to take up the slack to the tune of
£1m a year. The closures will put pressure on social services because, as more
people are sent home earlier instead of recuperating in a community hospital,
social services will have to provide care for them at home. Cllr Thomson pointed
out that the figure does not even include increased transport costs as patients
have to travel further to hospital. The trust has been widely criticised for not
consulting adequately on its plans. The chairman of West Wiltshire's health
Watchdog, the Patient and Public Involvement forum, has sent a damning letter to
the primary care trust chief executive expressing the forum's concerns, in
particular over the "not easily understandable" consultation document. Summary by
Keep our NHS Public
of Western Daily Press 23 June 2006
- Stark Warning.
A report from
Oxfordshire County Council's director for social and community services has
criticised a lack of consideration for the knock on
effects of rapid NHS
budget cuts. Councillor Charles Waddicor singled out the speed of budget
balancing that left no time to consider the full impact of cuts, saying that the
measures should be phased in over two or three years in order to take a measured
look at any proposals. Summary by
Keep our NHS Public
of Oxford
Mail 14 July 2006
- NHS cutbacks hit
social care.
Oxfordshire's social services are creaking at the seams because of the NHS
funding crisis, councillors claim. On Tuesday, members of the Tory-run
council's cabinet called for a halt to cuts in community-based NHS services.
They were told that the knock-on effects meant the
council had already spent £250,000 more on social care at this stage of the
financial year than projected. It is almost certain this figure will more than
double by the end of March next year as demand for council-run services grows
due to NHS cuts. Summary by
Keep our NHS Public
of Oxford
Mail 20 July 2006
- Health cuts due
to NHS deficits. Health services in Shropshire are being lost as a result of
NHS deficits, according to the county council. Shropshire
County Council spokesman Paul Masterman said the £36m NHS deficit across
Shropshire was having a range of effects on health care. Services in the
community, such as chiropody, have been affected and the authority was filling
the gap left in NHS funding. The assessment of elderly people to move into care
homes was being delayed meaning patients were spending longer in hospital than
was necessary, he said. "In some cases waiting times are longer, in some cases
the local authority is providing more of the services and in some cases the
service is not being provided." Summary by
Keep our NHS Public
of BBC
Online 26 July 2006
- Evidence that the
NHS cuts deeply. Now there is hard evidence of the knock-on effect that
NHS cuts are having on social services. A survey
of social services directors by the Local Government Association has found clear
evidence of a link between areas where PCTs have deficits and cuts to social
service provision. Almost two-thirds of directors confirmed that the NHS
deficits had adverse repercussions. Just over a third (36%) said their local NHS
had cut beds and 35.5% said cuts had prompted the withdrawal of funding from
some jointly funded services. One in 10 said waiting times for social care
assessments and services were affected, while a quarter (25.5%) said they were
experiencing difficulties with non-payment of bills by PCTs. In some cases this
has led to legal action. Summary by
Keep our NHS Public
of Guardian
26 July 2006
- Teething troubles
for care agendas. Difficulty in relations with the NHS
is emerging as the number-one concern of social care leaders in a series of
"get-it-off-your-chest" meetings being held across England. Directors and lead
councillors of both adults' and children's services are complaining about a
paralysis of action brought on by structural change in the health service,
the adverse impact of
health spending cuts on partnership work and growing problems caused by the
NHS's so-called
democratic
deficit. Summary by
Keep our NHS Public of Guardian
13 September 2006
- Your excellent coverage of the financial problems facing some NHS trusts
only tells part of the story (NHS chief admits flawed accounting behind
deficits, December 12). While publicity tends to focus on the high-profile
hospital trusts, the reality is that many primary care trusts which provide
critical community health services are also experiencing massive problems. For
example,
Brent primary care trust has recently announced in-year savings of £14m with
a massive £31m savings package in the 2007-08 financial year. These cuts are, of
course, justified on the grounds of returning all NHS trusts to financial
balance, but they will inevitably impact most severely on some of the most
vulnerable members of the community. One important consequence of these
accountant-driven savings packages is the huge knock-on effect on local
government. Here in Brent, we estimate that the council might have to pick up an
additional bill of up to £9m in the next financial year in order to
maintain services to clients with both medical and social
care needs. Brent council simply cannot absorb the financial cost of
unilateral cuts introduced by our supposed "partners" in the NHS and inevitably
many local authorities, particularly in London, will be forced to consider
bigger increases in council tax than they would otherwise have wanted to
introduce. To the extent that tax rises cannot meet this requirement, we will be
forced to cut council services to make up for the funding shortfall in the
health service. The problems being experienced in Brent are being felt across
the country and they sit uncomfortably with government's much-vaunted claims of
a growing national budget for the NHS. Tell that to local residents whose
walk-in centre is about to close or whose elderly dependants are being denied
access to much-needed rehabilitation beds in their local hospital. The question
many local councillors and council managers are asking is why can't the NHS
deficit - which is a small proportion of the £80bn national health budget - be
managed within the NHS system and without the dumping of responsibilities and
costs on to already hard-pressed local councils? Gareth Daniel Chief executive,
Brent council Letters
Wednesday December 13, 2006 The Guardian
- Patients cost
taxpayers for use of beds when fit to leave. Bed-blocking at East
Surrey Hospital has cost taxpayers more than £100,000 since April.
Bed-blocking is caused when patients are declared clinically fit to leave but
social services cannot find a suitable place for them to go. It is usually
caused when elderly or vulnerable people cannot be found a place at a care or
nursing home. The knock-on effect has delayed operations and forced Surrey and
Sussex Healthcare NHS Trust to send some patients to other hospitals for
treatment. Overworked doctors and nurses have struggled to cope in recent months
and the A& E department has often been
placed on "black status". Staff expect the problem to get worse as more A&
E departments are downgraded throughout West Sussex. Zena Dodgson,
Crawley representative for health campaign group Keep Our NHS Public, warned the
problem will put lives at risk. "It will definitely get worse there is no doubt
about that. We have always said that East Surrey Hospital doesn't have the
capacity to deal with the repercussions of hospitals closing down throughout the
southeast. Talking about downgrading hospitals is nonsense because all it will
result in is longer waits and fewer available beds. When you close down or
downgrade hospitals there is a domino effect that will leave people in Crawley
waiting longer for hospital treatment." Summary by
Keep our NHS Public of Surrey
Mirror 8 January 2007
- GPs should prescribe social care, says Hewitt. Family doctors will be
allowed to use NHS money to prescribe social care support such as home helps and
respite breaks for carers under plans to be announced by the government today.
GPs will also be encouraged to spend NHS funds on home aids or adaptations such
as grab rails or even relaying carpets where an elderly or disabled person may
be at risk of falling or tripping - avoiding a large health service bill for
emergency hospital treatment. The proposals, which will be announced today by
the health secretary, Patricia Hewitt, represent the biggest shakeup of the
rules governing commissioning of health and social services since the health
service was set up after the second world war. Ms Hewitt will set out the
government's consultative proposals for a commissioning framework for health and
wellbeing, which have been drawn up jointly with communities and the local
government secretary Ruth Kelly, at a Guardian conference on integrated health,
social care and housing services. Some GPs are already commissioning services
imaginatively within the rules, Ms Hewitt will say. They prescribe exercise for
patients who are overweight, supply self-monitoring equipment and make available
social work, counselling and occupational therapy services. But there is a need
now to go further, the minister will add, by giving GPs and their primary-care
colleagues reassurance that they will not be stepping beyond legal limits if, by
agreement with their local authority and NHS primary care trust, they decide to
use health money to buy social care services. David Brindle
Tuesday
March 6, 2007 The Guardian
- Council care hit by NHS cuts. Two in three councils say their social
care services have been hit by knock-on effects of the NHS cash crisis, which
include the referrals of people who should be getting healthcare for long-term
needs. David Brindle
Friday March 16, 2007 The Guardian
- Extra home help
to lower numbers of bed blocking. Sick and elderly people will be offered
more care at home to help avoid unnecessary and lengthy hospital stays.
Lincolnshire Social Services says it is "modernising" its services to the
ill, the old and those with mental health problems. A rehabilitation and rapid
response team will be created to put together home care packages for people who
are in hospital, to avoid 'bed blocking'. The new team could also organise care
in the home in place of hospital, where appropriate. The council, which uses a
mixture of in-house staff and contractors to deliver home care, would
restructure its in-house service. But no further details on how much it would
cost or how many extra staff would be appointed are available yet. Last year
social services raised home care charges, generating an extra £420,000 for the
budget. Hourly charges were increased from £5.15 to £10 and maximum payments
raised from £41 per week to £120. Social services user Becky Wheeler (31) has
rheumatoid chronic juvenile arthritis and currently receives home care each day.
"It all sounds wonderful but I wouldn't be able to pay extra for the service,"
said Miss Wheeler. Summary by
Keep our NHS Public of Lincolnshire
Echo 20 March 2007
- First things first. The financial realist [David Stout]
heading the new primary care trust network tells John Carvel that it is time for
the NHS and local government to stop bickering over health and social care
'cost-shunting' and get on with the job.
Wednesday April 4, 2007 The Guardian
- Councils' care
funding crisis 'is shifting burden to PCTs'. NHS primary care trusts have
countered claims that they are burdening local authorities by saying that they
are also victims of 'cost-shunting' as social care cuts increase demand for
NHS services. Up to 31% of 49 PCTs surveyed by the Primary Care Trust Network
reported increased pressure as a result of councils halting care for adults
whose needs are deemed 'moderate' or 'low'. This tightening of care
eligibility has led to increased burden on PCT community health services,
out-of-hours GP services and NHS nursing homes, the network claimed. David
Stout, director of the network, said: "This common move by local authorities
to try and tackle local government deficits has meant that many NHS
organisations have had to cope with a higher demand for services." Last year
the Local Government Association warned that government underfunding and NHS
cost-shunting meant two-thirds of councils could provide care nly to the most
vulnerable, and that if the trend continued then no council would be providing
care for all but the most severe needs by 2009. A recent survey by Public
Finance of 48 local authorities found a further five were considering
tightening their criteria in this way. The PCT network paper calls for a more
collaborative approach to services to aid both patients and budgets. However
it also concedes that in five areas, PCTs and councils had already abandoned
new shared funding arrangements. It also warns that moves towards unitary
status for councils "illogically" undermined recent reconfiguration of PCTs to
establish common boundaries between the two.
Summary by
Keep our NHS Public of Public
Finance 6 April 2007
- Why
bed-blocking is making an unwelcome comeback. Fines for social services
departments brought early success in reducing bed-blocking, but the numbers
are creeping up again as more difficult problems - which may be a result of
targets and choice - rise to the surface. Figures released by the Department
of Health show that the number of patients affected in England dropped from
3,220 in December 2003 (just before fining was introduced) to 2,190 last
December - a 32 per cent decrease. However, almost all of this reduction was
achieved in the first year of fining and the figures have declined only
slightly since December 2004. The last three quarters' figures are all higher
than in the same period the year before. There are a number of reasons why
delayed transfers of care should be hitting the NHS particularly hard at the
moment: rising numbers of people coming into accident and emergency are
putting extra pressure on the whole system and emphasising the need to get
patients out of hospital once they are well enough to be discharged; trusts
have to meet A& E targets and are
increasingly turning their minds to the 18-week target. Discharging patients
promptly is vital for both of these; bed-blocking costs money which is often
not fully reflected in the payment by results system - and acute trusts are
under increased pressure to break even. They are also working at very high
bed-occupancy rates so there is no 'spare' capacity if a bed is occupied
unnecessarily; reconfiguration plans often involve fewer beds in acute
settings, and these are hard to support when beds are full and the lack of
social and community support for discharged patients is so evident. The focus
four or five years ago was on reducing the delays because of social services
issues, such as delays in assessing and agreeing to fund patients who needed
to be in a care home. Uncomfortably, there is some evidence that the 'easy
wins' from sorting out social care delays may have been delivered fairly
quickly and what is left is more problematic. Some of the remaining delays are
down to social services needing to assess or place patients but the majority
may now be due to other factors - a combination of NHS delays and ones related
to personal choice and decisions made by patients and carers. The Department
of Health cannot produce a breakdown of the reasons for delayed discharges.
The Local Government Association says that delays due to social services fell
by 12 per cent last year. While 60 per cent of delays were social services
linked when fining was introduced, the LGA says more recent figures suggest
that around two-thirds of delays are now for NHS reasons - such as patients
not being able to move out of an acute bed. LGA adviser Tim Hind says that a
lot of work has been done on social care-linked delays and many have been
eliminated. "There may have people who were in hospital inappropriately," he
says. "It appears that now that is not the case. They stay in hospital for a
long time because they are extremely unwell or they are waiting for an NHS
resource. The linkage with the community hospital issue may be important." In
East and North Hertfordshire trust, for example, the main problem has been the
tightening of available beds in the community. "At any one time, the
equivalent of a ward to a ward and a half of patients remain in our hospitals
when their acute health needs have been met,' says a spokesman. "We have
struggled in recent weeks and months with the A&
E target - that is the measurable impact on us."
Summary by
Keep our NHS Public of Health
Service Journal 12 April 2007
- The right
choice for the NHS. Councillor Merrick Cockell, Chairman of the London
Councils, writes in a letter to the Guardian: "The news that four hospital
trusts in London are mired in debt comes as little surprise. The NHS in London
is forecasting a deficit of £55m for this financial year - and there is deep
cross-party concern at the severe implications. London is facing cuts to
doctors and nurses, delayed operations, hospital closures, and reductions in
support for patients leaving care to save money. These "savings" will see
healthcare costs shunted from primary care trusts to London's boroughs in
higher social care costs. We have identified over £20m worth of costs already
being shunted on to London boroughs - and more could be on their way. This
shunting of NHS costs on to councils leaves local authorities facing the
unenviable choice of either cutting other services or raising council tax. In
effect, the government is turning the council tax into a health tax."
Summary by
Keep our NHS Public
of Guardian
30 April 2007
- The Complexities Of Bed-Blocking.
Cardiff and Vale NHS Trust is the largest NHS trust in Wales, providing
health services to half a million people in Cardiff and the Vale of Glamorgan.
It also provides specialist health services – such as paediatric, renal,
cardiac, neurological services and bone marrow transplantation – to patients
from across Wales. It has a total income in excess of £576m and it employs
approximately 13,500 staff. The trust runs two acute hospitals – the
University Hospital of Wales and Llandough Hospital – both of which bear the
brunt of bed-blocking. The trust has consistently had some of the highest
levels of delayed transfers of care – the figures for March show that 8.3% of
its beds are currently blocked.
Care and Health
22 May 2007
- Joint working in Knowsley. With local government and NHS
responsibilities increasingly overlapping in the areas of public health and
social care, integrated working is becoming more important.
Knowsley has seen a pioneering approach to this issue when Knowsley
Metropolitan Borough Council and Knowsley Primary Care Trust (PCT) developed a
series of joint teams and effectively combined their workforces.
Care and Health
31 May 2007
-
North East Lincolnshire PCT awarded Care Trust Plus status. This new
status will enable fully integrated health and social care, develop the
targets set out in Every Child Matters, and improve care for the older
population.
Care and Health
31 May 2007
-
Streamlining the
system for NHS continuing care. Thousands of people in England are likely
to receive more help towards their care costs, said Care Services Minister,
Ivan Lewis. Download:
The National Framework for NHS Continuing Healthcare and
NHS-funded Nursing Care. Download:
A National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care
in England- response to consultation.
Care & Health 26 June 2007
-
'Care guidance a smoke screen - so we'll help instead' Alzheimer's Society.
The National Framework for NHS Continuing Healthcare and
NHS-funded Nursing Care has been heavily criticised by
charities including the Alzheimer’s Society who believe the guidance doesn’t
go far enough to give vulnerable people with dementia access to long term care
funding. Responding to the framework’s shortcomings, the Alzheimer’s Society
stepped in to launch a network of volunteers who will use their experiences to
help others navigate through the tricky care system.
Care & Health 26 June 2007
- NHS cash to tackle row over long-term care. The government has agreed
to provide £220m a year from the NHS budget to resolve a long-running row about
who pays for the continuing care of patients transferred from hospital to
nursing homes. Ivan Lewis, the care services minister, said yesterday that the
decision would help up to 10,000 people with severe dementia or other
incapacitating conditions, who were liable to pay for intensive support to carry
out the basic routines of daily life. Mr Lewis said the aim was to eliminate a
postcode lottery whereby older people in some parts of England were provided
with free care, while others who might be in greater need were denied it. John
Carvel, social affairs editor
Wednesday June 27, 2007 SocietyGuardian.co.uk
- DoH moves to
curb care cost shunting on to councils. The government has moved to stop
the NHS shifting millions of pounds in care costs to councils' budgets, but
has admitted it must go further to address a 'care gap' of up to 1.6m people.
The new guidance is designed to end a 'postcode lottery' in decisions over
whether an individual's care needs should be met by the NHS or by their
council's means-tested social services departments. The DoH expects the new
guidance to mean that between 5,000 to 10,000 people deemed ineligible for
free NHS care services will become eligible, resulting in an extra £220m cost
to the NHS in one year. Councils, charities and care leaders welcomed the move
but insisted that much more has to be done. Figures seen by Public Finance
suggested that as many as 1.6m disabled older people living in their own homes
were not receiving council homecare services. Outgoing care minister Ivan
Lewis said it was not possible to say how much of the £220m was being paid for
by individuals and how much by councils, who have estimated that the combined
effect of past continuing care decisions and other cutbacks have meant a 'cost
shunt' of £200m a year from the NHS. He added that councils had 'a legitimate
sense of grievance' over cost shunting. The new guidance will apply from
October 2007. Lewis said that the NHS would not be allocated any extra central
funding to cover that in 2007/ 08,
but said that primary care trusts and strategic health authorities had told
the DoH they could afford it. But Lewis conceded that the 5,000-10,000 people
who would receive the reprieve under the new guidance were just a fraction of
those inadequately catered for by the current social care funding system.
Summary by
Keep our NHS Public of Public
Finance 29 June 2007
- Care in
community part of reform. Hospital services are to be reformed to provide
more healthcare in the community. The future shape of NHS services will see
more care being delivered away from hospitals in patients' homes. The grand
plan for the county will be unveiled by
Cumbria Primary Care Trust on September 19. The trust has been working on
its new strategy, Closer To Home, since February, when meetings were held to
give the public their say on what happens to health services. The plan has
been a long time coming because the trust is still working through the
financial complexities. It inherited a £28.5m debt when it was formed last
October. The new way of working will mean transferring resources from
hospitals into the community so there will be fewer hospital beds and more
district nurses.
Summary by
Keep our NHS Public
of Cumberland
News 3 August 2007
- Auditors call
for more data on care costs.
Scotland's public sector watchdog has criticised the NHS and councils over
a lack of information about the costs of providing care for people with
long-term conditions. In a report published on August 16, Audit Scotland said
the shortage of data on costs and activity means that many decisions on the
use of resources are made with limited evidence about what works for patients.
'The NHS and councils need to urgently address this in order to meet its aims
of effectively developing more services based in the community,' the report,
'Managing Long-term Conditions', states.
Summary by
Keep our NHS Public
of Public
Finance 17 August 2007
- Fly on the wall interviews: Local authority and primary care trust
partnerships. IDeA's National Adviser for Healthy Communities, Liam
Hughes, introduces a compelling series of case studies that explore the
relationships between councils and primary care trusts (PCTs);-
Barnsley Council and PCT 17 October 2007;
City of Bradford Metropolitan District Council 17 October 2007;
London Borough of Brent 17 October 2007;
Cannock Chase Council and PCT 17 October 2007;
Croydon Council and Croydon's PCT 16 October 2007;
Gateshead Council and Gateshead PCT 16 October 2007;
Greenwich Council 17 October 2007;
Herefordshire Council 17 October 2007;
Kent Council and PCT 15 October 2007;
Knowsley: joint appointment council and PCT; 15 October 2007
Lewisham Council and PCT 15 October 2007;
Shropshire County Council 15 October 2007;
Stockton-on-Tees Council and PCT 17 October 2007;
Tameside Metropolitan Borough Council 15 October 2007. Care
& Health 18 October 2007
- Trial project for older people hailed a success. By linking health
and social care together, fewer older people in
Southwark are being placed in a care facility after hospital treatment and
are instead returning to the comfort of their own home.
Care & Health 23 October 2007
- Delays in hospital ‘compromise patients’ independence’. Auditor
General of Wales identifies a 'whole systems' problem that needs changing. The
independence of vulnerable people, and the treatment of others, is being
compromised because of delayed transfers of care, according to the Auditor
General for
Wales.
Care
& Health 6 November 2007
- Minister admits
slip up over NHS figures. Care services minister Ivan Lewis has issued a
statement admitting that the Department of Health mistakenly provided figures
showing a rise in cases of bed-blocking. Mr Lewis blamed technical problems
and apologised for marring the efforts of those combating delayed discharge.
The figures were provided in an answer to questions from Norman Lamb, the
Liberal Democrat health spokesperson. The incorrect figures gave showed a rise
from 756,481 "bed days" lost in 2005-06 to 963,776 in 2007-08, suggesting an
increase of 30%, despite several years of improvement. The actual figure for
2007-08 is 718,102, and after corrections for under-counting on both figures,
there has been a 5.6% fall. Mr Lewis said: "It is regrettable that, due to a
technical error, the original information was inaccurate and gave a misleading
impression. I wish to apologise to NHS and social care staff who, by working
together, have done an excellent job in improving hospital discharge
arrangements over a number of years." Summary by
Keep our NHS Public of Guardian
9 November 2007
-
Wales told to cut bed blocking. Delayed discharge from hospital
is compromising the health and independence of vulnerable older people and
damaging wider health service delivery, according to a hard-hitting report by
the Wales Audit Office.
Care & Health 12 November 2007
- Councils turn backs on care for older people. Nearly
three-quarters of local authorities in England are rationing social services
to exclude tens of thousands of vulnerable people from help with the basic
tasks of daily living, official figures revealed last night. The charity
Mencap obtained information showing the worsening plight of people who cannot
wash, dress, prepare a meal or go to the shops unaided. It said the problem
affected older people and adults with learning disabilities in areas where
cash-strapped councils have decided they can no longer afford to provide
services to everyone in need. The information, from the Commission for Social
Care Inspection (CSCI), found 73% of local authorities were planning to refuse
care to everyone whose needs were not considered to be "substantial". John
Carvel, social affairs editor
The Guardian Thursday November 22 2007
- NHS in surplus by £1.8bn. The NHS is set to underspend by £1.8bn or
2% of its budget for the current financial year, the Health Service Journal has
calculated. The figure is more than three times larger than the £510m surplus in
the last financial year, and in contrast to the deficit of £547m in 2005-6. The
Department of Health said it would be retained by the NHS and spent on further
improving services and patient care, but the size of the underspend may embolden
nurses calling for an above inflation pay rise. The Health Service Journal
reported that the surplus was made up of money "top sliced" by strategic health
authorities (SHAs) from the budgets of primary care trusts. The NHS deficits
were politically embarrassing for the government and the then home secretary,
Patricia Hewitt, said she would resign if the NHS wasn't in surplus by April of
this year. However, the surplus shown by today's figures may be just as
damaging. The King's Fund chief economist, John Appleby, told the HSJ: "An
underspend by that amount will be seen as just as bad as an overspend.
Parliament does not approve of large NHS underspends as it commits those
resources for health spending, not to just sit there." ... Hospital Doctor
magazine also reported today that millions of pounds had been cut from NHS
training budgets in the last two years. It said SHAs took almost £360m from last
year's training budgets, more than double the amount the year before. The
figures, released by the Department of Health, showed that £357.5m was taken
from NHS education and training budgets for 2006-7, up from £150m in 2005-6, the
magazine reported. The figures showed that London SHA took the most, diverting
nearly £75m of the multi-professional education and training levy allocated by
the Department of Health last year. Allegra Stratton and agencies
Guardian
Unlimited Thursday November 22 2007
The HSJ also reported that NHS trusts earned £98m from car parking charges in
2005-6.
- NHS
Lothian helps people go home after treatment. The number of people
forced to stay in hospital because they have nowhere else to go has dropped by
almost half in a year, according to the latest new figures.
Care & Health 20 December 2007
- Postcode lottery alleged for older people needing care. Pressure
mounted on the government last night to reform the system of long-term care for
older people who need help to cope with the daily routines of living. A
coalition of 15 thinktanks and charities said there was a postcode lottery of
care which was "unclear and unfair". The Caring Choices coalition, led by the
King's Fund and Joseph Rowntree Foundation, spent nine months consulting service
users and providers about options for reform. John Carvel, social affairs editor
Monday
January 7, 2008 The Guardian
See Society Guardian index on
Long Term Care.
|