A report provided findings from a commission that examined options for a new settlement for health and social care in England. Overall, it recommended: moving to a single, ring-fenced budget for the National Health Service and social care, with a single commissioner for local services; for a new care and support allowance; for greater focus on more equal support for equal need (with more social care free at the point of use); and for the use of personal budgets and additional support to promote independence. The report proposed funding changes (including changes to national insurance contributions) to meet the additional costs and said that various forms of wealth taxation should be reviewed, with a view to generating additional resources for health and social care funding.
Source: Commission on the Future of Health and Social Care in England, A New Settlement for Health and Social Care: Final report, King's Fund
Links: Report | Project | Kings Fund press release | Alzheimers Society press release | CSP press release | NCPC press release | RCN press release | RPS press release | Turning Point press release | UNISON press release | Guardian report | Telegraph report
A report called for person centred care to become the central ambition for health reform in England, to improve the quality of life, health, and well-being of people, and the sustainability of care systems. It also discussed the potential contribution of the voluntary and community sector. Recommendations included: for a greater focus on preventive public health measures; to make people the centre of reform, with 'what matters to people' forming one of the key organizing principles for services; for better support and shared decision making for people with chronic conditions and disabilities; for recognition of the role of carers, volunteers, engaged citizens, and the voluntary and community sector, with better support and investment; for better funding for health and social care; and for an end to top-down reorganizations of services.
Source: Person Centred Care 2020: Calls and contributions from health and social care charities, National Voices
An article examined the development of 'whole-system' integrated health and social care in England, and the key lessons learned.
Source: Claire Kennedy and Simon Morioka, 'The development of whole-system integrated care in England', Journal of Integrated Care, Volume 22 Number 4
The government responded to a report by a committee of MPs on the care, treatment, and support of people with long-term health conditions.
Source: Government Response to the House of Commons Health Select Committee Report into Long-Term Conditions, Cm 8937, Department of Health, TSO
A think-tank report presented findings from a survey of people with long-term health conditions, which asked their views on self-managing their conditions and having more of a say over their services. The report called for: people to be given a named contact for day-to-day queries about their health, healthcare, and care co-ordination; patients to have legal ownership of medical records, and better information and advice; peer support, facilitated by organizations within the local health economy; comprehensive healthcare plans, drawn up in partnership with patients; and personal, integrated health and social care budgets, based on healthcare plans.
Source: Catherine McDonald, Patients in Control: Why people with long-term conditions must be empowered, Institute for Public Policy Research
A new book examined the engagement of social workers with social policy formulation processes, often termed 'policy practice', in eight liberal democracies, including England.
Source: John Gal and Idit Weiss-Gal, Social Workers Affecting Social Policy: An international perspective, Policy Press
A report evaluated peer support groups to facilitate self-help coping strategies for people with dementia in extra care housing. It said that, overall, the evaluation found positive impact of the peer support groups on participants' well-being, social support, and practical coping strategies, as well as benefits to staff, families, friends, other residents, and the housing provider. The report made a range of recommendations for providers and policy-makers.
Source: Lauren Chakkalackal and Jayasree Kalathil, Evaluation Report: Peer support groups to facilitate self-help coping strategies for people with dementia in extra care housing, Mental Health Foundation
An article examined the conditions and implications of personalization policy, discussing policy change within different welfare contexts and drawing on a comparative analysis of the Norwegian and English 'cash-for-care' schemes.
Source: Karen Christensen and Doria Pilling, 'Policies of personalisation in Norway and England: on the impact of political context', Journal of Social Policy, Volume 43 Issue 3
An audit report in Scotland said that councils had started to make changes to social care, but progress in implementing self-directed support had been mixed among councils, and they had adopted different methods of allocating social care spending. It said that the risks and advantages associated with each model needed to be managed carefully without unnecessarily limiting people's choice and control over their support. The report said that social care professionals had welcomed SDS because it had the potential to improve support for people who needed it, but called on councils to work more closely with people, and with their carers, providers, and local communities, to develop the choices that would improve people's lives. The report made a range of recommendations for councils in their implementation of the policy.
Source: Self-directed Support, Audit Scotland
The government began consultation on draft regulations and guidance relating to the care and support reforms and provisions in the Care Act 2014, which would come into effect in April 2015. The guidance was said to be intended to provide local authorities with information about how they should meet their legal obligations, as well as to inform local authority officers, people using care and support, their families, the voluntary sector, and service providers. The consultation would close on 15 August 2014.
Source: The Care Act 2014: Consultation on draft regulations and guidance for implementation of Part 1 of the Act in 2015/16, Department of Health
The Scottish Government began consultation on draft regulations regarding the implementation of the provisions of the Care Act 2014, as they applied to Scotland and the issue of cross-border placements. The consultation would close on 18 August 2014.
Source: Consultation on the Draft Regulations Relating to the Care Act 2014, Scottish Government
Links: Consultation document
The Care Act 2014 was given Royal assent. The Act provided for a range of measures regarding health and social care, including: a cap on the cost of social care in England; the legal right of carers to support from their local council; provision for local authorities to assess the care and support needs of children, and young carers, who might need support after they reach the age of 18, to facilitate the transition to adult social care; entitlements to personal care budgets and provisions for deferred payments for care; a rating system for hospitals and care homes, and new powers of intervention to the chief inspector of hospitals; and the creation of two new public bodies, Health Education England and the Health Research Authority, designed to provide additional training and support for health professionals.
Source: Care Act 2014, Department of Health, TSO
An article examined policy approaches to working with families of looked-after children in four countries: England, Denmark, France and the Netherlands.
Source: Janet Boddy, June Statham, Inge Danielsen, Esther Geurts, Helene Join-Lambert, and Severine Euillet, 'Beyond contact? Policy approaches to work with families of looked after children in four European countries', Children & Society, Volume 28 Number 2
A paper examined the development of accountable care organizations (ACOs) in the United States and considered the implications for integrated care initiatives for England. It said that an ACO generally consisted of a group of providers that agreed with commissioners to provide all care for a certain population for a defined period of time, being held accountable to pre-agreed quality outcomes within a given budget or expenditure target. The paper said that the transfer from the United States to the United Kingdom context was not straightforward, however, and recommended caution in transferring the concept to the English National Health Service.
Source: Stephen Shortell, Rachael Addicott, Nicola Walsh, and Chris Ham, Accountable Care Organisations in the United States and England: Testing, evaluating and learning what works, King's Fund
A report provided an overview of the adult social care system in England. It said that care needs were increasing at a time when state spending was falling, and there was unmet need. The report highlighted changes within the care system (including those arising from the Care Bill and the Better Care Fund), challenges faced by local authorities and health commissioners, and risks to safeguarding of vulnerable adults. It said that new monitoring and improvement arrangements were not yet fully established and, as changes took effect, central and local government were at risk as a result of having insufficient evidence on service levels, unmet need, care quality, and value for money.
Source: Adult Social Care in England: Overview, HC 1102 (Session 201314), National Audit Office, TSO
An article examined the debates around greater choice and control within welfare services in England, and concepts such as direct payments and personal budgets. It reviewed the debates and their limitations, arguing that many existing accounts were based on problematic principles and did not apply a consistent burden of proof.
Source: Jon Glasby, 'The controversies of choice and control: why some people might be hostile to English social care reforms', British Journal of Social Work, Volume 44 Number 2
A report examined the future workforce requirements of the adult social care sector in England. It said that approximately one million further workers would be required by 2025, with a need for increased diversity within the workforce. The report said that there were challenges to achieving this, including: pay levels in the sector; the emotionally demanding nature of the work; staff turnover levels; perceptions of poor learning and development opportunities; and the demographic composition of the existing workforce. The report made recommendations.
Source: Ben Franklin, The Future Care Workforce, International Longevity Centre – UK
An article provided a critique of the United Kingdom government's conclusions regarding a new safeguarding power of entry, proposed in a consultation in 2013.
Source: David Hewitt, 'You are not, any of you, my mother: what happened to the safeguarding power of entry?', Journal of Adult Protection, Volume 16 Number 1
An article examined the uses of covert research in studying the social contexts of vulnerable groups, its potential worth in areas where overt strategies could not be used, and the issue of participant consent. It said that although covert research was critiqued as breaching the moral legitimacy of informed consent, it might have ethical and practical utility for research related to safeguarding concerns, potentially allowing the revelation of abusive and oppressive practices. The article noted that such research needed to follow rigorous ethical standards.
Source: Jonathan Parker and Sara Ashencaen Crabtree, 'Covert research and adult protection and safeguarding: an ethical dilemma?', Journal of Adult Protection, Volume 16 Number 1
A report by a committee of MPs said that the National Health Service had made savings, but there was a question mark about the sustainability of savings (particularly related to pay restraint) and it was not clear how the money saved had then been spent. The report noted the challenges surrounding the integration of the health and social care sectors, where one budget was static and the other reduced at a time of rising demand, and recommended that the existing level of real terms funding for social care should be ring-fenced. The committee noted the consequences of integration for commissioning and repeated its earlier recommendations for health and well-being boards to develop an overarching role across health and social care, and for a review to establish the best method of consolidating commissioning through the boards.
Source: Public Expenditure on Health and Social Care, Seventh Report (Session 201314), HC 793, House of Commons Health Select Committee, TSO
A report by a joint committee of MPs and peers examined the human rights implications of the Care Bill. It welcomed various measures, while also raising concerns about lack of provision to fill some gaps in protections. In particular, it recommended further protections for the rights of parent carers of children with disabilities, and for the Bill to include a free-standing statutory right to independent living.
Source: Legislative Scrutiny: Care Bill, Eleventh Report (Session 201314), HC 1027 and HL 121, Joint Select Committee on Human Rights, TSO