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
A report examined the way in which local authorities implemented third party top-up fee arrangements, and their concerns in light of the implementation of the Care Act. It said that around 56,000 people in England had their care home fees paid in part by the council and in part through a top-up fee paid by a third party, and said there was a wide variety of practice across different local authority areas, with some gaps and uncertainties around monitoring and in ensuring the sustainability of arrangements. The report said that there was great uncertainty about the implications of the Care Act for top-up fee arrangements, and that local authorities had voiced concern about how the top-up rules would work alongside deferred payments and capped care costs. The report made a range of recommendations.
Source: Sue Arthur, Care Home Top-Up Fees: Research with local authorities, Independent Age
A briefing paper said that the number of children in the care of councils in England rose by 7,210 (12 per cent) over a four year period to March 2013, but councils' costs increased by only 4 per cent nationally. Regional costs varied from a 15 per cent rise in the north east to a 7 per cent reduction in London, and the paper said that there was significant variation between councils in the average amount spent on each looked-after child. The analysis had found inconsistencies in data reporting, but a range of factors were said to affect how much councils spent, including: how easy it was to recruit local foster carers; the availability of suitable local placements; the balance between the council's use of its own and agency foster care services; and the nature of the foster care market operating in the local area.
Source: Councils' Expenditure on Looked after Children, Audit Commission
An article said that the incorporation of active ageing into the policy agendas of the welfare systems for older people should be understood by reference to the perceived effects of demographic trends on demand for services. It said that the active ageing agenda had became inextricably linked with the broader policy agenda to reduce older people's call on public resources in order to manage the increasing proportions of older people in the population, and the implications of these developments for social work were significant.
Source: Liz Lloyd, Denise Tanner, Alisoun Milne, Mo Ray, Sally Richards, Mary Pat Sullivan, Christian Beech, and Judith Phillips, 'Look after yourself: active ageing, individual responsibility and the decline of social work with older people in the UK', European Journal of Social Work, Volume 17 Issue 3
A report examined the integration of health and social care, the Better Care Fund, and the role of county councils in shaping the future of care in England. The report drew on the findings of a survey of county councils.
Source: Delivering the Better Care Fund in Counties, County Councils Network
A report examined the use of, and outcomes from, integrated care funding transfers for 2012-13 and 2013-14, which were granted to support adult social care services that also had a health benefit, encourage health and social care integration, support existing services facing budget pressures, or deliver new services through transformation programmes. Based on freedom of information requests sent to local authorities in England, the report said that funding was used primarily as a means to support existing services, rather than to transform and more closely integrate health and social care services. It said that there was a wide variation in how funding was invested and reported, but it was not sufficient to meet increasing health and social care needs of local populations, there was a lack of robust outcomes data, and less than 4 per cent of funding had gone to local mental health services. The report concluded that, while there had been much support for the integration of health and social care, service change remained subject to significant local variation and the results had important implications for the introduction of the Better Care Fund from 2015.
Source: All in this Together? An analysis of spending on integrated care by commissioners in the new health and social care system, MHP Health
A report examined the role of integrated financial mechanisms in supporting and incentivizing integrated health and social care. The report was based on a literature review, which found 38 studies across eight countries (including England). It said that schemes that integrated funds and resources seldom led to improved health outcomes and, if schemes were successful in assessing patient needs, they would be likely to identify previously unmet need, thus increasing overall cost. The report said that the evidence from England revealed that outcome evaluation was challenging, as new schemes often emerged in the context of other evolving policy initiatives, and that future policy should bear this in mind.
Source: Anne Mason, Maria Goddard, and Helen Weatherly, Financial Mechanisms for Integrating Funds for Health and Social Care: An evidence review, Centre for Health Economics (University of York)
An article examined the introduction of 'personal budgets' for users of social care services in the United Kingdom, and the question of how to determine the level of funding to be made available to any individual with a given set of needs. It presented three studies of needs-based resource allocation systems and suggested (contrary to some recent academic work that suggested that modelling did not produce adequate accuracy) that it was possible to predict costs from needs.
Source: Paul Clifford, Rob Saunders, and Laura Gibbon, 'Modelling the relationship between needs and costs: how accurate resource allocation can deliver personal budgets and personalisation', Research, Policy and Planning, Volume 30 Number 2
An article examined evidence around the introduction of personal budgets and personalization for users of social care in the United Kingdom, updating earlier work by the authors on this topic. It said that the evidence showed that the existing government strategy was still failing in its aims. It said there was an urgent need for policy change.
Source: Colin Slasberg, Peter Beresford, and Peter Schofield, 'The increasing evidence of how self-directed support is failing to deliver personal budgets and personalisation', Research, Policy and Planning, Volume 30 Number 1