40% of people delayed in hospital awaiting social care package – Community Care

A plan, published by the Department of Health and Social Care (DHSC) and NHS England and a letter from ADASS, LGA, and SOLACE describing their priorities for future action to tackle pressures on hospitals, and surprisingly I tend to agree with both.

Unfortunately, all of this was there to be seen for many years previously, but during those years we have had un-listening Governments who, even if they had listened would not have been prepared to take the appropriate actions. So the crisis in social care and also that of the NHS were left to fester.

Many of the problems of the NHS are down to the crisis in social care, but that is not down to social care and also to the Local Authorities (LAs) who are responsible for funding social care to a large extent but the funding of LAs by the Governments, especially since 2010 with the dreaded austerity cuts imposed on LAs by the tory Governments since then have caused very serious problems. But, in reality, the funding for social care has never been fully sufficient, but the cuts from 2010 certainly added to the problems, very greatly, and not just social care, but all other services which LAs are responsible to fund. All of this is down to Governments who apparently have never been blamed.

So, yes both social care and the NHS are in dire need of substantial need of additional funding, but the funding is far too little and to a very large extent way far too late. If most of the way too little additional funding goes to the |NHS and not social care this again will be so wrong.

Both the NHS and social care are extremely short of staff, perhaps social care even more so. While there is currently, strike actions by some NHS workers for a very justifiable salary increase, the increase in pay rates for care workers could be way more justified., for care workers have never been paid sufficiently. Most are only on the National Living Wage of around £10 per hour increasing to around £11 per hour in April 2023 but in reality, the rate should be at least £15 per hour.

These increases are required now in full and not over 2 years, and these pay rates have to be sustainably increased for all the years to come. But for care workers, it is not just pay rates, but also employment terms and conditions, which include travel expenses holiday pay, and to some extent recognition of holiday entitlement sick pay, and much more.

These problems are totally at the door of the Government and need to be actioned without further delay.

It could be said that all of this can’t be afforded, and I would say it can’t be afforded not to.

 

Source: 40% of people delayed in hospital awaiting social care package – Community Care

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‘Hospitals at home’ plan to save NHS

This is all well and good, but everyone has broadband to allow video links and in many cases the care that could well be required would need social care input, which is not there to any degree due to staff shortages in social care and the exreme lack of funding for social care.

So, in theory yes, but not, in some instances practible.

While looking to releave the crisis in the NHS, the crisis in social care also needs to be dealt with and this, in many instances, is much more serious than that in the NHS.

Not only does it require many £billions, but much needed sustainable funding. If the hourly rate for care workers is not drastically increased to around £15 per hours, not in years, but so much immediately then we can say goodbye, not to just social care, but also the NHS. One can’t exist without the other no matter how you look at it.

That is the main problem as no one is really looking at it, not now and for many years before.

If social care had been part of the NHS then it could well have been in a better position, but it never was.

Every Government up to and including the current has ignored social care to a large extent and as far as I can see forever in the future.

Social care has to be a priority as never before for if not both social care and the NHS will just disappear.

No point looking for family involvement as families are already saving the UK £193 billion in care costs, and in doing so families are ignoring their own health, so delaying treatments and in the end they too require social care and more NHS care.

No longer can social care be ignored, for the future of the NHS depends on the social care crisis being solved, even £12 billion won’t cover it, but just about bring it back to the 2010 level, which even then was way insufficient.

Source: ‘Hospitals at home’ plan to save NHS

‘Risk of future deaths’: coroner issues rare warning to health secretary over hospitals crisis | NHS | The Guardian

‘A coroner has urged the health secretary to take action to prevent needless deaths after a woman died of heart failure following a four-hour wait in the back of an ambulance.

The coroner said that the QEH was regularly overwhelmed, with “too many patients in the emergency department” and a lack of social care in the community preventing people from leaving hospital.

But the coroner said evidence indicated the problem was “much wider and more complex” than a single NHS trust and that action was needed at government level.’ Guardian article 29 January 2023

This Coroner is so correct for while the NHS is on the ‘frontline’ they are doing as much as they can without the sufficient resources required and what is urgently required is Government action, not just from the Secretary of State for Health and Social Care, Steve Barclay MP, but also the Chancellor of the Exchequer Jeremy Hunt MP and the Prime Minister Rishi Sunak MP.

Hunt being a former Secretary of Health and Sunak a former Chancellor of the Exchequer, so both should know more about health and finance than they appear to be. But many of these problems were well around before the these last Tory Governments came in 2010,  as was the crisis in social care.

This is something that no UK Government as really looked at, if at all and this crisis could well be so much worse than that of the NHS, as both rely on eachother, for without one there won’t be the other.

Also social care is so much more than the care for the elderly as it includes children and adults, in home, supported living, respite, hospices and others. If it was not for Family Carers social care would hyave colasped well before now as Family carers are saving around £193 billion a year in the UK, if it wasn’t for family carers this is what social care would need in addition to what is already required for paid care. For £12 billion would just equate to, in real terms what it was in 2010 and even then it was way insufficient.

Social care is just as important as the NHS and so much as necessary.

Most family carers do the caring for their relatives for life or as for as long as they can with their own deteriorating health or the death of their relative, whichever is sooner. With the deteriorating of the health of family carers this requires even more social care for them too and results in more care required within the NHS. For while caring for their relatives their last thoughts are their own state of health and this deteriorates without notice in many instances until it is virtuallly too late.

Not only is social care extremely necessary, it is in most instances also an emergency service which goes unrecognised by this unlistening Government. But to be fair, all previous governments also.

Not one has given social care any real consideration if any at all and now, but has been for years, it is noticeable in the NHS or it should be, if anyone is prepare to look. But looking is far too late as it is and has been for many years action required or we can say goodbye to not only social care but the NHS as well. This could be what the Tories are wishing for, but as far as I can see Labour are no different, so Labour Leader Keir Starmer what have you to say?

I doubt very little for it appears to be nowhere on their agenda.

Source: ‘Risk of future deaths’: coroner issues rare warning to health secretary over hospitals crisis | NHS | The Guardian

Care workers’ lack of power at work behind tolerance of poor pay and conditions, finds report – Community Care

In many instances I do agree with this report, especially of the low pay of care workers and the lack of effective travel pay to cover all expenses as while distance could be covered, time may not be. In some instances the timing between caring for one person and the time needed to get to another, is virtually impossible to do, especially where traffic conditions are far from good.

Yes, some care providers could do much more for the care workers they employ, but as their funding comes mainly from Local Authorities (LAs) and a fair proportion of LAs funding comes through the Government grants to LAs, which has been considerably reducing in real terms since 2010 due to the Tory imposed Austerity Cuts. But, in effect was social care really correctly funded before 2010, I feel not as social care has never been sufficiently funded.

A great mistake was not to include social care within the NHS in 1948 and with hindsight this should have occurred, then there wouldn’t have been to ‘toing and froing’ between LAs and  Continuing Health Care  (CHC) as to who should fund what and the duplicity of some work would also have been mitigated. This would also have dealt with the discrimination in which conditions are health and which are social care and the ways they are looked at, especially how funded. i.e. will a person be contributing or not.

Not saying that the funding would have improved greatly as the NHS has also been seriously underfunded to some extent over the years.

What does need to be done is to greatly improve the pay rate for all care workers and I would say at least £15 per hour as this would encourage more to enter the care profession. But also allow more immigration so many non-UK persons can come to the UK to also enter the care profession. In doing so also improve the travel expenses and other working terms and conditions, such as recognised holiday pay, sick pay and others.

All are needed as for some times many persons in need of social care have not been receiving any or if some, nowhere near the required amounts. Demand for social care is forever increasing while in real terms the funding has been reducing. Much of this lack of social care has been taken on by family carers well past when their own health has deteriorated, in which case this again increases the demand and need for social care and eventually much more care within the NHS.

This Government and all future Government have to listen and take this on board as no Government has done previously, if at all, for not to do so will not just be the demise of Social Care, but also the NHS.

The start of this has been happening for years, but now it is much more evident, but still this Government is not listening, is it because they are failing to see the problem or, more likely no wish to see the problem.

 

Source: Care workers’ lack of power at work behind tolerance of poor pay and conditions, finds report – Community Care

Sajid Javid calls for patients to pay for GP and A&E visits | NHS | The Guardian

Sajid Javid MP is calling for patients to pay for GP and A&E visits, is he for real? These are not free but funded through the universal UK Health Care System which is funded through various forms of taxation, so that no one can, or should not be without the health care they need.

Perhaps, if everyone was on a MP salaries then this could, possibly be afforded by some, but in reality the majority of the UK population would not be able to afford it and in doing so the health of the UK population would seriously deteriorate, so much greater than it is currently doing.

It would lead to much less employment, and this would also occur in all areas of the health services, there are insufficient now, but bring in these direct charges and it will lead to many more less, as many would become to sick to work.

Perhaps, this is want Sajid is wishing for, only the rich survive, but the rich would not wish to do the jobs in health and many would never have the ability to do so.

We are a nation of individuals, but individuals of differing abilities and for everyone to survive we all needs to work together.

But, in all of this Sajid and members of the Tory Government and the Labour opposition are making no mention of social care, which is also in crisis, perhaps an even greater crisis than the NHS.

Again there is serious under-investment and in many areas so insufficient that it appears there is no investment at all. When you look at the history of social care not once has it been sufficiently funded and since 2010 this underfunding has been seriously been made worse. It is so bad that many can’t see how social care is existing and for many in the UK it is not.

The NHS needs social care and social care needs the NHS for neither can exist without the other.

If social care was funded sufficiently and on a consistent and sustainable basis then many of the NHS problems would be greatly mitigated and over time been so reduced so that the NHS can eventually get back on a sustainable footing itself.

All of this will take time and this time should have been done years ago, but for that to have occurred then we would have needed a listening Government, which irrespective of the the Party in power we have never had and it is unlikely on how both this Government and Labour in waiting are discussing our future.

Social care needs very serious, extremely urgent investment, which don’t appear to be on this Government’s agenda or the agenda of Labour in waiting.

They are both setting up the UK to fail and then there will be no social care or NHS to go to for anyone, unless you are rich enough to fund your own, but then will there be anyone to fund in the UK, perhaps they will need to go away from the UK for what they need, but that is only available to the rich and the rest of us will be left to decay and eventually not exist.

Source: Sajid Javid calls for patients to pay for GP and A&E visits | NHS | The Guardian

Government should declare “national emergency” over NHS crisis, say peers | The BMJ

Yes, I so agree, but as the NHS can’t survive without the social care crisis being solved, then the ‘national emergency’ needs to include both the NHS and Social Care. However, not just Social Care for the elderly, but for all Social care which includes both, children and adults, which encompasses, care homes, home care, respite, supported living, hospices and others.

While funding, even though insufficient and often misplaced has been given to the NHS, no Government has done anything for Social Care and without substantial funding both social care and the NHS will fail to survive.

Yes, the rates of pay in the NHS needs to be increased and also the Employment terms and conditions, but this is even more so for social care.

Care workers need and deserve much more respect and recognition than they have ever been given and a rate of pay more inline with the work and responsibilities they undertake, which should be, at least £14/15.00 per hour, so much more than the existing £10 and the increase to around £11 in April 2023 with the promised increase in the National Living Wage, while the Real Living Wage has already been increased.

I have been saying this for years and now others appear to be listening, except this Government of ‘3 wise monkeys‘, which is very wrong to associate with monkeys, who are so much more intelligent than anyone in this Government and all previous Governments.

It will be said the UK can’t afford to do all of the above, but, in reality, it can’t afford not to, as the survival of both the NHS and social care are at stake, for one can’t exist without the other. If that occurs then Safeguarding concerns with go through the ‘roof’, but nothing will be available to deal with any of the concerns and in effect there will be no structures of any nature to be still available to the majority of the UK. The rich, the 1% or perhaps, the 5% will still be able to purchase what little there is, but any aspect of ‘universal’ care will have gone and our care system will be on a par with the unmentionable American system.

 

Source: Government should declare “national emergency” over NHS crisis, say peers | The BMJ

Reinstate hospital social workers to improve discharge outcomes, PSWs urge Barclay – Community Care

To some extent, I agree, but the real problem is the dire lack of sufficient social care, mainly due to the long-standing lack of funding for social care which means the pay rate for social care workers is so low as to not encourage more to enter the care profession. But it is not just the pay rate but the whole employment terms and conditions for care workers. This is coupled with the immigration restrictions which are not enabling non-UK workers to come to the UK to enter the care profession either short-term or long-term.

This is all down to current Government policy although the dire funding covers so many years as no government has funded social care sufficiently, which has led to this current crisis not only in social care but also in the NHS.

The current amounts of funding to try to solve the NHS bed shortages due to patients not being able to be discharged are way too little and way too late, for to solve, to any degree, it is £billions required and not the £millions currently being offered.

One may say the country can’t afford it, but in reality, it has to for any hope of saving both social care and the NHS for one can’t exist without the other.

 

Source: Reinstate hospital social workers to improve discharge outcomes, PSWs urge Barclay – Community Care

Risk of ‘poor or potentially illegal’ practice in care home discharge plan, warns ADASS – Community Care

This all so true and I welcome the Association of Directors of Adult Social Services (ADASS) now speaking out, but this should have been done much earlier for this crisis is nothing new, but is so much more than it has been.

The crisis with the funding of Social Care goes back years, even well before 2010 when the dreaded Tory austerity cuts were introduced. It was so clear then and well before that social care could not continue as it needs to with totally insufficient funding it was receiving and the Austerity cuts, followed by COVID and now the cost of living inflations are making it even more necessary for so much more funding. It is surprising that Social Care has continued to be there, which it has in a very seriously depleted form on the backs of the totally insufficiently paid care workers.

Due to the extremely low pay in the care profession, less and less people are prepared to enter the profession for a meagre remuneration, when much more can be earned in other areas with so much less responsibilities required.

Then with the Tory so inappropriate immigration policies this then drastically cut the numbers of persons wishing to come to the UK to enter the care profession on either a full-time or even part-time basis. Then there are the totally inappropriate Terms and Conditions available, again totally insufficient travel expenses, no proper sick pay arrangements and no recognition for working Bank Holidays and in some instances even holiday entitlement, but there are many other difficulties.

This has led to a serious deficiency in staffing and even more so now, so these small amounts of Government funding at this late stage will do so little to achieve. it is not £millions required, but many £billions, at least £12billion.

If this Government and all previous Government had been really concerned about social care then these current situations would not be here, but all these Governments viewed social care has being insignificant, if they even viewed social care at all.

We are all now and the NHS suffering greatly for all this current and all past Governments great insufficient concerns and there will be so much more suffering for those who are in the greatest need of care, for deaths will and are occurring due to all these lack of concerns by all Governments.

Every area of the NHS is suffering not just hospital beds, just as social care has been suffering for years without any real concerns.

For the NHS to have any real chance of survival then social care has to be fully, sufficiently funded and not just for now, but the required funding has to be sustained, otherwise these crises will just reoccur and in a greater extent to that currently.

Safeguarding is so much a concern and many more will be occurring.

Wake up Government for once in its life and break the habit of a lifetime and do all that is required for both social care and the NHS for both depends on it for any forms of survival.

Care workers are very much misaligned and deserve so much more respect from all quarters of the UK, especially this Government.

 

Source: Risk of ‘poor or potentially illegal’ practice in care home discharge plan, warns ADASS – Community Care

Less than one in five care staff vaccinated against flu or boosted against Covid, figures reveal – Community Care

I would encourage everyone to have both the COVID- 19 and Flu vaccinations to enable them to have the full possible protection possible and in doing so protect others, but I can see the reasons of some not to.

This is especially so in Social Care for if they do get a reaction from the vaccinations the loss of earnings they would suffer will be extremely dire to them, especially as their pay rate is so low to start with and the lack of sick pay for the first 3 days being off work. As for many just working all the possible hours could well be insufficient to support themselves and even more so if they have a family.

Then with the lifting of restrictions by Johnson this gave the impression to many of the UK workforce including those in social care that vaccines for COVID and then the flu were not worth bothering with.

When Nadhim Zahawi MP was Parliamentary Under-Secretary of State for COVID-19 Vaccine Deployment much was heard about the importance of having the vaccines, but hardly any mention from his successor to the role in September 2021. This was Maggie Throup MP in the revised role of Parliamentary Under-Secretary of State for Vaccines and Public Health. With her lack of prominence this further led to the belief that the vaccine was not now that important, but so mistaken.

The Johnson Partygate scandal was, also to blame for some of the indifference to COVID.

But vaccine fatigue would also have been a factor and still is with the still mistaken beliefs that the vaccine is not proven and in some instances causes COVID.

In some instances there could also be the mistaken belief that with the severe shortage of care workers and that COVID was no longer of any significance due to its apparent mild nature which again is to some extent not totally true, for even a mild occurrence of COVID could well lead to severe and long standing Long COVID experiences, going into work is more desired.

Now with the increases in inflation and the cost of living crisis these are now considered more important than COVID and while they are very important COVID is still around and could well be for much time to come.

So much more is required to improve the standing of social care and social care workers and that has to be a much needed and deserved increase in their rate of pay, at least another £3/4 per hour, bring their rate of pay to £14/15 per hours and much more improved working conditions, a proper sick pay arrangement for one.

Care workers are very much misaligned and deserve so much more respect from all quarters of the UK, especially this Government.

 

Source: Less than one in five care staff vaccinated against flu or boosted against Covid, figures reveal – Community Care

Sir Keir Starmer: I will slash ‘nonsense’ bureaucracy in the NHS

Yes, it is true that the NHS needs great reform and there is too much bureaucracy, but it needs to be done by negotiation with all of the NHS. But bureaucracy is just one of many problems.

As to making all GPs employees of the NHS and taking away their current self-employed status, yes, they say it will be done gradually, but that will take years.

You may not be aware but it was the original intention in 1948 for all doctors and also dentists to be employed by the NHS but they didn’t wish to be and they and the BMA rebelled. If the Government in 1948 hadn’t agreed that they could remain self-employed and be paid per enrolled patient instead of employees and only the Practice be in the NHS then there wouldn’t be an NHS. So, will the GPs or the new GPs agree? If they do, then there will be a 2 tier NHS for many, many years.

But this is just one of the problems for the crisis in Social care is just as major and also needs to be solved for the NHS to survive and that needs major funding and care workers’ remunerations and conditions of employment. Care workers’ remunerations need to be greatly increased to encourage many more needed care workers to enter the care profession for without them social care won’t survive and neither will the NHS.

Is Starmer listening, well I hope so, but a doubt it?

Source: Sir Keir Starmer: I will slash ‘nonsense’ bureaucracy in the NHS