News

The trustees of the MS Society are soon to debate whether the charity will keep open its four residential respite care homes, or whether it will close them and redirect the funds into a more personalised respite care service. Its decision could have repercussions for other disability charities that currently use traditional methods of respite care. Increasingly, the trend is to move away from residential homes and day care centres and to provide respite care in individuals’ homes or in the form of a holiday. And with the new government’s pledge to increase the personalisation of health and social care, it looks likely that patients and their carers will be given a greater choice over how and where they spend their respite breaks in future. Although a recent MS Society review shows that many people are still in favour of using traditional methods of respite care, the majority of respondents said they would like more choice and control over their own and their carers’ respite care.

The General Medical Council (GMC) has published new guidance on end of life care to support healthcare professionals in making difficult decisions about the care of terminally ill patients. The new guidance is much more comprehensive than the previous version and is aimed at all clinicians that are involved in end of life care, not just those that specialise in palliative medicine. Key areas covered in the guidance include:

• The need for doctors to weigh up the benefits of continuing or withdrawing treatment
• That it should be assumed the patient still has capacity to make decisions
• The patient’s relatives should be dealt with in a sensitive manner.

However, the charity Alzheimer’s Society has criticised the new guidance for not giving enough attention to the needs of dementia patients. Pointing out that a third of people aged over 65 will die with dementia, the charity comments: ‘People with dementia have specific end of life care needs…We need dementia-specific guidance for clinicians if we are to ensure people with dementia get the dignity they deserve at the end of their lives.’

The charity Alzheimer’s Society has welcomed the appointment of Paul Burstow, a Liberal Democrat MP, as Care Services Minister in the new coalition government. A former member of the All Party Parliamentary Group on Dementia, Mr Burstow is well known for his support of issues relating to dementia and the care of older people. The charity comments: ‘Paul Burstow’s strong social care background and tireless championing of the rights of people with dementia are excellent attributes for a minister for social care.’

In other dementia news, the government has recently published its Programme for Government, which includes a promise that dementia research will be prioritised from now on. The news was welcomed by the Alzheimer’s Research Trust, which commented: ‘Dementia is the greatest medical challenge of our time, costing our economy £23 billion each year. Through this groundbreaking pledge, the new government has recognised the urgency of Britain’s dementia crisis.’

The new government has announced it is establishing an independent Commission on Long Term Care that will advise on how social care should be funded in future. The Commission will report back within a year. Health Secretary Andrew Lansley (Conservative) also revealed that the government will not be introducing Labour’s Personal Care at Home Bill, previously scheduled for April 2011 – indicating that the new government has abandoned Labour’s plans for free social care. The new Care Services Minister, Paul Barstow (Liberal Democrats), comments on the Commission’s role: ‘The Commission on Long Term care will be tasked with delivering a sustainable settlement, which is a fair partnership between the state and the individual.’ His comments suggest that any new system will be at least partly funded by the taxpayer.

The government also announced plans to reform the NHS with a view to improving patient outcomes. Key measures include:

• Merging health and social care budgets and prioritising preventative care
• Rolling out personal health budgets to more older and disabled people and their carers
• Increasing direct payments to carers and improving access to respite care.

These intentions have been welcomed by charities representing older and disabled people, including Age UK, the Alzheimer’s Society, Parkinson’s UK and Counsel and Care. However, the charities also called on the government to make sure it honours its commitment and acts quickly and radically enough to rescue the social care system from its current state of crisis.

Now that the Conservative party and the Liberal Democrats have come together to form a coalition government, the two parties must agree on how to shape the future of adult social care and how it is funded. It is encouraging to note that in his first speech as Prime Minister, David Cameron acknowledged the plight of the nation’s elderly people. Speaking from outside 10 Downing Street, Mr Cameron said that he aimed to ‘…help build a more responsible society here in Britain…I want to make sure that my government always looks after the elderly, the frail, the poorest in our country.’

However, although the Prime Minister has pledged to spend more on the NHS, neither the Tories nor the Liberal Democrats ruled out public spending cuts to the social care budget in the run-up to the election. And the new government has already faced criticism from the charity Carers UK for failing to make social care a political priority. Spokesperson Emily Holzhausen comments: ‘…we are deeply disappointed that the programme for Government published in the coalition agreement this week does not establish social care as a political priority. Clear plans must be brought forward as a matter of urgency, setting out a sustainable funding model for fair, universal, and transparent care services.’

You can watch clips from Mr Cameron’s speech at the BBC website, or read it in full at the Conservative party website.

The Law Commission is appealing for input from the general public about how adult social care laws should be reformed. The organisation was recently tasked with overhauling the current system of laws, which are confusing and in some cases, date back over 60 years. There are two ways that people can make their views known: they can attend meetings in London or York in June, or they can complete a simple online questionnaire. Areas that will be covered in the meetings and also feature in the questionnaire include:

• Choice and control
• Person-centred planning
• Location of care
• Dignity in care
• Personal budgets
• Eligibility for care funding
• Care plans.

To find out more, visit the In Control website where you can also view a PowerPoint presentation which gives you background details on why the law reforms are necessary.

The new charity Age UK, formed when Age Concern and Help the Aged merged in 2009, has published a series of new factsheets on its website, www.ageuk.org.uk. The factsheets replace those that were previously available separately from Age Concern or Help the Aged and have been updated to reflect the latest information. Topics covered include:

• NHS Continuing Healthcare
• Paying for permanent residential care
• Treatment of property in the means test for permanent care home provision
• Hospital discharge arrangements.

There are also numerous factsheets covering the benefits that may be available to older people and their carers, including Attendance Allowance, Disability Living Allowance and Carers’ Allowance.

As well as the factsheets, the new Age UK website contains a wealth of other information that is relevant to and useful for older people and their carers.

Welsh Health Minister Edwina Hart has published four new action plans that aim to improve services for people suffering from dementia. The plans will each tackle a separate area:

• Enabling earlier diagnosis
• Shortening hospital stays
• Reducing the inappropriate use of anti-psychotic drugs
• Improving the availability and quality of support services.

Around 37,000 Welsh people are believed to have dementia, with this figure expected to reach 50,000 within the next 20 years. Ms Hart comments: ‘The action plans show clearly how services must work together to…meet the anticipated increase in demand over the coming years. My focus is to ensure we improve patient care…I expect the NHS to work with other organisations to deliver the necessary changes.’

In related news, the Welsh NHS has just launched the 1,000 Lives Plus Programme which aims to improve patient safety, with dementia services being one of the Programme’s key target areas. The new scheme will take up where its predecessor, 1,000 Lives, left off and work to improve the quality of all NHS services in Wales, but especially dementia care and maternity services.

The Care Alliance has launched a new online survey to find out whether the recent economic pressures that have been put on local authorities have affected the amount or quality of social care that they are providing. The survey can be completed by the person receiving care, their carer, a relative or friend. It takes around five minutes and focuses on the different ways older people are helped to carry out day to day tasks, such as washing and dressing, in their homes or in a care home. You can access the survey through the cancer charity Macmillan’s website. Macmillan is a member of the Care Alliance which is a group of charities and organisations that have come together to raise the profile of social care and help improve the care system.

The Times reports on the potential risks of investing in a bond to cover the future cost of care. The article gives the example of Rosemary Upton, who took out a long-term care bond in 1997 after the death of her husband. The bond should have provided around £750 a week should Rosemary develop certain care needs later in life. By 2010, the bond was worth just £3,000, its value decimated by poor investment performance and spiralling care costs. Rosemary was told she either had to make up the shortfall herself, or accept the loss in benefits. She decided to cash in the bond. Care bonds like Rosemary’s – which was a type of insurance policy partly based on investment performance – were mostly sold in the 1990s and are no longer widely available.

However, as The Times points out, many more people could find themselves in Rosemary’s position as they try to make financial provision for themselves in the face of potentially long delays before the next Parliament decides on the future of social care funding.

Cheselden urges anyone considering buying any type of financial product to pay for current or future care costs to consult an experienced and reputable independent financial adviser before proceeding.