Issue 34 January 2012 Please note: Opinions expressed in this newsletter are the views of the author, and are not attributable to the Lancashire LINK.
Transcript
1. Issue 34 January 2012Please note: Opinions expressed in this
newsletter are the views of the author, and are not attributable to
the Lancashire LINK.
2. WORLD LEPROSY DAY 2012 JANUARY 29 ONE BODY... Many members
World Leprosy Day We will not turn away In times of despair. We
will come near, walk alongside. We will
care...WWW.LEPRAHEALTHINACTION.ORG
3. Contents 3 6Editorial 4 The LINk and Local Healthwatch.LINk
News 7 5 Signs of the times? Summary of Transport Survey 2010. 6
NHS 111 service. 7 BMA seeks confidentiality assurances over
patient data. 8 Board Member profile. Night-time Hours Service
changes. 9 Patient Stories. UHMBT Hospital Appointments. 12 8 Shock
report reveals human rights abuse. 13 Health and Social Care Update
Number Four. The Dilnot Proposals on Funding of Care Services. 14
Counting the cost of care. 16 Counting the cost of care - Patients
stories. 17 Cancer patients hit by return to work
proposals.Out-and-About 12 10 Out-and-about with the LINk. 17 19
20Features 18 Lancashire Hospital trusts feature in highest death
rates. 19 Is your care up to standard? 20 999 Call
Categorisation.
4. Editorial LINk News Out-and- Features News 4 5 about 10 18
214 EditorialThe LINk We hope to keep you informed as things takes
shape.and Local HealthWatch In the meantime, we are happy to answer
some commonly asked questions:As many LINk members will be aware,
underthe Governments health and social care Will Local HealthWatch
be the same as the LINk?reforms, the LINk will be replaced by
newLocal HealthWatch organisations in October Local HealthWatch
organisations will carry on2012. with all the involvement and
scrutiny activities ofThe new Health and Social Care Bill states
that the LINk, including promoting involvement;Local HealthWatch
organisations will be the local obtaining views; monitoring health
and careconsumer champion across health and social services; making
reports and recommendations;care. and carrying out enter and view
visits.But the proposals have prompted many questions However,
Local HealthWatch will have severalfrom LINk members who have asked
what will extra duties, including providing information tohappen to
the LINk over the next few months, and support patients to make
choices about theirhow will the changes take effect. health or
social care and providing, or signposting people to NHS complaints
advocacy services. AsWe are happy to reassure our members that the
well as this, the Government states that thereLINk will still be
carrying out its activities as usual must be a Local HealthWatch
representative onover the next few months. That means we will still
the newly established Health and Wellbeingbe dealing with your
issues and concerns around Boards.health and social care, and
feeding these tocommissioners and managers within the NHS and What
sort of organisation will Local HealthWatchLancashire County
Council. be?We will still be keeping you informed of ongoing The
Government proposes that Localdevelopments concerning national and
local HealthWatch will not be a network organisationhealth
policies, via our newsletter and other in the way that the LINk is.
Instead it will be abulletins, and inviting your responses. body
corporate. This is a legal term which simply means it would be
constituted as an organisationWe will still be organising events
and conferences in its own right, with its own constitution andto
provide people with the opportunity to have arrangements for making
decisions in antheir say on health and social care. accountable
way.And we will still be keeping our band of trained This is likely
to mean Local HealthWatch wouldvolunteers busy as they undertake
enter and view be set up in the same way as many local
charitiesvisits to care homes and health settings, or carry and
voluntary organisations. The governmentout mystery shopping. sees
this as a way of making sure that Local HealthWatch is really
independent andHowever, at the same time, we hope to provide
answerable to local people.information on developments around Local
However, there will still be an important role forHealthWatch, as
they arise, and will also be patients, service-users and those
interested inhelping to support the promotion and roll-out of
championing health and social care to becomeLocal HealthWatch
within Lancashire. involved in Local HealthWatch.Lancashire County
Council is taking the lead on The role of local Local HealthWatch
will bethe development of a Lancashire Local overseen by
HealthWatch England, a nationalHealthWatch and discussions are
currently taking healthwatch organisation.place on the structure of
this new organisation.
5. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 LINk News 5Signs of the times? attendant directed me to one of
stress of trying to park their car, the car parks, but I couldnt
find a finding where they need to be car parking space. going, or
finding enough moneyDo hospital direction signs put for car
parking.you in a spin? Does trying to Because all the direction
arrowsfind an empty hospital parking were pointing one way, I
followed I realise there are no easyspace drive you to distraction?
them all the way to the end only answers to this, but are thereIf
so, the LINk would like to to be met by a ticket barrier. But I
ways hospitals could come uphear from you. didnt have a ticket
because I with more imaginative solutions: hadnt parked and there
was a staggered visiting hours,We would love to hear your views
queue of irate drivers behind me, perhaps? Better advertising andon
which of the regions hospitals waiting to come out! promotion of
public transport? Afare best and worst when it realistic maximum
charge so thatcomes to parking and direction I had to somehow
manoeuvre my family members who need to staysigns. car and
backtrack to find a car with their loved ones are not parking
space, which I did penalised with a hefty parkingAs anyone who has
to visit a eventually. But I was miles away bill?patient in
hospital, or attend from the maternity unit. By thishospital as a
patient or outpatient, time, I was feeling really hot What are your
experiences ofwill readily testify, visits can be under the collar,
anxious to see hospital signs and car parking?fraught with tension
and anxiety my daughter-in-law and Which hospitals fare the best
andat the best of times. Trying to find grandson. worst in relation
to parking? Thewhere you are going or LINk would love to hear
yoursomewhere to park can send The day before, my daughter-in-
views and experiences. Contactstress levels soaring even higher.
laws mother had driven up from [email protected] her home in
Reading, arriving atLINk news editor and community lunchtime, to
spend the full day atengagement officer Angela Norris the hospital.
When she got to herhad this experience when she car later that
night, she wasvisited Royal Preston Hospital dismayed to find she
had beenrecently to see her daughter-in- charged 10 to park for the
day.law and new grandson, Stanley. Commented Angela: ManyAngela
recalled: It was afternoon people who visit hospital mayvisiting
and I queued for what have concerns and worries aboutmust have been
20 minutes to get the patients they are going to see,on to the
hospital site. A car park without having the additionalSummary of
Transport Survey 2010Research by Lancaster-based One Voice
Disability Forum reveals that most people with disabilities relyon
buses for transport and find them affordable, reliable and
comfortable.However, nearly half of those interviewed said they
needed help when travelling and pointed to problems withramps as an
area of concern.Wheelchair users said some bus drivers did not know
how to use the ramp, or were reluctant to get out of theirseat to
lower the ramp. Other users reported that some drivers were not
aware the bus could be lowered to thekerb. Problems were
exacerbated by unhelpful drivers and, as a result, many wheelchair
users no longer usedbuses.The research also discovered that taxis
are a popular form of travel for disabled people and most taxi
driversare responsive to their needs. However, some taxis do not
have straps to secure a wheelchair and manypeople reported
difficulties in booking a taxi at peak times.The report calls for
more information on public transport services to be available in
large print. For a copy of thereport email
[email protected]
6. Editorial LINk News Out-and- Features News 4 5 about 10 18
216 LINk News advisor will ask you questionsNHS 111 service about
your symptoms and, based on the answers youThe NHS 111 service is
there to give you give, they will give you adviceadvice if you
think you have an urgent health on which service is the best
forneed, but you are not sure what to do. you, based on where you
live and the closest serviceAs reported in the November newsletter,
111 is the available. If the call advisornumber for a new free to
use telephone service thinks you need emergencywhich gives advice
on which service to use if you attention they can immediatelyhave a
minor injury or illness that needs medical dispatch an
ambulance.attention but is not an emergency.If you are feeling
unwell or have an injury, it can be 999 remains the single number
to call if you ordifficult to know which NHS service to use,
someone you care for has a serious or lifeespecially if you have a
number of different threatening health emergency such as a
seriousservices in your area such as a walk-in centre, a accident,
a heart attack, a stroke or breathingminor injuries unit or urgent
care centre as well as problems.your local high street pharmacy,
your GP and If you have used 111 since it was introduced
wehospital. would be interested to hear your thoughts.
PleaseCalling 111 gives you access to a trained call contact
[email protected] or calladvisor, who has information
about the different 01772 431195.services available to you in your
area. The call Together we can keep Lancashire moving this
winter
7. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 LINk News 7BMA seeks confidentiality assurances over patient
dataThe BMA has warned the Nathanson, head of science and
ethicsGovernment that they must ensure at the BMA said: Whilst the
BMA doespatient confidentiality is protected believe the use of
anonymised healthin light of the Prime Ministers data could benefit
patients, we areannouncement that patient records concerned that
elements of thewill be made available to the Governments proposals
could, ifprivately run life sciences industry implemented,
undermine patientfor research purposes. confidentiality.The NHS
Health and Social Care She said the BMA was particularlyInformation
Centre is to set up a worried that researchers from largesecure
data linkage service by commercial companies would be able Dr
VivienneSeptember, 2012. This will provide to access patient
records, find out Nathansonextracts from patient data to life about
peoples health status andsciences businesses for research,
treatment, and then may try to contactincluding research into
drugtreatments.David Cameron this week assured thepublic that any
records would remain them. In response, a Department of Health
spokesman said: The data will be Whilst the BMA does
believeanonymous, claiming this doesnt stored electronically and
linked when the use of required to meet a specific health
anonymisedthreaten privacy and patients could question. This means
the data the health dataopt out of having their data shared.
researcher receives will be only that isPatients will also have
access to their relevant to the research. could benefitGP records
by 2015, with details of the patients, we *Article from The Pulse,
the journal for are concernedfull timetable to be published by the
BMA -http://www.pulsetoday.co.uk/September 2012.
newsarticle-content/-/ that elementsThe Department of Health plans
to article_display_list/13153083/bma- of theannounce a consultation
to change the raises-alarm-over-nhs-patient-data- GovernmentsNHS
Constitution so that patient data sharing-plans proposalsis
automatically included in clinical could, if What do you think
about theresearch, but giving patients a clear implemented,
Governments plans to share patientopportunity to opt-out if they
wish todo so. data with the research industry? Will undermine they
compromise patient patientHealth secretary, Andrew Lansley,
confidentiality? How will patients be confidentiality.said: What we
are talking about is not informed of their right to opt out?
patients individual medical records. Email the Lancashire LINk with
yourWhat were talking about is linking up views:
[email protected] the data sets across the NHS
tocreate what is population-based dataabout the success of new
treatmentsacross the NHS and the ability to linkup research data
with the data abouthow patients are responding inresearch
trials.But the BMA raised concerns overpatient confidentiality. Dr
Vivienne
8. Editorial LINk News Out-and- Features News 4 5 about 10 18
218 LINk News Night-time hoursBoard member Can you name your
favourite service changesprofile book? Not really. There are too
many, Burnleys night-time out of hours but Sophies World by Jostein
doctors service has been movedName: Gaarder is one. I almost never
from the St Peters Centre inMichael Swarbrick go to the cinema
without falling Burnley to Burnley GeneralJob title: asleep.
Hospital. As part of a trial run overVice-chair the winter months,
GPs will be Can you tell us one fact about based at the urgent care
centreWhich area do you work in or yourself that others might be
from midnight until 8am eachrepresent? surprised to hear? night.I
am interested in the changes Although I was physically This will be
the only change to theto the structures of Health and disabled at
birth, at the age of service at St Peters, which willSocial Care
because I can 18 I was called into the army continue to operate as
normal atremember what it was like and served 2 years in the all
other times.before the foundation of the RAMC. (Well, the Korean
WarNHS. It would be good if the Health bosses said the scheme was
on. If you were male, couldNHS survived for my would test whether
it is feasible to stand up and didnt have flat feet run both
services together on agrandchildren. you were in.) permanent basis
in the future.How long have you been Information from NHS
Eastinvolved with the LINk? Lancashire shows a low take-upSince it
began. of people using the serviceWhat brought you to the between
midnight and 8am, averaging at fewer than twoLINk? patients per
evening.The NHS keeps me alive. I oweit something. It is felt that
by co-locating the GP out of hours service with urgentWhat do you
feel are the care services at Burnley Generalstrengths of the LINk?
Hospital this will ensure thatIt strives to be the independent
patients receive the rightvoice of patients and ordinary treatment
from the right doctormembers of the public. It has no however they
access the service.reason not to tell the truth as The GP out of
hours servicepatients see it. operates as an appointment-Can you
tell us a little bit based service where patients canabout your
career call the new 111 service whenbackground? their GP practice
is closed. The 111 service assesses patientsI left school at 15. On
the way to and determines whether thea career in education I worked
patient needs to attend an urgentfor two breweries and improved
care centre or see an out of hoursmy education in my spare time. I
GP. Where a patient needs to seetook full advantage of the fact a
GP out of hours they will bethat in those days a part time given an
appointment over theuniversity education was phone and advised
where toaffordable but I was an old attend, thereby avoiding
anystudent by the time Lancaster confusion where a patient
needsawarded me a Ph.D. to go for treatment.What are your hobbies
and If you have had to use the serviceinterests outside of work?
since the changes wereMy grandchildren. implemented and would like
to share your experience with us please contact
[email protected]
9. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 LINk News 9Patient Stories internal training, but may be simply
written if respondents prefer.Do you know of anyone aged over 65
who Oakridge is looking for a mix of patientmight be willing to
talk about their experience experiences, good, bad or indifferent,
so all storiesof being a patient of Lancaster Royal Infirmary, are
welcome. Each will be edited down to aWestmorland General Hospital
or Furness maximum of 10 minutes so respondents need notGeneral
Hospital, during the last 12 months? necessarily have long, complex
stories to tell, and the more stories that are collected the
better.On behalf of University Hospitals of Morecambebay NHS
Foundation Trust, Oakridge has been Experienced interviewers are
happy to travel tocommissioned to collect 100 stories from people,
peoples homes, or to a hospital or venue of theiraged over 65, who
have been patients of choice at a time to suit them. The
interviewer willLancaster Royal Infirmary, Westmorland General be
accompanied by one technical person to recordHospital or Furness
General Hospital, during the their story. Each interview will be
carried out withlast 12 months. sensitivity.The purpose is to
improve the standard of elderly For further information, call Julia
or Jo on 01625patient care. Stories would ideally be filmed or
572474 or emailvoice-recorded, so that they can be used for
[email protected] Hospitals of
Morecambe Bay NHS Foundation TrustHospital AppointmentsThe
University Hospitals of Morecambe Bay NHS having a suspicion or
diagnosis of cancer, being inFoundation Trust (UHMBT) has set up a
helpline need of an urgent referral, or simply requiring afor
patients worried about follow-up appointments routine
referral.following problems with the outpatient booking Since then,
the Trust has identified 154 patients assystem. having a suspicion
or diagnosis of cancer and asAn external review commissioned by the
Hospital being at risk of harm due to delays in diagnosis orTrust
identified a backlog of 30,000 patients treatment. A further 682
patients were identified aswaiting for urgent and routine
appointments. being in need of urgent referral. Measures were put
to place to ensure that each of these patientsThe problems with the
outpatient booking system was seen by the beginning of
December.originally thought to be due to the IT system have now
been put down to process failure. Fears For routine patients, a
process of clinical validationwere raised in the media concerning
cancer is underway and these patients will be seen overpatients
losing out on vital diagnosis and treatment the coming months. The
Trust is looking at thedue to urgent follow up appointments being
missed wider NHS and possibly the private sector foror delayed
support in dealing with routine cases.Since the issue emerged, the
Trust has acted Patients and relatives worried about
appointmentsswiftly to ensure all urgent and priority patients are
can call the 24-hour helpline on 0845 608 0278.seen (reported in
LINk newsletter, November GPs are also being asked to report any
patients2011). they are concerned might not have received
appointments.Hospital managers have put in place a process
toidentify all patients who should have received a The Trust is to
set up a booking hub made up offollow-up appointment but havent;
those who have managerial, clinical and administrative staff -
tobeen given an appointment but have not yet been review outpatient
demand and identify staffingseen; and those whose records should be
closed issues, in order to prevent the situation arisingas
completed. again.Patients were further categorised on the basis
of
10. Editorial LINk News Out-and- Features News 4 5 about 10 18
2110 Out and About with the LINk We will keep you updated with
Urgent Care Centre at BurnleyEast progress. General Hospital. We
continue our work with If you have feedback on these children and
young people. or any other services you haveFollowing on from the
Dementia Their experience of accessing used recently please
contactLarge Scale Change health services is an important either
Anthony or Karen onconference in Manchester in part of shaping
services. At a 01282 714384 / 01282 714385November, Board members
in meeting of Rossendale Youth or emailEast Lancashire have agreed
to Council in November, there was [email protected] orlook at
the use of antipsychotic an open and honest discussion
[email protected] for people with dementia. about what they
expect ofThis corresponds with a call to services and the staff
whoaction on the use of provide and support thoseantipsychotic
drugs for people services.with dementia, launched by the Areas
covered includedDementia Action Alliance. The dentistry and how the
group feltaim of this is to ensure that: they needed reassurance
fromAll people with dementia who the dentist, i.e. what wasare
receiving antipsychotic happening whilst being treated. 01/01/2012
- 31/01/2012drugs should receive a clinical Communication was
another of Love Your Liverreview from their doctor to the main
themes, with theensure that their care is majority of the group
feeling that 04/01/2012 - 04/01/2012compliant with current best
communication could be World Braille Daypractice and guidelines,
and that improved. Included in this wasalternatives to medication
have the need of health practitioners 14/01/2012 - 14/01/2012been
considered, by 31 March to communicate with younger STIQ Day2012.
people in a way that they could understand what was being
19/01/2012 - 19/01/2012In some cases the use of explained.
Personalised Health Care:antipsychotic drugs is the right We would
like to thank the youth Theory to Practicetreatment option, but it
isestimated that around two thirds leader and members of the Youth
Council for their warm 22/01/2012 - 28/01/2012of the use of
antipsychotics in welcome and for allowing us to Cervical Cancer
Preventionpeople with dementia is join their meeting.
Weekinappropriate. The use ofantipsychotic drugs is linked to In
the New Year, we will be arranging to meet with students 23/01/2012
- 29/01/2012serious side effects, creating at colleges in East
Lancashire Food Allergy andmobility problems, sedation and and also
meeting with health Food Intolerance Weeksometimes death,
particularlywhen used for longer than 12 professionals who work
with children and young people. 23/01/2012 - 29/01/2012weeks. Be
Loud! Be Clear! Two areas that we will be monitoring over the next
few 29/01/2012 - 29/01/2012 months are the new non World Leprosy
Day emergency number 111 that gives advice on which service to
31/01/2012 - 31/01/2012 use if you have a minor injury or National
Bug Busting Day illness that needs medical attention but is not an
31/01/2012 - 31/03/2012 emergency, (see page 6) and National Bowel
Cancer the GP out of hours pilot which Symptom is trialing moving
the night time Awareness Campaign GP from St Peters Centre to
the
11. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 Out and About with the LINk 11Central The LINk attended the
Lancashire Third Sector Mental Health Consortium meeting in
Preston, when there was a series of presentations on dementia. The
Charnley Fold Enhanced Day Support Service featured twice forThe
LINk attended the Chorley & South Ribble Mental its work in
general towards therapeutic and socialHealth Users and Carers
Network meeting, when a actives. Charnley Fold is also the base for
the Dementiadiscussion took place around the concerns many carers
Adviser Service supporting people with onset or aof mental health
users have in relation to the possible diagnosis of
dementia.withholding of information by clinicians. Staff
providingcare do not always give carers information, citing Staff
also attended the Lancashire Youth Council Openpatient
confidentiality as their reason for withholding Evening and had an
opportunity to find out more aboutinformation on certain issues.
However, relatives feel its campaigns and meet the young
volunteers.this not always in the best interests of the patient. If
you A meeting on the future of Community/Volunteer Cars inwould
like to comment on this issue, please contact the Preston took
place. Although primarily a meeting forLINk - this could be done
anonymously if preferred. Lancashire County Councils Transport Team
and theEmail Pat at [email protected] managers of the services
under discussion, the LINkLINk members from Central Lancashire
received enter asked if membership of this group could be opened
upand view training to enable them to visit health and to other
organisations. As a result, a representativesocial care premises.
We will be reporting on their from the Royal National Institute for
the Blind has beenactivities in future editions of this newsletter.
invited to join the group, as an organisation which has a
particular interest in how transport changes affect theThe LINk
hosted an information stall in the entrance of visually
impaired.the Civic Centre in Leyland. LINk staff attended
theMethodist Church Cafe on Turpin Green in Leyland with The LINk
will be attending the Chorley Communitya stand and information. A
coffee morning is held there Transport Meeting on Thursday January
12. Onevery Wednesday and the LINk had the opportunity to Thursday
January 26, LINk staff will be present at twospeak with people who
had come along for coffee and events: the Preston Strategic
Partnership Conference ina chat or lunch. Some of the issues raised
included the morning and the Chorley Voluntary Communitytransition
of care home services following the collapse Faith Sector meeting
at St Josephs, Harpers Lane inof Southern Cross and mental health
community service the afternoon.provision.In the North, a report,
written by LINk team leaderElham Kashefi, on the problems
experienced by NorthPolish migrants from Lancaster and
Morecambewhen accessing health services, has been presented
completion of the prison project, on-going work withto the
University of Morecambe Bay NHS Foundation children and young
people, and keeping a watchingHospitals Trust, NHS North Lancashire
and the brief on mental health in-patient services.Lancaster,
Morecambe, Carnforth and GarstangClinical Commissioning Group
(CCG). Future work includes keeping a watch on developments
relating to the Dementia Strategy,The report highlights serious
concerns over developing stronger links with the North
Westtranslation services and makes a number of Ambulance Service
(NWAS), undertaking enter andrecommendations for ensuring non
English speaking view visits to care homes and keeping a watch
onPolish residents are supported when visiting hospital
developments relating to the future of hospitals onor healthcare
settings. For full details of the report the Fylde Coast.and
recommendations see the next LINk newsletter(February 2012). DATE
FOR YOUR DIARY Lancaster, Morecambe, Carnforth and GarstangAt a
Christmas get-together meeting of the North Clinical Commissioning
Group Public Engagementlocality group, members celebrated progress
made Dayover the past 12 months and discussed the areas of Thursday
23 Febraury 2012 10 - 1work for the coming months. Positive aspects
of our PCT Headquarters, Moor Lane Mills, Lancasterwork included
training a number of LINk volunteers to The CCG will update us on
progress withundertake enter and view visits and mystery
commissioning so far and would like to hear fromshopping, working
alongside hospital staff to conduct residents in all the areas that
are covered by thean A&E audit at the Royal Lancaster
Infirmary, Group. To book a place please contact the
Northorganising health and social care events, the locality team
(details on the back of the newsletter).
12. Editorial LINk News Out-and- Features News 4 5 about 10 18
2112 LINk NewsShock report reveals Neglect due to tasks in the
calls for more information and care package not being advice to be
made available tohuman rights abuse carried out, often caused by
those who use home care lack of time. services.A hard hitting
report into the Financial abuse, for example The report can be
found at:care older people receive from money being systematically
www.equalityhumanrights.com/home care services uncovers stolen over
a period of time. homecareinquirythe shocking catalogue of Chronic
disregard for olderabuse individuals may have peoples privacy and
dignityreceived at the hands of those when carrying out
intimatepaid to look after them. tasks.The report, Close to Home,
was Talking over older peoplewritten following an Inquiry into
(sometimes on mobileOlder People and Human Rights phones) or
patronising them.carried out by the Equalities and Little attention
given to olderHuman Rights Commission peoples choices about
how(EHRC). It points out that and when their home care
isindividuals are having their basic delivered.human rights
breached by failings Risks to personal security, forin the care
system. example when care workersThe Lancashire LINk was among are
frequently changed,the many individuals and sometimes without
warning.organisations that contributed to Some physical abuse,
suchthe inquiry. We submitted a copy as rough handling or usingof
our report, Who is Looking unnecessary physical force.After Uncle
Albert?, following The EHRC states that many ofresearch with over
40 care these incidents amount to humanservice users and their
family rights breaches. The impact onmembers. older people can be
profoundlyThe findings from the EHRC depressing and stressful,
*Following the publication of theshare many similarities with those
resulting in tears, frustration, report, the Care Qualityuncovered
in the LINk report, in expressions of a desire to die and
Commission (CQC) hasidentifying wide-ranging concerns feelings of
being stripped of self- announced that it will now beraised by
service users and family worth and dignity. inspecting home care
providersmembers. alongside care homes, hospital The report argues
that theThe EHRC report states that underlying causes of these
wards and other health settings.around half of the older people,
practices are largely due to CQC chief executive Cynthiafriends and
family members who problems within the care system Bower said: "The
operation ofgave evidence to the inquiry rather than the fault of
individual home care is not as transparentexpressed real
satisfaction with care workers and reflect a failure as care in
hospitals and othertheir home care. At the same to apply a human
rights approach sectors because the interactionstime, the evidence
revealed many to home care services. happen behind closed
doors.instances of care that raised real "That is why we want to
focus on It makes a number of this sector of social care in
thisconcerns such as: recommendations, including way." Older people
not being given making sure that home care The CQC already runs
routine adequate support to eat and agencies are covered by the
spot checks, but this will be an drink (in particular those with
Home Rights Act, in the same extra inspection. dementia) and an
unfounded way that care homes are, and belief that health and
safety making sure those who restrictions prevent care commission
and monitor home workers from preparing hot care services apply the
Human meals. Rights Act in their work. It also
13. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 LINk News 13Health and Social Care Update Number FourThe Dilnot
Proposals on Funding of Care ServicesIn this update, we focus on
the Dilnot Inquiry on the funding of social care services.
Economist Andrew Dilnot was asked by theCoalition Government to
chair the Commission on the Funding of Care and Support, which was
set up to investigate ways offunding social care in the
future.Dilnot was asked to lead the Commission and his report,
Fairer Care Funding, was published in July this year. The
informationhere comes from a briefing paper produced by the
National Pensioners Convention (NPC).The Commission believes that
the current care system is not fit for purpose and needs urgent
reform. It has identified a number ofproblems: The current system
is confusing, unfair and unsustainable. Eligibility for support
varies depending on where you live. There is a lack of financial
products to help people meet their care costs.Following the review
of current services, Dilnot made a number of recommendations:1.
Costs An individuals contribution to their care costs would be
capped at between 25,000 and 50,000. The Commission suggests 35,000
as the fair figure. The state would then pay additional care costs
once the individual had met that cap. However, individuals will
still have to pay more than 35,000 if they want to go into a home
which costs more than the local authority is prepared to pay.
Means-tested support for residential care would be available to
those with assets/income worth between 14,250 and 100,000
(including the value of any property). The current figure is
23,250. For those with assets worth 75,000 the cost of care would
be around 15,000. Those with less than 14,250 would not pay any
care costs. Those in residential care would still be liable to pay
for their food and accommodation costs capped at a maximum of
10,000 per year. This would mean individuals paying up to 190 a
week. Individuals could fund their care either through private
insurance, savings or money from their estate by selling their
property or through equity release. Whilst some local authorities
promote deferred payment schemes which recoup the money paid for
care after the property is sold, the Commission recommends the
system be standardised across England. They also suggest that for
the first time local authorities should be allowed to add interest
onto the amount owed. The Commissions proposals are estimated to
cost 1.7bn a year rising to 3.6bn by 2026. The recommendations
suggest that this money could be raised either through additional
income tax, re-allocation of existing government expenditure or
using a specific tax such as national insurance on those aged 65
and over.2. Assessment There should be a new national assessment
system which would guarantee support to those with substantial
needs or worse but not anyone with moderate needs (including those
requiring help getting in and out of bed). This assessment would be
portable and apply if you moved from one area to another.The report
adds that existing universal disability benefits should continue as
now, but Attendance Allowance should be re-brandedto clarify its
purpose. There is no recommendation to pay the carers allowance to
those over state pension age.National Pensioners Convention (NPC)
analysisThe NPC has highlighted a number of areas where the Dilnot
Commissions recommendations have fallen short of theexpectations of
older people, their families and carers. These include the
following: Raising the threshold on assets to 100,000 before being
liable to pay care costs will not prevent older people from still
having to sell their homes in order to pay for care. The Commission
accepts that the average housing wealth for a single pensioner is
160,000. Introducing a cap on care costs of 35,000 amounts to just
over one years worth of care in a nursing home. The Commission
estimates that a years residential care costs 28,600. However, only
a quarter of all over 65s are likely to ever need care that costs
more than the capped amount. Given this, it is questionable whether
the state would ever step in to pay any additional costs in all but
a minority of cases. Suggesting that additional funding for care
could be found by making older people pay national insurance places
an unacceptable burden on a single generation - rather than sharing
the cost of care across society as a whole. It would be the only
area of welfare provision where one section of society was paying
for itself eg. older people paying for the care of older people,
rather than the costs being shared across the population as a
whole. Introducing a higher threshold of need before someone can
access care will leave hundreds of thousands of vulnerable older
people without any support in the community. Access to care
services needs to be widened, rather than restricted in this way.
The removal of low level support will inevitably lead to a
worsening in conditions which will accelerate more severe care
needs and higher costs.Dot Gibson, NPC general secretary said: "The
Dilnot Report has really created more heat than light when it comes
to the socialcare debate. Nothing in the recommendations will end
means-testing, improve standards or prevent people from still
having to selltheir homes to pay for care. The current care system
is in crisis, yet these recommendations wont go anywhere near
putting thatright.The Dilnot proposals are being used to inform a
White Paper on social care, expected next Spring. Any proposals
would not beintroduced until 2014 at the earliest.*As the LINk
newsletter went to press, it was reported in the national media
that the reforms outlined by Dilnot may take 10 to 20years to come
into effect, due to the high costs needed to implement the
proposals. An article in the Guardian news web pagesays the
Government would need to find 1.7 billion to fund the scheme.
14. Editorial LINk News Out-and- Features News 4 5 about 10 18
2114 LINk NewsCounting the Cost of Care including imposing a cap on
the amount of money people have to pay for their care to between
25,000 and 50,000; raising the threshold forFunding cuts and
changes to care services are liability towards care costs to
100,000 (currentlyhaving a devastating impact on carers. This those
with assets worth more than 23,000 arewas the powerful and emotive
message to required to pay towards funding their care); andemerge
from the Counting the Cost of Care introducing a system of deferred
payments, so thatevent organised by the Lancashire LINk in the
state takes responsibility for funding care, withpartnership with
Help Direct Wyre and Fylde money settled through the individuals
estate.and Carers Point! Dilnot also recommends that there would be
aCarers recounted their stories of the daily greater role for
financial services to play instruggles they face to look after
family members providing insurance cover to help people fund
thefollowing cuts to services, difficulties in obtaining cost of
their care services. However, heequipment and practical support,
and general emphasised that every effort would be made tofeelings
of powerlessness in the face of ensure the vulnerable were
protected.overwhelming bureaucracy. Mr Maynard pointed out that
during the lastMore than 60 carers, service users and Spending
Review, the Coalition Government hadprofessionals attended the
event on Carers allocated 2 billion of non ring-fenced cash to
localRights Day - at Thornton Little Theatre, Thornton authorities
to spend on developing care servicesCleveleys, to hear Blackpool
North and Cleveleys that were locally accountable and responsive
toMP, Paul Maynard, and Lancashire County local needs, in line with
the new localism agenda.Councils Director of Commissioning, Steve
Gross,outline national and local changes to social care. He
highlighted the challenges posed by the current care debate,
including developing a service that isDiscussing national policy,
Paul Maynard admitted localised, yet at the same time meets
nationalthat funding care services presented a massive benchmarks;
offering personalised care packageschallenge in the light of a
growing ageing to meet individual needs, yet recognising that
notpopulation, economic issues and the sheer everyone wants choice
or is able to exercisecomplexities involving in delivering a
coherent care choice without support; and joined up health
andservice. He said he had been involved in the same care
organisations working together to deliver aon-going debate about
care services for the last 10 seamless service.years but now it was
time for this issue to betackled head on. He said the current
climate meant that it was even more important for statutory and
voluntary sectorHe outlined the proposals for the Government
organisations to work together to provide efficientWhite Paper on
Social Care, due in Spring 2012. care and support services, and
emphasised thePart of this will focus on the recommendations need
for early intervention, including fallsmade in the Dilnot Review,
set up by economist prevention services to prevent costly
hospitalAndrew Dilnot to investigate the future funding of
stays.care services (for a specialist report on the DilnotReview,
see Health and Social Care Update Emphasising that dignity should
be at the heart ofNumber Four on page 13). care delivery, Mr
Maynard said the role of the CareThe review makes a number of
recommendations, Quality Commission (CQC) would be strengthened,
with more unannounced inspections
15. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 LINk News 15of care services. He also pointed out that the LINk
Government targets to offer everyone access toand, from October
2012, Local HealthWatch (the personalised care by 2013. Currently
7000 serviceorganisation that will replace the LINk) would have
users have been issued with a personal budgeta vital role in
monitoring care services. and 2200 people are using this as a cash
payment or to employ their own personal assistants. ThereSteve
Gross, Director of Commissioning at are now 2500 people working as
personal careLancashire County Council, described the assistants
within the county.challenges faced by the council in having to
makecuts of 65 million to adult social care services, as However,
he said personal budgets were not forpart of 179 million overall
funding cuts over three everybody and he outlined the role of the
localyears. authority, voluntary sector organisations and family
members in providing support and brokerage.Savings had been
achieved by changing the FairAccess to Care (FACs) eligibility
criteria, One effect of the move towards personalisationincreasing
care charges and reducing funding had been a 10% drop in people
buying home careavailable to care providers. or day care services.
As a result, only those home care services that offered good,
person-centredUnder the FACs criteria, those with care needs care
services would survive, and this would driveassessed as moderate
are no longer eligible for up quality. He described this as a
reflection of thecare services. However, Mr Gross said that since
role of the service user as a consumer, able tothe changes, two
thirds of those whose care had exercise choice in relation to care
services.been reviewed had now been re-categorised ashaving
substantial or severe care needs and Mr Gross pointed out that
Lancashire Countywere now eligible for care services. This left
Council was working closely with the NHS toapproximately one third,
or 800 people, who were develop falls prevention initiatives and
community-no longer seen as eligible for care. based re-ablement
services, to prevent hospital admissions and ensure people are
supported inHe said that, in relation to the services it provides,
their community following discharge from hospital.Lancashire still
fared well, in comparison with other This included the provision of
community-basedlocal authorities, though he admitted that the 50%
support for people with mental health problems,of service users who
were funding their own care following the reduction of in-patient
services.were faced with having to pay more for theirservices. He
said increased care charges had had And he said there was greater
emphasis onan impact on uptake of residential and day care working
with the voluntary and community sectorservices, with some people
withdrawing from care, to commission services, including support
foralthough fewer than expected had stopped their carers. Funding
for the network of carers forumscare. across Lancashire had been
protected and this remained a high priority.Mr Gross stated that a
Judicial Review challengingthe councils funding decisions had
upheld the Mr Gross admitted that change was complicatedCounty
Councils actions, and an appeal had and unsettling but felt it
provided a realjudged in favour of the council. The High Court
opportunity to join up services, use resourcesruled that LCC had
acted fairly, although a further differently, avoid fragmentation
and remove theappeal would be heard early next year. need for
service users to have to undergo frustrating and time-consuming
multipleHe outlined the developments that had taken place
assessments of their needs.to create a personalised care service,
in line with
16. Editorial LINk News Out-and- Features News 4 5 about 10 18
2116 LINk NewsCounting the Cost of Care Another women said she had
looked after herCarers Stories husband, who is severely disabled
following a stroke, for 15 years. She described how in June this
year her husbands care package wasCarers gave moving and powerful
accounts reduced to 22 hours per week, and this hadof their care
experiences to a stunned increased pressure on her to the point
that sheaudience. felt physically and emotionally overwhelmed.One
single mother of an 18-year-old disabled A man who cares for his
aunt described theboy described how she had been trying for
difficulties in getting through to Lancashirenearly a year to be
re-housed because her son County Council for information about
careis struggling to get up and down stairs. She had funding. He
was fed up of trying to make callsapproached various housing
organisations but to and having to be put through to differentno
avail. departments and re-tell his story over and over again.In
another case, a woman tearfully describedhow, when her severely
disabled son was Pamela Hill, from Age Concern Blackpool,
feltadmitted to hospital, he was given a bed that that comments
from carers indicated there was adidnt have side supports. Fearful
for his safety general lack of awareness about the range ofand
concerned that his care needs were not support services available.
She felt that GPsbeing met, she made a point of staying at the were
not doing enough to signpost carers tohospital each day from early
morning until relevant services, and that carers
assessmentsbedtime, to provide the care he needed, by GPs needed to
be mandatory and subject tobecoming stressed and exhausted in the
monitoring.process. Paul Maynard and Steve Gross promised toThe
woman explained how she had been caring investigate individual
cases. Mr Maynardfor her son single-handedly for 20 years since
admitted that in 10 years of campaigning forher husband died, with
little support from social better support in care services, the
Governmentservices. Despite having a carers assessment was still
some way from getting things right. Heshe felt little had been done
to improve her referred to the excellent support offered
bysituation. organisations such as Carers Point!, but said that it
was important that people were made aware ofAnother woman, who
looks after her son who the service. It was also important that
serviceshas severe mental health problems, said that, were
commissioned to ensure those with unmetafter listening to the
speeches made by Paul needs were supported.Maynard and Steve Gross,
she felt they must beliving on a different planet. She felt that
what Steve Gross said he was aware that servicesthey said had
little bearing on the realities faced were not perfect. However,
the reality was thatby carers on a daily basis. Lancashire County
Council had to live within its means, and this presented a massive
challenge.She pointed out that service users are desperate He
warned that, with the Governments proposalsfor services and
frontline staff are not paying to extend austerity measures and the
challengesenough attention to carers needs, with most faced by
growing numbers suffering fromcarers assessments seen as
inadequate. She dementia, the pressure to maintain servicesfelt the
support offered through carers forums would inevitably become
harder over the comingwas not enough. People are often too busy
years.caring to attend forums and what they need ismore in the way
of practical support and Do you have a story to tell about
yourrecognition of their difficulties. experiences as a carer?
Contact the Lancashire LINk, on 01772 431195, or e-mail
[email protected]
17. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 LINk News 17 Cancer patients hit by return to work
proposalsThousands of seriously ill Instead, cancer patients on The
ESA replaces a range ofcancer patients could be chemotherapy in
hospitals will incapacity benefits. All freshforced to take medical
tests now have to prove that they are claimants now undergo a
workand face "back to work" too sick to work, and take part in
capability assessment, and 1.5interviews under new the work
capability assessment million existing recipients will beGovernment
proposals, to determine whether someone reassessed using the
newcharities have warned. is eligible for benefits. If cancer
system from this month. The patients are found able to returnA
report to ministers by Prof welfare reform bill introduces a to
employment they may also beMalcolm Harrington, the one-year time
limit on those required to participate in work-government adviser
on testing people claiming ESA in the related practice job
interviews,welfare recipients, contains "work-related activity
group", as a condition of receiving theirproposals to force cancer
who are expected to move into benefit.patients who are undergoing
work.intravenous chemotherapy to Such assessments have been A DWP
spokesman said: Thisprove they are too ill to work. attacked by
charities amid must be about an individuals mounting evidence that
peopleAt present, patients who are needs. Our proposals would with
serious illnesses are beingunable to work because of ensure a
person would only be judged fit for work when they arecancer and
the side-effects of asked to attend a face-to-face not.treatments
are allowed to claim assessment where absolutely Cancer experts and
30 cancerthe highest rate of employment necessary. charities argue
that patientssupport allowance (ESA), worth undergoing "stressful"
cancer Are you or a member of yourup to 100 a week. More than
treatment and who have to family currently receiving9,000 cancer
patients were leave work should be treatment for cancer? What
doplaced automatically on the automatically eligible for ESA. you
feel about the proposals?welfare payment from October Ciarn Devane,
chief executive Contact Lancashire LINk at2008 to June 2010. of
Macmillan Cancer Support, [email protected], the
expert report says said: Cancer patients in the middle of treatment
are, in many *Article taken from Guardianthis "automatic
entitlement" has cases, fighting for their lives. website:
http://encouraged dependency on www.guardian.co.uk/benefits,
"encouraging wrong Yet the government is
society/2011/dec/06/cancer-behaviours from employers and proposing
to change the rules patients-welfare-work-testsstigmatising cancer
as so all cancer patients will havesomething that can lead to to
undergo a stressfulunemployment or assessment to prove they
areworklessness". unable to work.
18. Editorial LINk News Out-and- Features News 4 5 about 10 18
2118 FeatureLancashire Hospital trusts of measures, including how
patients are diagnosed and treated over the weekend; how
quicklyfeature in highest death rates hospitals deal with hip
fractures; and how hospitals perform in procedures that are not
carried out routinely.Two hospital trusts that serve Lancashire
patients Blackpool Teaching Hospitals NHS Foundationhave featured
in a league table of hospital trusts Trust showed above expected
waiting times forwith the highest death rates. surgery following a
hip fracture.Research from Dr Foster showed that BlackpoolTeaching
NHS Foundation Trust and University The report points out that
patients are more likely to die if they are admitted to hospital
over theHospitals of Morecambe Bay NHS Foundation weekend because
they are less likely to receiveTrust were among the 19 hospital
trusts in the prompt diagnosis or treatment.country with the higher
than average mortality(death) rates. In the case of hip fracture,
the odds of survival forThe researchers used two measures the
vulnerable older adults are much higher if they are treated
quickly, ideally within two days. If they areHospital Standardised
Mortality Ratio (HSMR), a admitted on a Friday or Saturday, the
chances ofmeasure of deaths while in hospital, based on prompt
treatment are lower.common conditions that can lead to death, and
theSummary Hospital Level Mortality Indicator However, Lancashire
Teaching Hospitals NHS(SHMI), based all deaths that take place in
or out Foundation Trust was identified as one of theof hospital up
to 30 days following discharge. hospital trusts that follow all
sections of the rapid recovery pathway when treating patients with
hipUsing a score of 100 as an average, Blackpool and knee
replacements.scored as 117 on the SHMI and 112 on the HSMR,and
University Hospitals of Morecambe Bay The researchers also examined
hospital trustsscored 114 on the SHMI and 124 on the HSMR.
performance on non-routine, specialisedDr Foster researchers also
examined hospital procedures. They looked at abdominal aortic
aneurysm surgery, as an example, and found thatrecords to look at
performance against a number hospital trusts that performed fewer
operations for this condition had higher death rates. Blackpool NHS
Teaching Hospitals Trust was among the trusts that performed fewer
than 35 of these operations in 2010-11. The authors commented that
hospital trusts that do not carry out this operation regularly
should look at sourcing this work to other trusts that offer this
expertise. *In Lancashire this is being addressed through proposals
to set up specialist vascular centres (see LINk November
newsletter). Elsewhere the report stated that: Private hospitals
that provide services to NHS patients have good outcomes and
positive patient ratings Staff behaviour is crucial to patient
experience. Disrespect and not being kept informed were cited as
two reasons why patients would not recommend a hospital. Responding
to the mortality findings, Tony Halsall, Chief Executive Of
University Hospitals of
19. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 Feature 19Morecambe Bay NHS Foundation Trust, said Wehave been
looking very carefully at the detailedinformation and we have asked
our doctors tocontinually review all deaths within the hospitals
toensure appropriate care was given in each case.We also undertake
clinical audits to identifyimprovements in clinical care and
provide staff withprotected time for this. Is your care up to
standard?There have been problems in the way someinformation has
been recorded and this has We need your help to build a picture of
whatresulted in a significant increase in the Dr Foster quality
care looks like for men with prostatefigure. This has been put
right and we expect to cancer.see this reflected in improved
figures next year. We know that men face a postcode lottery
whenOver the last five years we have seen a decrease accessing
prostate cancer services across thein deaths at our hospitals, and
we believe that the country. This is not acceptable.main reason for
any increase in our Dr FosterHSMR figure is to do with coding and
the recording We would like to work with you to makeof mortality
data. improvements where they are needed most. To do this, we are
identifying standards of quality careDr Paul Kelsey, Medical
Director for Blackpool that all men with prostate cancer deserve -
atTeaching Hospitals NHS Foundation Trust, said every stage of
their journey.the data should be treated with caution as it doesnot
give a true reflection of the quality of care You can help by
telling us what quality prostatepatients can expect. cancer care
means to you by taking part in our survey. Anyone with experience
of prostate cancerHe said: One of our concerns is that the new is
welcome to take part, whether you have beenmortality indicator does
not take into account diagnosed with the disease or are a friend
orissues such as deprivation and public health family member of
someone who has.issues. Blackpool has amongst the highest levelsof
deprivation in the country with lower than To take part in the
survey and read more about ouraverage life expectancy. The town
also has higher quality care project, please visit:than average
deaths related to alcohol, smoking,
www.prostate-cancer.org.uk/qualitycare.IV drug use and heart
disease and as the SHMI If you would like a paper copy of the
survey pleasedata is not adjusted to reflect this our figures will
ring 0208 222 7182.be higher.Improving quality of care and
enhancing patientsafety are our key priorities and our aim is to
haveno avoidable deaths and no avoidable harm. Wehave robust
systems in place to monitor mortalityand quality of care and our
mortality rates havesteadily reduced over the past few years.We
were also recently one of 10 Trusts to takepart in a national study
which looked at the casenotes of 100 deceased patients to see
whethertheir deaths could potentially have been avoidableand our
Trust had the second lowest number ofavoidable deaths.The Dr Foster
Hospital Guide can be found
on:http://drfosterintelligence.co.uk/wp-content/uploads/2011/11/Hospital_Guide_2011.pdf
20. Editorial LINk News Out-and- Features News 4 5 about 10 18
2120 Feature 999 Call CategorisationThe North West Ambulance
Service NHS these calls should receive a response withinTrust has
issued important information eight minutes or less. This is a
nationalabout how 999 calls are categorised. standard.When a 999
call is received, it is categorised by Green 1 and 2: These are
calls that arethe Trusts Advanced Medical Priority Dispatch
prioritised as serious but not immediately lifeSystem (AMPDS) to
determine the response threatening. As such the Trust aims to
reachrequired. Determination of the response required these
patients as quickly as practicable. There isis dependent upon the
severity of the patients no national time standard set for this
category.symptoms at that time, based upon the answers Green 3 and
4: These are calls that are neitherprovided to a series of specific
questions. This serious or life threatening. The Trust willsystem
works to ensure that the most serious, undertake further telephone
triage bylife threatening cases are prioritised and it also
paramedics in the control centre to assess theassists in the
identification of any suitable patients needs and refer on to more
appropriatealternative courses of action. services, or the Trust
may pass callers to NHSFrom the 1st April 2011 changes were made to
Direct for further assessment. However, therethe way ambulance
services are measured. The will still be instances when an
ambulance will beprevious three main categorisations (known as
dispatched.Category A, B and C calls) were redefined as The new set
of clinical indicators introduced fromReds (level 1 and 2) and
Greens (level 1,2, 3 1st April 2011 measures performance againstand
4). Importantly, a new set of quality outcome for stroke, cardiac
arrest and otherindicators to measure patient outcomes was types of
intervention after other forms of heartintroduced. attack. A Trust
spokesperson said this type ofCall Descriptions: measurement
ensures a focus on quality of outcome as well as response time.Red
1 and 2: These are calls that are prioritisedas immediately life
threatening such as cardiacarrests, serious bleeding, severe
breathingdifficulties and choking. Seventy five per cent of
www.nwas.nhs.uk
21. Editorial LINk News Out-and- Features News 4 5 about 10 18
21 News 21Are you Age 50 or over and The Government contract, from
identification)living or working in the Department for Work
andRossendale? For more information or to make Pensions (DWP), is
estimated at a referral please contact:Do you:- 4.8 million and
Remploy has Pamela Beswick, Chief Care about issues and been
appointed to deliver all of Executive, on 07825207021, or services
in Rossendale the seven available contracts to Sharon Calverley and
beyond and how deliver Access to Works mental Project Director, on
they affect our health provision, spanning 07825207023 experiences
and quality England, Wales and Scotland. Or visit the Website for
the of life? This new service aims to assist Referral Procedure:
Enjoy meeting like minded more than 1,600 people with
www.signposts.org.uk - Refer topeople and new friends? mental
health conditions to stay Us. Have skills and views to in
employment.share, and are perhaps Fleetwood Family Carer Visit the
website for moreinterested in developing new Group
information.ones? Come along to our informal getValue your right to
have a voice Targeted Youth Support together, meet other carers,and
influence the area you live in ,and the services delivered there?
Lancaster