Every autumn, staff working on the frontline of the NHS form an orderly queue, roll up their sleeves and have their annual flu jab. Such enthusiasm to be vaccinated reflects a general consensus that flu can be very nasty and, in some cases, fatal. In fact, who could disagree with the rationale – that if healthcare staff don’t get vaccinated, they could pass the virus on to their patients, some of whom will be particularly susceptible to developing complications. And of course, who will look after the patients if healthcare staff go down with the flu and are too sick to care for them?
This is part 2 of the previous blog, so read that now if you haven’t. We established that individuals and Government have a responsibility to provide care.
The Coalition Government have created a commission to look at the funding of care and support in England. A chief consideration will be creating either a mandatory or voluntary insurance scheme whereby you pay in advance of having care needs and the policy will cover the costs of your support needs that are not met by the Government’s contribution.
So, I pay £20 p/m and then when I’m 75 and need support to live at home or residential care, my insurance company will cover the costs (let’s assume reasonable insurance companies for this blog’s purpose). Sounds simple.
But what if my wife (this isn’t a public proposal Mum) decides that she would like to care for me and doesn’t care that the insurance wouldn’t pay her to do it? We’ve just paid all that money for no reason. This could lead to two things:
1. Fewer people provide care because they feel as though the insurance company, or Government if it is publicly run, should pay for all care
2. People don’t pay for insurance because they expect to receive family provided care
Let’s start with the first scenario. Fewer people caring increases demand on paid care, pushing up costs of the system. This is bad news for a Commission that is trying to create a more sustainable system because of projected funding gaps. If carers currently provide £87bn worth of care, the system could very quickly become completely unsustainable if families stop caring.
But the second scenario doesn’t look good either. This would increase the demands on families to provide care when we already know there is too much pressure on them currently.
The solution to overcome these problems must encourage and account for families who are providing care.
There is no way of knowing how much informal care you will receive whilst paying your insurance, which is generally before you have support needs. So the only way to recognise the caring contribution is by giving rebates to families when they are providing care.
Does this solve the problem? Not quite. How much do you decide to give them?
It’s another ‘to be continued’ as the next blog will look at this question.
Till next time, take care
Note: The following post has been contributed by Carole Cochrane, the Chief Executive of The Princess Royal Trust for Carers
Wednesday 28th July was another hot day in London (well it was for northern based lass). And like many of my London working days it was crammed with various meetings.
The day started with a breakfast review meeting with The Trust’s Director of Fundraising before we both went off to meet with someone who had recently made a significant donation to The Trust (always good to thank in person).
As I say it was a hot day and by the afternoon I was already feeling pretty tired and dishevelled and I had to change into a new set of clothes. Feeling a bit more like a Chief Executive, I headed off to my last appointment of the day which was to launch the Triangle of Care report at the House of Lords.
Tony Baldry MP, Co-Chair of the APPG and a real supporter of carers, was really the person launching the report. I was asked to speak and although I had some points prepared, after talking to carers there I felt that I wanted to speak as a sister of someone with a ‘severe and enduring’ mental health issue.
I talk to so many carers of someone with a mental health issue, who are often worn down with caring and fighting to get good services and I felt that I needed to speak for my parents, my sister and all those other carers who don’t get the chance to do so.
I know only too well the impact my sister’s illness has had on our family unit and in particular on the health of my elderly parents, who are still the ones that pick up the pieces when my sister is ill and again when she is discharged back into the community, sorting out a flat, furnishing etc.
The Triangle of Care report attempts to bring together the carer; the cared for and the professional and get them all working as partners. So many carers tell me they feel invisible when care packages are being put together but are all too often the ones that have to implement and manage the care.
The essence of the document is to clearly identify the six key elements
required to achieve better collaboration and partnership with carers, with good practice examples and resources.
1. Carers and the essential role they play are identified at first contact or as soon as possible thereafter.
2. Staff are ‘carer aware’ and trained in carer engagement strategies.
3. Policy and practice protocols re confidentiality and sharing information are in place.
4. Defined post(s) responsible for carers are in place.
5. A carer introduction to the service and staff is available, with a relevant range of information across the acute care pathway.
6. A range of carer support services is available.
I had a really enjoyable time at the event and spoke to some wonderful carers who I know are hoping that the Triangle of Care becomes everyday practice so their loved ones get the services they so richly deserve.
P.S: had a recent text from my sister who tells me she is really happy – it has been over 25 years since we have heard those words – so I know things are getting better for her and my parents and that is what I am sure those parents that spoke to me on the night long to hear.
Note: This post is from our guest blogger Tony Baldry MP who is Co-Chair of the All Party Parliamentary Group for Carers. Tony Baldry MP made a speech at the meeting of The Princess Royal Trust for Carers held in the House of Commons on Wednesday, 28th July 2010.
Last week, the Prime Minister repeated his commitment to the Big Society making it clear that its’ success will depend “on the daily decisions of millions of people – on them giving their time, effort, even money, to causes around them”. My whole political life has been predated on this same principle.
However, I am concerned at a potential and unintended conflict between the Coalition Government’s very understandable desire on the one hand to promote the Big Society and the need to cut the budget deficit.
In my constituency in Banbury we have the North and West Oxfordshire Carers’ Centre, member of The Princess Royal Trust for Carers and has been successfully running now for nearly two decades.
Such has been the dedication and commitment of the volunteers that the centre has won the Queen’s Award – one of very few such awards in Oxfordshire. The Banbury Carers’ Centre like the Oxford and South Oxfordshire Carers’ Centres are comprised of a mixture of experienced volunteers and some paid staff, enjoying the financial support of the local community.
They help train carers. They provide outreach services for carers. They provide a place where carers and different types of carers can come and meet, share experiences, unwind and support each other.
As we all know, carers come in many kinds from young carers to very elderly spouses still looking after a much loved husband or wife.
In undertaking this valuable work, for many years the Banbury Carers’ Centre has received funds from Oxfordshire County Council to deliver specific agreed services to carers. The reasons the County Council was procuring these services from Carers’ Centres are exactly the reasons set out by the Prime Minister in support of “the Big Society”; Carers’ Centres and their volunteers are exactly the people who are making a difference, are in contact with other carers and are in the best position to understand, articulate and meet carers’ needs. They are full of people who come together and work together to affect social change and to improve life for carers.
As far as I am aware there has never been a suggestion that the Banbury Carers’ Centre or the other Oxfordshire carers’ centres have failed to meet the objectives with which they have agreed with the County Council. However, the Council has to make savings in their budget.
They are proposing withdrawing their funding from the carers’ centres in Oxfordshire and replacing that service by a telephone call centre, almost certainly run from outside of the county to which carers will be able to call.
Part of the justification of this move, in addition to the need to save money, is an assertion that it will help them reach more carers. However, there doesn’t appear to have been any or any real discussion with the existing Carers’ Centres as to the number of carers that they are already reaching.
I would suggest the issue here is that many people who are carers simply don’t recognise themselves as being carers and if they don’t recognise themselves as being carers, they are not likely to ring a carers’ telephone hotline.
We need a collective effort to help carers voluntarily register themselves as carers so that they are recognised as being carers by GPs or by schools if they are young carers. This requires a sustained campaign in GPs surgeries, in the schools, and in the media to make people ask the question “are you a carer?”
I suspect that for many years GPs haven’t been asking the question of whether someone is a carer, because there has been very little that they could do to support them. However, now that PCTs have funds to support respite care, GPs are in a position to refer carers for respite care and short holiday breaks and for that reason alone, one would hope that every GP practice would know which of their registered patients are also carers.
I think the reality is that for many years central government has used local government to support a whole range of social interventions. Money for carers’ breaks is given in part to PCTs and given in part to local Councils. However, if local government is obliged to save money, they understandably start by reducing funding for those organisations for which they have no immediate responsibility.
However, there are a very large number of active citizens undertaking constructive voluntary work within our community who to a certain extent depend on some funding from local government. An alternative, of course is to allow organisations such as the Banbury Carers’ Centre to bid direct to central government to provide carers’ services.
Here we appear to be bedevilled that Oxfordshire County Council has decided to bundle up all its carers’ contracts into a single contract, thus bringing it within the parameters of the EU procurement directives and requiring compulsory tendering. This makes it much more difficult for local voluntary organisations to bid and appears to run completely counter to the desire for localism and the Big Society.
I think we all have to accept that these are particularly difficult and unusual times. No peace time government has had to tackle a similar financial deficit. We need to develop the Big Society. We need to see how we can best reconcile these two policy objectives. However, to start with we have to recognise and acknowledge that there are some real tensions that need to be worked through.
Tony Baldry MP
House of Commons
Note: The following blog post has been contributed by Beryl Cross who is the Development Manager (South East) for the Princess Royal Trust for Carers.
Today is the launch day for The Princess Royal Trust for Carers “Out of Hospital” report and we are calling for the NHS to take practical steps to work together with carers as equal partners when planning for the discharge of patients from hospital.
The “Out of Hospital” project included partnership work between carers, Carers’ Centres and hospitals in Barnet and in Swindon. This afternoon carers, carers’ workers and NHS workers from Swindon and Barnet will be at the launch to share the practical tips that they found worked to get everyone acting together to benefit patients and carers and avoid readmissions to hospital.
I’m hoping the launch will inspire those NHS workers who attend to develop their partnership with carers and in turn help them in changing hospital systems and culture. We’ve already received messages of support from the Royal College of GPs and other NHS bodies so that’s a really positive start.
Have a look at the key messages from the report and it would be great if you could share them with other carers, carers’ workers and NHS planners and staff that you know.
I will be back soon to let you know how the launch went, including what the carer presenting at the launch had to say.
All the best,