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Cameron, Clegg and Milliband agree to social care reform talks

Trekkies love it when Captain Jean Luc Picard (Patrick Stewart) orders in a commanding, deep voice “make it so” and in an instant his crew set to work. Mistakenly, we often think that politicians have similar power.

Paul Burstow MP, Health Minister, honestly wants the NHS to do more to support carers. He thought providing additional money (£400m) and requesting the NHS to work with carers’ organisations on plans and budgets would provide this. Of course,  our report showed that this has not happened. Burstow told us at the Lib Dem conference that he was upset at this, was trying to improve the situation and will give even stronger guidance that the NHS has to prioritise carers.

But he cannot make the NHS do this because they have local decision making powers and no one person can control everything that happens in an organisation as large as the NHS.

The Government is actually structured so that power is shared amongst many people – Prime Minister, the Cabinet, MPs, Lords and other advisers. Some hold more than others, but each have some power with nobody having absolute power. And they all have their own priorities fighting to be the one Government acts upon.

This is why Burstow has appealed for disabled people, carers and charities to get angry and make a racket of noise regarding social care reform following the Dilnot and Law Commissions’ recommendations. He wants reform and says that he will be angry if the Lib Dems does not make this a priority.

Norman Lamb MP, chief adviser to Nick Clegg, said he wants social care reform in this Parliament and that any reform must mean more money for social care. However, his message was that it will only happen if politicians keep hearing from the public that reform must happen. Otherwise it will slip down the list of priorities.

Cameron, Clegg and Miliband have agreed to cross party talks on social care reform. This is a good start but only a start. The Government have announced another listening exercise for the reform of social care. This can either be used to build consensus on future reform or delay the need for a decision pushing reform further down the list of priorities.

Burstow and Lamb understand the urgent need to reform social care but not everybody does. I was left aghast when John Hemming MP (Lib Dem) said he did not see the connection between reforming social care and helping workplace productivity and employment, despite having just heard from John Lewis Partnership that more and more people are struggling to combine work with caring because support from social services is lacking.

We have to realise that for some, social care reform is not an issue or a priority. We need to change that. We need to make sure leaders and MPs from all parties hear how important it is to millions of people. It’s time to make some noise.

Gordon

September 21, 2011 Posted by | Carers Strategy, Conservatives, David Cameron, Liberal Democrats, Party Conferences, Social Care | , , | 10 Comments

Paul Burstow is serious about supporting carers

It was about primary 4 when I got the letter. I’m sure it even had her scent on it. It was smuggled to me in between

Paul Burstow, Carers Minister

practicing our times tables but I don’t think I could have added 2 plus 2 after I received it. What a feeling!

It obviously wasn’t the greatest love letter in history, but then again the Department of Health are not known for their letters of love. But I have recently fallen in love with one letter from them.

It was sent to each Strategic Health Authority (SHA) which monitor the performance of Primary Care Trusts (PCTs). It asks SHAs to confirm with the Government by 2nd September that each PCT has published local plans regarding services to support carers. Missing this date would be understood only in exceptional circumstances.

Furthermore, SHAs must make sure that PCTs (apologies for the acronyms!) have taken into account the Government’s updated Carers’ Strategy which provided an additional £400m for carers in PCT budgets. Sometimes, you wonder what takes Government so long to act but in this case the Health Minister Paul Burstow MP must be applauded for taking immediate action.

On 12th July Rob Wilson MP asked him about his local PCT not engaging with his local Carers’ Centre to develop plans for carers as they were meant to. On 14th July, we published our report which showed that only 9% of PCTs had so far published updated plans and 37% were not planning to.

Paul Burstow and civil servants must have immediately discussed what they could do to improve the situation and drafted the letter that was sent out 27th July. Supporting carers is an issue that Paul Burstow is serious about and this episode shows his determination to improve support for carers.

We have already heard of instances where PCTs are responding and are now engaging with carers’ organisations to develop plans and budgets. I’m glad, because the clock is counting.

To make sure the PCT acts in your area, we’ve set out 5 easy steps to persuade your PCT. Carers are getting breaks in Richmond, Sunderland, Surrey and other places – let’s make sure carers all over the country get them.

Take action

Gordon

August 3, 2011 Posted by | breaks for carers, Carers Strategy, Health, Social Care | , , | 12 Comments

Any breakthrough for carers?

This blog post has been contributed by Will Davidson:

I’m Will Davidson, I have been volunteering with the Policy department at The Princess Royal Trust for Carers for the past two months, helping to research how government proposals will affect carers, especially on the issue of Carers Breaks.

Today we launched a report looking at whether Primary Care Trusts (PCTs) have been working with carers’ organisations to develop plans and budgets for carers breaks and if these plans have been published. Late last year the Coalition Government announced increased support for carers by allocating an additional £400m over 4 years to PCTs to focus on providing breaks for carers. They requested that each PCT works with local authorities and carers’ organisations to publish policies, plans and budgets to support carers. 

So are PCTs following these guidelines set out by the Government? Do carers’ organisations feel more engaged now than they did before these announcements?

We found that only 9% of PCTs had developed updated plans and budgets for carers taking into account the additional money. 54% said that they would do so during 2011/12, and some very shortly. Carers will be disappointed that many PCTs are still developing plans eight months after the Government announcement and guidance. The remaining 37% said they would not be updating their plans.

For me, the most concerning finding is the number of PCTs still not working with carers’ organisations to develop plans and budgets. 82% of PCTs advised that they were working with carers’ organisations to develop plans and budgets, but carers’ organisations did not agree. 40% of PCTs were judged by carers’ organisations not to have engaged at all to develop plans and budgets.

Having minimal or irregular contact with carers’ organisations, or providing some funding for organisations connected to supporting carers does not in our view constitute real co-production of plans and budgets.

That said the examples in Sunderland and Richmond highlighted in previous blogs show that there is progress being made in some places, and we do think that more PCTs are now engaging with carers’ organisations and funding services than before. But the NHS as a whole has not made a breakthrough in supporting carers. PCTs must redouble their efforts, admittedly at a time of uncertainty for them, and Government must remember its’ responsibility and commitment to carers when considering its response to our findings.

Further info:

Read the full report: Any breakthrough for carers?

Find out more about the Give Carers a Break campaign

July 14, 2011 Posted by | breaks for carers, Health | , , , | 5 Comments

Carers breaks – where is it working?

You wait on one for ages, and then two come along. Not long after Sunderland PCT announced over £600,000 to support carers, NHS South West London and the London Borough of Richmond upon Thames have pledged £281,000 to give carers a break this year. Some of the projects funded will also provide counselling and debt advice projects, respite breaks for older carers and a mental health carers information project. 

Unsurprisingly, there is a strong carers’ voice in Richmond with a Carers’ Forum that meets quarterly, an annual carers’ conference, a survey and a Carers’ Strategy Reference Group which brings together the council, the Primary Care Trust with charities such as Richmond Carers’ Centre and Crossroads Care Richmond.  Caroline O’Neill of NHS South West London Richmond Borough Team was clear that working with local carers and carers’ organisations and influenced their decisions.

“We are committed to ensuring that carers are supported by both the health and social care services provided for them and those they care for.  We are proud of our partnership approach working closely with local authority colleagues and local carer organisations to deliver for carers.”

This theme of local authorities and PCTs working with charities was also pinpointed by Melissa Wilks, CEO of Richmond Carers’ Centre:

“Strong local partnerships between Health, Social Care and the voluntary sector are vital to making a difference to carers lives.  Richmond Carers Centre welcome this approach and the investment in short and long-term support for both adult and young carers.”

Both Sunderland and Richmond have strong local carers’ organisations and carers who are used to talking with local decision makers about the support that they need and how things can be improved. But there are some areas that do not have well-funded local charities doing this and there are some councils and PCTs that are not engaging with carers or carers’ organisations.

The Government’s idea of local communities being active in decision making is partly dependent on have strong local charities who are involved before decisions are made and finalised. Government has asked each PCT work with local carers’ organisations to develop plans and budgets, so we have been researching whether Richmond and Sunderland are the norm, or are just the exceptions.

 We will be publishing our findings on Thursday 14th July  and you can read about it here.

Take care

Gordon

July 11, 2011 Posted by | breaks for carers, Uncategorized | , , , , | 2 Comments

Sunderland pledges to give carers a break

The Princess Royal Trust for Carers and Crossroads Care launched our campaign to Give Carers a Break in May and since then many Carers’ Centres and Crossroads Care schemes have been working hard with their local Primary Care Trust (PCT) to increase investment in support for carers. Primary Care Trusts and your local NHS, have been given £400m by Government to improve support for young and adult carers, but the money is not ring-fenced so can be spent on anything at all. We fear that many PCTs will choose to spend the money in areas other than supporting carers.

However, there are some PCTs who are showing that even in such tight financial times, increasing support should be a priority.

After working closely with Sunderland Carers, Sunderland Primary Care Trust are investing £630,000 this year for extra services to give carers the support they need and deserve.  Penny Davison of Sunderland PCT explained that supporting carers was key to the care of people with disabilities and long-term illness when she said:

“We value and recognise the huge contribution carers make to caring for friends or relatives who may be disabled or seriously ill. We have seen the benefits that providing short breaks to carers can have on their health and wellbeing and are keen to ensure that carers can access a range of quality services that will support them in their caring role.”

Ailsa Martin, Chief Executive of Sunderland Carers’ Centre, has been instrumental in working with the PCT to put this plan together and believes more carers will get support earlier helping them to maintain their own wellbeing.

“We want to reach carers at any early stage, preventing unnecessary. This extra investment enables us to provide new services, including group breaks for isolated carers who may be didn’t take breaks previously because they had no one to go with.”

The NHS is facing tough times but Sunderland PCT has shown carers should be a priority. Using the money allocated to them by Government, they will help carers maintain their own health and that of the people they are caring for. The whole NHS needs to follow the lead of Sunderland PCT and Ailsa is right when she advises that “ Sunderland PCT and NHS South of Tyne and Wear should be applauded for their commitment to carers.”

Do leave comments about what is happening in your area, and whether there is something to applaud or something to be angry about. You can get involved in our Give Carers a Break campaign by sending letters to your MP or councillor asking them to make sure your PCT follows Sunderland’s lead.

Take care, and action (!)

Gordon

July 1, 2011 Posted by | breaks for carers | , | 4 Comments

Local authority spending: Cuts are unacceptable to carers

The Comprehensive Spending Review was the start, now the game has got real. This week, Government announced how much each local authority and primary care trust (PCT) will receive in 2011/12 and it is now up to them to decide how to spend the cash.

So far, charities and the sector have given grave portent of councils being forced into swinging cuts and services being lost. But we are wrong to continue this hands up in horror approach.

Firstly, the average cut for each council is 4.4%. Now, when you are talking about council budgets of £200m, then this is a lot of money – £8.8m. But think about it, 4.4% does not require whole services cut or individual funding packages ravaged as we have been hearing.

Inflation does mean the real term reduction is more and similar cuts will be made in 2012/13, but councils will also be able to find savings without cutting services. By playing up the funding reduction, we give councils cover for cuts to social services that they don’t need to make.

Indeed, you could argue that there should be no cut to social services.

The Department of Health gives grants to councils for adult social care and this forms part of the total grant to local authorities. These grants, such as the Carers’ Grant, have previously been an identifiable amount within the total grant although not ring-fenced.

For 2011/12, these grants will continue and INCREASE in line with inflation. The only difference is that they are no longer identified within the total grant given to each council.

So, we’ve done it instead. Take the Carers’ Grant for each council in 2010/11 and increase it by 3% (current inflation is 3.3%) and you have the indicative amount for each council’s share of the Carers’ Grant in 2011/12.

With the additional £100m given to PCTs for 2011/12 to spend on carers, which is meant to be pooled with council’s budgets, there is no excuse to cut support for carers. No excuse at all.

The NHS Operating Framework, published along with each PCT’s budget, says every PCT must work with carers’ organisations and councils to publish policies, plans and budgets to support carers. This Government and Paul Burstow should be applauded for this instruction.

The reality is councils have no excuse to cut carers’ services and PCTs are to discuss with us and councils how their extra money is to be used. Folks, we’re here ready to talk. And not about cuts, but about the extra support that carers need and deserve.

Take care,

Gordon

Note:                                                                                                                                                                                                                             Read in detail on the local authority spending for 2011-2012

December 17, 2010 Posted by | Benefits, Carers Strategy, Conservatives, David Cameron, Liberal Democrats | , , , , , , | 3 Comments

Carers Strategy Launch in Scotland

Note: The following post has been contributed by Lynn Williams, the Policy Officer for Scotland at The Princess Royal Trust for Carers

***

Well, we finally reached an important landmark on Monday 26th July, with the publication of “Caring Together”, the new Carers Strategy for Scotland, and “Getting it Right for Young Carers” the UK’s first separate Young Carers’ Strategy.

As we move into one of the most difficult financial periods for decades the Scottish Government has allocated approximately £5.5 million to the Carers and Young Carers’ Strategies – and all of this will go to the voluntary sector. £5 million will be focused on developing and expanding innovative respite and short break services for unpaid carers and young carers.

The Princess Royal Trust for Carers has been directly involved in helping to shape the content and actions of both documents.

Key highlights include:

  1. Creating a Carers Rights Charter – the Government is also consulting on legislating for carers to have access to Direct Payments in their own right.
  2. Investing in carers training, building on an existing £281,000 investment during this financial year.
  3. Improving the identification of carers by health and social care services
  4. Making carers’ own health and wellbeing a priority
  5. Promoting carer-friendly employment practices and encouraging income maximisation
  6. In a Scottish and UK first, it includes a separate strategy on young carers – “Getting it Right for Young Carers”. This includes a range of actions which will help professionals from a range of agencies to better identify and support young carers to achieve their full potential.
  7. An investment of £150,000 to The Trust to develop a 4th Scottish Young Carers’ Festival in 2011, which will help review progress in implementing “Getting it Right for Young Carers”.

Carers and young carers in Scotland will directly benefit from the welcome additional investment in a range of ways, demonstrating the Minister for Public Health’s commitment to carer and young carers’ issues in Scotland.

As a carer going through our own crisis situation at home, I know how hard we will all need to work to ensure that both documents are fully implemented. Much still needs to be done, and the strategies are a brilliant starting point.

We retain some concerns about what happens now that the strategies have been published:

  • The need to ensure that sustainable funding is in place for Carers’ Centres and young carers’ projects. They continue to experience a substantial increase in demand for support in their local areas, but in many cases, with no increase in funding to deal with this.
  • The Concordat between local and national government which means that there is no compulsion on local authorities to implement the strategy documents.
  • As we move toward unprecedented public sector cuts, the strategies make a clear case for investing in support for Scotland’s 657,000 carers and 100,000 young carers. However, the fact is that carers and young carers are still an easy target when cuts are being sought – recent developments at Westminster in relation to benefits and feedback from local areas in Scotland demonstrate this.

It is vital that an implementation plan is put in place as quickly as possible with all key players ‘signed up’ to take things forward. The Trust has a key role to play in this.

Carers’ Centres and carers can also use the documents at local level to hold councils, health boards, Community Health Partnerships and others accountable. How are they implementing the documents; what actions are they taking locally to improve carer support; what are local authorities doing with other partners to ensure that young carers have the chance to be children and young people first?

So, we are on the next stage of the journey – and we are under no illusion about the challenges which lie ahead in implementing both the vision and actions within each document. We would urge carers to speak to their local MSPs to ensure they are supporting and pressing for the strategies to be implemented. Meet with your local Councillors to ask how local authorities will take the strategies forward.

We will also be working with Carers’ Centres to ensure that decision makers are fully aware of the brilliant work that they do, how this benefits carers and what carers and young carers need to enjoy a quality life in their own right.

Keep campaigning!

Lynn

Note:

The Independent Budget Review report was published yesterday (29th July). Lead by Crawford Beveridge, it outlines that no part of public sector spending should be exempt from cuts. John Swinney has invited all political parties to look at the findings and the options for Scotland’s budget in future. Members of the public have been asked to contribute ideas about public spending. Please take some time to submit ideas and highlight the importance of maintaining funding for carer support.

See below for more information:

http://www.scotland.gov.uk/About/IndependentBudgetReview

http://www.scotland.gov.uk/News/Releases/2010/07/29082429

July 30, 2010 Posted by | Budget, Carers Strategy, Scotland, Uncategorized, Young carers | , , , , , , , | Leave a comment

Carers and the Big Society

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.
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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

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July 28, 2010 Posted by | Budget, Carers Strategy, Conservatives, Liberal Democrats | , , , , , , , , , , | 8 Comments

Government’s White Paper on Restructuring NHS in England

Thankfully, the birthday card I got at work yesterday included some humourous messages from colleagues giving me comic relief from the Government’s White Paper on restructuring the NHS in England. The White Paper is obviously important, but it’s just not the most fun read in the world.

In a nutshell, the proposals are:
• GPs will commission the vast majority of all health services for patients and carers meaning Primary Care Trusts (PCTs) will vanish. A NHS Commissioning Board will oversee GP commissioning.
• There will be a new Public Health Service with local Directors of Public Health being appointed jointly with local authorities, who will have new Health and Wellbeing Boards to replace Health Overview & Scrutiny committees.
• Patients should have a choice of providers – so not just NHS organisations
• More information should be shared with patients and carers and decisions taken jointly with health professionals – no decision about me without me

I don’t think the question should be whether GPs being responsible for commissioning is a perfect structure (it really isn’t) but whether it is better than the alternatives. Not everybody seems convinced of that either.

However, proposals for more patient and carer involvement and a new performance framework that focuses on outcomes for patients rather than processes should be welcomed.

This focus on the duties of health services is timely given Barbara Keeley MP’s Bill in Parliament today proposing that all health services should be required to identify patients who are carers or have a care, and consider the carers’ needs. The Bill would also require schools to have a policy to identify young carers – something which we have campaigned on.

There is little chance that Barbara Keeley’s Bill will become law unless the Government support it. So, we should ask our MPs to to support this Bill and ask them to write to Paul Burstow MP (Minister for Care Services) asking him to take the Bill forward.

The Bill has received support from MPs in the Conservative (Tony Baldry MP), Liberal Democrat (Annette Brooke MP) and Labour parties (Diana Johnson MP + others), plus Caroline Lucas MP of the Green Party. The NHS has a history of neglecting carers and it is imperative that carers are not further forgotten during and after any restructuring. This Bill could ensure that doesn’t happen.

Take Care
Gordon

July 14, 2010 Posted by | Carers Strategy, Health, Uncategorized | , , , , , , , , | 5 Comments

Budget and benefits: what’s happening with the pledges on carers?

Waking up from the hangover of England’s World Cup campaign? Here’s what you missed.

coins arranged as a question mark

Cuts could still happen at the local level

Budget and benefits

All benefits, except pensions, will rise in line with the Consumer Price Index measure of inflation, which excludes most housing costs, rather than Retain Price Index. CPI is usually about 1% lower meaning benefits will rise slower in future.

There will be a new medical test for Disability Living Allowance from 2012 and Iain Duncan Smith MP has subsequently said that  people who are able to work should do community work to keep benefits.

Will social care escape funding cuts?

Paul Burstow MP, Minister for Care Services, advised that no grants for adult social care would be cut in 2010/11. The Carers Grant remains unring-fenced although each local authority has an amount identified within its’ budget as its’ share of the £256m national Carers’ Grant from the Dept of Health. £20m will be reinvested in respite for disabled children from what would have been invested in the now scrapped Child Trust funds for disabled children, and this will be ongoing annually.

However, because these grants are not ring-fenced local authorities could use some of the funds to cover shortfalls in other areas of their funding where there have been cuts. So cuts could still happen at the local level but it would be madness to cut support for carers – see an earlier post. Sir David Nicholson, CEO NHS England, has recognised this whilst saying that the NHS should use its funding to cover shortfalls in social care.

What’s happening with the pledges on carers?

The previous Minister for Care Services, Phil Hope, requested that Strategic Health Authorities scrutinise what PCTs are doing to support carers. The new Minister, Paul Burstow MP, is currently analysing information from SHAs.

Burstow has also said that in future he will:

  • encourage the NHS to do more to identify and respond to carers’ needs earlier to prevent ill-health
  • improve information, advice and support to help carers stay in or get back to work if they are able and willing
  • refresh the Carers’ Strategy as it only taken partial steps to improve support for carers

However, the recently revised NHS Operating Framework for 2010/11 does not increase carers as a priority for the NHS, but does ask PCTs to publish how they are implementing the Dementia Strategy. Why can’t they do this for the Carers’ Strategy?

So there should be a lot for MPs to talk about during their debate on carers on 1st July. Kick off is 14:30 in Westminster Hall. Let’s hope there’s something to cheer about.

Take care

Gordon

June 28, 2010 Posted by | Budget, Carers Strategy | , , , , , , , , | 4 Comments