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Proposals to deal with rushed care visits

Tougher checks may be introduced to help clamp down on rushed home care visits that risk stripping people of their dignity and which put unfair pressure on staff, Care and Support Minister Norman Lamb will announce today.

Speaking at the National Children and Adult Services conference, he will say that from next April the Care Quality Commission is proposing to look at whether home care visits are long enough to respond to people’s needs.  They will also consider looking at how staff working conditions might be impacting on care.

To assess this, the CQC are considering looking at: 

  • whether the service is able to respond to people’s needs in the allocated time;
  • whether the care is delivered with compassion, dignity and respect;
  • how many staff have zero hour contracts; and
  • the levels of staff turnover.

Recent media coverage has highlighted the lack of time allotted to care for people who are older or who have a disability in their homes. It means many are left waiting to get into or out of bed, waiting to eat or drink or left wanting basic human contact.  This doesn’t just have an effect on those receiving care but places huge pressure on staff, who often have to work over their hours for below the minimum wage to make sure people get basic levels of support they need.

Care and Support Minister Norman Lamb said:

“The current approach to home care is not fair on those who need support, it’s not fair on care workers and it is stripping away the human element of caring.

“Fifteen minutes is not enough time to help people who are older or who have a disability to do everyday things like wash, dress and get out of bed. Some do not even get the chance to have a conversation with their home care worker, who may be the only person they see that day.

These tougher checks would ask specific questions about the amount of time allocated for visits and whether staff are suitably supported to do this. This is particularly important because these are services delivered in private, behind closed doors. I want to build a fairer society, and that means providing better care in care homes, and in people’s own homes.”

The CQC would use this information to drive its regulatory activity, so it knows when, where and what to inspect and is alerted quickly to the risk of poor quality care in home care settings.

BACKGROUND

  1. For media enquiries, please contact the press office on 0207 210 5447.
  2. From April next year, CQC will begin to focus much more keenly on leadership and culture in their regulatory approach for adult social care, and will begin to address and report against the five key questions - Is this service:
  • safe;
  • effective;
  • caring;
  • responsive; and
  • well led. 
  1. CQC will formally consult on changes to its adult social care approach in spring 2014 and throughout the spring and summer will widely test the new model, including ratings.
  1. The new approach will be fully rolled out from October 2014 and CQC anticipate that every adult social care service will have been rated at least once by the end of March 2016.
  1. CQC inspects and regulates the quality of care provided, and will make judgements on that basis using our five key questions - including whether the care is responsive to people's needs.
  1. The Government has amended the Care Bill to create an explicit requirement for local authorities to consider people's wellbeing when commissioning services.
  1. The Department of Health will work with the Association of Directors of Adult Social Services (ADASS) to develop a set of 'commissioning standards' to support and drive improvement across the country.
  1. The government has allocated significant additional funding to local authorities, including a transfer from the NHS worth £1.1 billion a year by 2014/15, to be spent on social care with a health benefit. Further to that, in 2015/16 it is creating a £3.8 billion pooled budget for health and social care in 2015/16 to help create joined up services that fit around people's lives and make the best use of resources. 

Industry comes together to recognise success

We’ve had a fantastic response to our awards this year, with an unprecedented level of entries for the British Healthcare Awards and Independent Living Design Awards (ILDA). 

The winners of these prestigious awards will be revealed at the Awards dinner on Thursday 5 December.

It’s great to see so many high quality new and established products in the marketplace, and the real creativity demonstrated by entrants in the Best Marketing Campaign and Best Creative Solution categories. All submissions are under consideration by our independent judging panel - representing the industry, healthcare professionals, trade press and end users - and will be kept a closely guarded secret until the dinner!

Our winners will be presented by BBC Breakfast’s Bill Turnbull, a veteran of 20 years in television, who has reported from over 30 countries as a BBC correspondent. Bill has also appeared on “Strictly Come Dancing”, won £150,000 for charity on “Who Wants to Be a Millionaire” and braved the hot seat on “Celebrity Mastermind”. In his spare time, he keeps bees and has written a book on apiculture, “The Bad Beekeepers’ Club”.

Host your clients, motivate your team or simply celebrate your success over a delicious three course dinner with wine, followed by drinks and dancing to a live band. An ideal opportunity to network with your peers in the industry, the gorgeous Millennium Gloucester Hotel is the perfect setting for a sophisticated evening.

To book your place, please complete and return the booking form.

NHS must fundamentally change to solve A&E problems, says Hunt

Health Secretary Jeremy Hunt has outlined radical changes to improve care for vulnerable older people and alleviate pressure on A&E.

Alongside specific plans to support NHS A&E departments in the short-term this winter, the Health Secretary set out proposals to fundamentally tackle increasing pressures on NHS A&E services in the long-term – starting with care for vulnerable older patients with complex health problems. 

Fundamental changes mean joined-up care - spanning GPs, social care, and A&E departments - overseen by a named GP.  Many vulnerable older people end up in A&E simply because they cannot get the care and support they need anywhere else.    

These changes will reduce the need for repeated trips to A&E, and speed up diagnosis, treatment and discharge home again, when patients do need to go to hospital. The facts are clear one in four of us already have a long term condition and half of all GP appointments and two-thirds of outpatients and A&E visits are now made by patients with multiple long term health problems. 

Overall, the number of people going to A&E departments in England has also risen by 32 per cent in the past decade, and by one million each year since 2010. The over-65s represent 17 per cent of the population, but 68 per cent of NHS emergency bed use. They also represent some of the NHS’s most vulnerable patients, and those most at risk from failures to provide seamless care.  

This is why, to support the NHS in the short term, the Government has made an extra £500 million funding available over the next two years.  Today, the Health Secretary set out how £250 million would be used by 53 NHS Trusts this winter.  

Of the £250 million:

  • Around £62 million for additional capacity in hospitals – for example extra consultant A&E cover over the weekend so patients with complex needs will continue to get high-quality care;
  • Around £57 million for community services – for example better community end of life care and hospices;
  • Around £51 million for improving the urgent care services - for example for patients with long-term conditions;
  • Around £25 million for primary care services – for example district nursing, to provide care for patients in their home, preventing them from being admitted to A&E;
  • Around £16 million for social care – for example integrating health and social care teams to help discharge elderly patients earlier and prevent readmission and; 
  • Around £9 million for other measures – for example to help the ambulance service and hospitals work better together.  

£15 million of this money will also be spent on NHS 111 - to increase the number of clinicians and call handlers so that non-emergency visits to A&E can be avoided. 

Flu also has a big impact on the NHS, with on average around 750,000 patients going to their GP with ‘flu symptoms and 27,000 people admitted to hospital as a result of the disease each year.  

That is why with Chief Medical Officer Dame Sally Davies, Mr Hunt also today announced specific measures to minimise the effects of ‘flu, and flu-related A&E visits in the coming winter months:

  • For the first time, any NHS Trust eligible for a share of the £250 million A&E funding for next year will need to ensure that at least 75 per cent of its own staff have been vaccinated against ‘flu this year;
  • A national flu campaign to protect the most vulnerable from the disease, and avoid flu-related A&E visits; and
  • A flu vaccination programme for children between two and three years old, to reduce potential spread of the disease.  

Setting out more fundamental long-term changes, Mr Hunt highlighted three key elements emerging as a result of the on-going engagement on improving care for vulnerable older people with complex health problems. Proposals being put together, in order to be rolled out next year include:

  • Patients should have a named clinician responsible for the coordination of their care right across the NHS – between hospital, in care homes, and in their own homes. This is subject to on-going engagement, but current views are that a GP should fill this role.
  • Care for older people must be joined up between social care services and the NHS, starting with the £3.8 billion integrated care fund recently announced by the Chancellor.
  • Information and patient records must be shared across the NHS and social care services so that accurate clinical information is available at all times to everyone involved in a patient’s care, and staff can spend more time providing care, not form-filling.  So by the end of 2014 at least one-third of A&Es should be able to see the GP records of their patients; and at least one-third of NHS111 services to be able to see the GP records of their callers.  

The Health Secretary said: 

“This winter is going to be tough– that’s why the Government is acting now to make sure patients receive a great, safe service, even with the added pressures the cold weather brings. But this is a serious, long-term problem, which needs fundamental changes to equip our A&Es for the future. 

“In the long term, I want a 24/7 service which recognises patients as individuals and looks out for them proactively.  Starting with our most vulnerable, this Government is going to support the NHS in doing exactly that.” 

The Health Secretary was supported today by senior NHS leaders, and by health minister Norman Lamb, who is specifically overseeing how the £3.8 billion integrated care funding will be used across social services and the NHS. 

Care and Support Minister Norman Lamb said: 

“We want to build a stronger economy and a fairer society. That’s why we recognise the need to join up services around people’s lives so that vulnerable people get better care, closer to home, and the NHS is sustainable for the long term. People shouldn’t fall between the cracks in services, being pushed from pillar to post and not getting the care they need simply because these systems do not work together.

“We have been talking about integrated care between the NHS and social care for years – and now the Government has put its money where its mouth is. We have created a £3.8 billion Integration Transformation Fund to make sure everyone gets a properly joined up service in order to get the care they need from whoever is best placed to deliver – the NHS or the local authority. 

“This can no longer be just an aspiration – by joining up service, we will help keep people out of hospital and provide better care.”

NHS Confederation Chief Executive Mike Farrar said: 

"Health and social care leaders will welcome receiving notification of where and how this money is to be spent, and that it will be available for services which can prevent patients needing to visit A&E in the first place.

"Our members have told us one of the most frustrating aspects of trying to plan for A&E pressures is not knowing how they will fund them until the bulk of winter has been and gone. Getting this detailed breakdown in September means the NHS can put the right plans in place and get ahead of some of the pressures we know are lurking round the corner.

"A&E is often seen as the NHS safety net, but that net is now stretched so tight it can't cope much longer. The warning signs are clear; the time for stop-gap solutions has passed. As a society, we need to drastically change how we regard hospital-based A&Es, so a public campaign reminding people of the full range of healthcare options available to them would be a good place to start." 

Chief Medical Officer Dame Sally Davies said: 

“Frontline staff, by the very nature of their jobs, deal with people who are unwell every day. Simply by having the flu vaccine, as recommended by the GMC, NHS staff can play an important role in not picking up the flu virus and passing it on to other patients – often people who are already poorly and vulnerable to infection.

“Currently less than half of frontline NHS staff get vaccinated against flu – and in some hospitals, this figure drops to fewer than 1 in 5.  I urge all frontline staff to get vaccinated and encourage their colleagues to do so too.”   

Notes to Editors

  • For further information, please contact Cariad Hazard, Juliette Marshall, or Tova Turkel at the Department of Health Media Centre on 0207 210 5892
  • A full list of the NHS Trusts receiving additional emergency demand funding is available on the DoH website
  • Trusts will not be eligible to receive a portion of the money in future years if they do not vaccinate 75% of their staff this year, except in exceptional circumstances where they can prove to the TDA, Monitor and NHS England that they have robust plans in place to ensure they meet this ambitious target the following year.
  • The three specific themes announced by the Health Secretary today will form part of a specific plan to improve care for older patients with complex health needs. Engagement on the plan is underway and it will be published later this year.

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