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policies on ageing
 
 

This resource provides easy access to the policy documents, reports and briefings that are raising the profile of issues around the support of older people and the implications of an ageing population. The initiatives and documents are listed chronologically with the most recent at the top. After thirteen years of a Labour government, a new coalition government of Conservatives and Liberal Democrats was formed in May 2010. The coalition issued a 'Programme for Government' that combined the two parties’ 'best ideas and attitudes' to provide a blueprint for action on public services and set out the underlying ethos of the coalition. The Bills included in the Queen's Speech (25 May 2010) with the potential to improve the lives of older people included the Health Bill, the Pensions and Savings Bill, the Energy Bill, the Welfare Reform Bill and the Decentralisation and Localism Bill.

 

The Care Act 2014


14 May 2014

On 14th May 2014 the Care Bill received royal assent and became The Care Act 2014. The Act includes:

  • a new framework of duties on local authorities in relation to the provision of social care, including assessment of care needs, duties to arrange care, funding and the Dilnot care cap. The provisions include:
    • new requirements to assess and meet the needs of carers
    • new provision for a single national test of eligibility for local authority involvement in arranging and funding care
    • provisions to increase transparency about costs of care and change the balance between self-funded care and local authority funded care
  • a requirement to arrange for the provision of prevention services
  • a duty to promote the wellbeing of individuals and promote integration between health and social care services
  • powers for local authorities to delegate many of their social care functions
  • duties on local authorities with respect to safeguarding of adults receiving social care
  • provisions with respect to the regulation of care providers, including:
    • a duty of candour, applying to all health and social care providers regulated by the CQC
    • a new criminal offence for some care providers of giving false or misleading information
    • changes to the CQC regulatory regime, including new powers to monitor the financial sustainability of providers
    • provision for the Human Rights Act to apply to some private sector care providers
  • a statutory basis for the Better Care Fund, i.e. powers to direct Clinical Commissioning Groups to use NHS funding in projects for developing integrated health and social care services
  • new arrangements in respect of discharge from hospital and after-care under section 117 of the Mental Health Act
The government created a number of factsheets to accompany the bill.

Commission on the Voluntary Sector & Ageing - Age of opportunity


1 April 2014

NPC, working in partnership with ILC-UK, have published a report Age of opportunity: Putting the ageing society of tomorrow on the agenda of the voluntary sector today to mark the launch of the Commission on the Voluntary Sector & Ageing.
The report provides context on the voluntary sector and the country’s ageing population, and then covers a number of areas thought to be of particular interest: relations between the different sectors, health and well-being, technology, volunteering and trusteeship, employment and fundraising.
The report asks a series of questions: in the context of an ageing society including: what will the voluntary sector look like in 20 years’ time? How will change impact the beneficiaries the voluntary sector works with? What will it mean for the workforce, and volunteering and fundraising strategies? And how will these changes affect the voluntary sector itself?

The King's Fund - Making our health and care systems fit for an ageing population


March 2014

The King's Fund has launched the report Making our health and care systems fit for an ageing population.
The report's view is that improving services for older people requires the consideration of each component of care, since many older people use multiple services, and the quality, capacity and responsiveness of any one component will affect others.
The key components considered are:

  • healthy, active ageing and supporting independence
  • living well with simple or stable long-term conditions
  • living well with complex co-morbidities, dementia and frailty
  • rapid support close to home in times of crisis
  • good acute hospital care when needed
  • good discharge planning and post-discharge support
  • good rehabilitation and re-ablement after acute illness or injury
  • high-quality nursing and residential care for those who need it
  • choice, control and support towards the end of life
  • integration to provide person-centred co-ordinated care.

Department of Health - Open consultation on 'Fundamental standards for health and social care providers'


23 January 2014

The Department of Health has launched an open consultation on Introducing Fundamental Standards, a consultation on proposals to change CQC registration regulations.
DH say that the proposals to amend the CQC registration requirements are part of a wide-ranging set of changes designed to improve the regulation of health and social care providers, and provide assurance that service users receive safe, quality care and treatment.
The purpose of the changes is to introduce fundamental standards; to make regulations more effective and improve enforcement against them; to be outcome focused; and to reduce the burden on business.
Easy read versions , draft regulations and an impact assessment are available from the .gov.uk website.
The consultation ends on 4th April 2014.

ONS - What does the 2011 Census tell us about the "oldest old" living in England & Wales?

09 December 2013

The Office for National Statistics has published its latest analysis about the older population of England and Wales, drawn from the 2011 census, What does the 2011 Census tell us about the "oldest old" living in England & Wales?.

Key facts about the "oldest old" (those aged 85 and over) include...

  • On Census Day 2011 there were 1.25 million people aged 85 or over who were usually resident in England & Wales. This compared to 1.01 million in 2001.
  • In 2011, women outnumbered men in this age group by 2:1, but there was a larger percentage increase in the number of men (45%) than women (16%) over the decade.
  • In 2011, about one in ten men and one in five women aged 85 and over lived in a communal establishment, with the remainder living in a private household.
  • For every 100 women aged 85 or over, 77 were widowed, 13 were married and 10 were either single, separated or divorced. Out of every 100 men aged 85 and over, 43 were widowed, 48 were married and nine were either single, separated or divorced.
  • 31% of men and 25% of women aged 85 and over in 2011 considered that they had very good or good general health. This compared to 24% of men and 26% of women who reported that they had bad or very bad health.
  • A larger proportion of those aged 85 and over were providing unpaid care in 2011 than in 2001; 8.8% in 2011 compared to 5.0% in 2001. Over half of those aged 85 and over who provided care in 2011 were providing 50 or more hours of care in an average week.

Government response to the Justice Committee’s report on Older Prisoners

November 2013

The Ministry of Justice has published the Government response to the Justice Committee’s Fifth Report of Session 2013-14: Older prisoners. The committee report made 30 recommendations. The Government response accepted that the treatment of older offenders should not be based on strict chronological age but individual need, informed by age and disability.
They accept that a formal analysis of the prison estate, by the National Offender Management Service (NOMS), is required to determine the extent to which older prisoners needs are being met by prison buildings and how this could be improved..
It is agreed that improved screening is required to ensure older offenders are appropriately allocated to establishments with the necessary facilities and that appropriate activies are available for those prisoners unable to participate in the 'normal' regime.
The responses included comments on health, mental health and social care needs and accepted the need to focus on the changing profile of the prison population, and to ensure that there is adequate provision to meet needs, especially prisoners’ needs for social care.

Department of Health - "Integration pioneers leading the way for health and care reform"

01 November 2013

The Department of Health (England) has identified 14 areas leading the way for health and care reform by bringing services closer together than ever before. The achievements in the announcement by Care and Support Minister Norman Lamb included

  • 2,000 fewer patient admissions over a two and a half year period, achieved through teams of nurses, social workers, occupational therapists and physiotherapists working together to prevent crises
  • Reducing waiting times from eight weeks to 48 hours at physiotherapy services by making professionals work closer together
  • Setting up a crisis house where people who suffer mental health problems can get intensive support
The fourteen areas were Barnsley, Cheshire, Cornwall and Isles of Scilly, Greenwich, Islington, Leeds, Kent, North West London, North Staffordshire, South Devon and Torbay, Southend, South Tyneside, Waltham Forest and East London and City, and Worcestershire.

The Economic Contribution of Older Londoners


17 October 2013

GLA Economcs and the Mayor of London have launched a report The Economic Contribution of Older Londoners estimating the economic contribution of Londoners age 50 and over from employment, caring and volunteering.
The report values older peoples economic contribution from volunteering at at £980 per older volunteer per year, from childcare by grandparents at between £3,200 and £6,300 per year for each grandparent providing childcare, for care for other adults at £14,600 per year for each giver of care and £57,000 per year for each older person in employment.
The report estimates the total economic contribution of older Londoners at £53.1 billion, mainly from paid employment but with £4.7 billion from the care of other adults.

Healthwatch England first Annual Report


8 October 2013

Healthwatch England has presented its first annual report to parliament.
The report provides an overview of the current state of health and social care in England including a survey and the results of a face to face deliberative event to determine what people really think about the care they receive.
It includes an explanation of the role of Healthwatch England and local Healthwatch and a report of its activities.
The survey found that, although 72% of the public say they get good quality care, 1 in 3 people say they are worried about basic levels of safety, with someone they know having experienced a serious mistake, abuse or preventable illness or death.

Equality and Human Rights Commission - Close to Home


8 October 2013

The Equality and Human Rights Commission has published Close to Home, a report outlining the experience of older people receiving care at home, the effects of different commissioning practices for home care serices, other challenges to older people's human rights and how threats to human rights in home care can be brought to light.
The report recommends that

  • the gaps in the current legal system are closed so that older people receive better protection
  • local authorities need to do more to incorporate human rights into the way they commission care services and overcome barriers to making complaints
  • older people and their families need to have better access to information when making choices about care provision
  • clearer guidance on human rights obligations should be provided to local authorities.

Summary and easy read versions are available from the .

ONS - What does the 2011 Census tell us about Older People?


6 September 2013

The Office for National Statistics has released results about older people from the 2011 census for England and Wales. The report,What does the 2011 Census tell us about Older People? reveals a number of key points:

  • In 2011, 9.2 million (16 per cent) of usual residents of England and Wales were aged 65 and over, an increase of almost one million from 2001.
  • Fifty Seven per cent (5.3 million) of those aged 65 and over in 2011 were married or in a civil partnership but the proportion of those aged 65 and over who were divorced almost doubled from 5.2 per cent in 2001 to 8.7 per cent in 2011
  • Just under a third (31 per cent) of those aged 65 and over were living alone in 2011; this was a decrease from 34 per cent in 2001.
  • Ten per cent of people aged 65 and over were economically active, Ninety per cent were economically inactive including 86% retired but the proportion of the population aged 65-74 who were economically active in 2011 (16 per cent) was almost double the proportion in 2001
  • Half (50 per cent) of all usual residents in England and Wales aged 65 and over living in households reported very good or good health in 2011 compared with 88 per cent for those aged under 65
  • Fourteen per cent of older people living in households in England and Wales provided unpaid care in 2011, compared to 12 per cent in 2001. The largest increase in proportion was for those aged 65 and over providing 50 hours or more unpaid care a week: up from 4.3 per cent (341,000) in 2001 to 5.6 per cent (497,000) in 2011

Department of Health to fund housing to help older and disabled people to live independently

24 July 2013

The Department of Health (England) has released funding for building projects producing homes that will support older and disabled people to live independently.
In 2012 the government asked local authorities to bid for a share of £300 million to boost the supported housing market. The Department of Health has now allocated funding to build 3,544 new homes.
Affordable supportive housing is designed to be accessible and aid independent living by having, for example:

  • very few or no stairs
  • cupboards that are at a reachable height for wheelchair users
  • adapted bathrooms that are easy to access for older or disabled people
  • handrails to reduce the chance of falls

Demos - Commission on Residential Care (CORC)


23 July 2013

Demos is hosting a Commission into the future of residential care chaired by former Care Services Minister Paul Burstow MP.
The Commission will consider the financial, operational, governance and cultural aspects of residential care and how these might be improved.
The Commissioners will gather evidence from charities, care providers, current care home residents and staff and members of the wider public, particularly the ‘next generation’ of care home users to assess future demand. They will also gather evidence from the public and organisations working in the care sector and make site visits, carry out interviews with practitioners and focus groups and with current and future care users as well as exploring best practice examples from abroad.
The commission will report in summer 2014.

Government reponse to the House of Lords Select Committee on Public Service and Demographic Change - Ready for Ageing?


18 July 2013

The Government has published a reponse to the, 13th March, House of Lords Select Committee on Public Service and Demographic Change - Ready for Ageing? report.
The response outlines the programme of reforms that the government has already put in place and lists additional activity since the House of Lords report was published including backing for the Big Lottery Fund 'Centre for Ageing Better', 'Living Well for longer' a call to reduce avoidable premature mortality, the May 2013 Pensions Bill to introduce a single tier flate rate state pension and a commitment to pooled health and social care budgets.
The Government will ask the Government Chief Scientist to lead an analysis of the challenges of an ageing society; publish an action plan to extend working lives and develop the detail of an NHS England plan for vulnerable older people in primary care and urgent and emergency care.
Lord Filkin, chair of the House of Lords committee has called the response "weak and failing to give leadership on the biggest social change facing our society."

House of Commons Justice Committee’s Fifth Report of Session 2013-14 - Older Prisoners


13 July 2013

The House of Commons Justice Committee has published its Fifth Report of Session 2013-14 on Older Prisoners.
The report looks at the characteristics of older prisoners, the suitability of the prison estate and regimes, the health and social care of older prisoners, resettlement, and the possibilities of a national strategy for older prisoners.
The committee's notes that the duty to treat each prisoner as an individual should not inhibit the identification of common features among the older prisoner population that can inform policy.
Its recommendations include that the National Offender Management Service (NOMS) should conduct a comprehensive analysis of prisons’ physical compliance with disability discrimination and age equality laws and that, in general, older prisoners should not be segregated.
There should be better coordination between healthcare and prison services, better training and awareness of mental health problems, improved provision of social care and that that NOMS should prepare guidance for prisons in liaising with local authorities social care teams,
Work into developing new guidelines in the use of restraint in clinical environments provides an opportunity to assess whether the balance between security and compassion is sufficiently achieved..
The committee conclude that the growth of the older prison population and the severity of the needs of that population, warrant a national strategy in order to provide for them effectively.

2013 Spending Review

26 June 2013

On 26th June 2013, George Osborne, Chancellor of the Exchequer, announced the government's spending plans for 2015, after the next general election.
A number of announcements made will have a direct impact on older people

  1. There will be moves to integrate health and social care with, from 2015, a £3.8bn health and social care budget for jointly commissioned programmes.
  2. From 2015 there will be an overall 'system wide' cap on welfare and benefit spending. This will include pensioner benefits but not the state pension.
  3. The winter fuel allowance will be subject to a temperature test so that pensioners living abroad in hot countries will no longer be eligible.
The review takes place against the background of earlier announcements which will impact on older people including local authority budget cuts of 10% on social care services and a question over whether the announced, and widely supported, investment in better integrated care will result in the hoped for new frontline services for older, disabled people, the seriously ill and their carers.

Details of the spending review are available from HM Treasury.

Kings Fund - Commission on the Future of Health and Social Care in England


26 June 2013

The King's Fund has launched a Commission on the Future of Health and Social Care in England.
The Commission will go back to first principles, fundamentally re-examining the post-war settlement,asking if it remains fit for purpose and, if so, how the NHS and social care systems could be brought closer together.
Chaired by Kate Barker, there will be four commissioners: Geoff Alltimes; Lord Bichard; Baroness Greengross and Julian Le Grand.
The Commission will produce an interim report in early 2014 and a final report by September 2014.

Kings Fund - Paying for Social Care: Beyond Dilnot


21 May 2013

The King's Fund has published Paying for Social Care: Beyond Dilnot providing a history of recent social care reform and detailing present and future 'pressures'. The report provides a summary of the Dilnot proposals and ways forward for the funding of health and social care.
The report suggests four key priorities to provide a 'roadmap' for social care reform

  • prepare detailed planning arrangements for implementing the Dilnot proposals
  • a single strategic budget settlement for the NHS and Social Care
  • Health and welfare boards to play a key leadership role in the transformation of local health and care services
  • a fundamental review of the way in which health and social care entitlements,benefits and funding are organised

Care Quality Commission - 'Time to Listen' - two reports on the dignity and nutrition inspection programme

19 March 2013

The Care Quality Commission has published 'Time to Listen', two reports on an inspection programme that looked at the care provided to older people in Care Homes and NHS Hospitals.
The programme focused on whether older people are treated with respect and dignity and get the food and drink that meets their needs.
In Care Homes: homes meeting CQC standards tended to promote a culture of care that put residents first, clearly understanding the preferences and care needs of residents. Homes that kept an accurate record of residents care, needs and prevences were more likely to reach the relevant standards. In successful homes, staff saw residents as individuals. CQC inspectors identified that problems commonly arise from cultures of care that put tasks before people.
In NHS Hospitals: an inspection of 50 hospitals revealed that while the proporton of hospitals where patients were given a choice of foods to meet their nutritional needs and were helped to eat and drink when necessary has imoroved since 2011 (83% --> 88%), the proportion always treating patients with dignity and respect has declined (88% --> 82%).
As with care homes, hospitals that performed best had good record keeping and systems 'firmly' in place to record and monitor patients' needs.

House of Lords Select Committee on Public Service and Demographic Change - Ready for Ageing?


13 March 2013

The House of Lords Select Committee on Public Service and Demographic Change - Ready for Ageing? report gathered evidence on how well the UK goverment and public services are prepared to adapt to the needs of an ageing population.
While welcoming increased longevity that would see, for example, the number of people in England aged 85 and over more than double between 2010 and 2030, the committee recognised a number of challenges and reached a number of key conclusions and recommendations including

  • Government and employers need to work to end 'cliff-edge' retirement allowing for greater flexibility in transition
  • Government and the pensions industry need to tackle the uncertainty of 'defined contribution' pension schemes
  • The financial services industry should improve the quality of, and hence confidence in, equity release schemes
  • Radical change is needed in the way health and social care service are provided with services working well 24 hours per day, 7 days per week. The structural budgetary split between health and social care is no longer sustainable.
  • Government should set out a framework for transforming healthcare before the 2015 election and political parties should prepare position papers.
  • There is a need to plan an adequate supply of appropriate market and social housing for both younger and older people.
  • The government should set out the issues and challenges of an ageing society, together with their vision for public service provision, in a White Paper to be published well before the next general election
  • The government elected in 2015 should quickly set up two commissions to report on
    • financial service provision - including pensions, savings and equity release
    • the structure and funding of health and social care to meet the needs of an ageing population
The report and evidence presented are both available from the select committee website.

Care Quality Commission - Care Update

12 March 2013

The Care Quality Commission Care Update report gives CQC’s latest view of the performance of care services in England in the nine-month period up to 31 December 2012
This Care Update finds that the health and social care system is struggling to care adequately for people with dementia. This is having an impact on hospital capacity and resources. In more than half of PCT areas in the country, people with dementia living in a care home are more likely to go into hospital with avoidable conditions (such as urinary infections, dehydration and pressure sores) than similar people without dementia. Once in hospital, people with dementia are more likely to stay there longer, to be readmitted, and to die there.
The report indicates that these findings highlight a system-wide challenge of integrating care across hospitals and care homes, and also raise questions about whether the right services for people with dementia are being commissioned and whether NHS services can cope.

Alzheimer's Society report - 'Low expectations: Attitudes on choice, care and community for people with dementia in care homes'

26 February 2013

The Alzheimer's Society report Low expectations suggests that 80% or more of residents in care homes have dementia or significant memory problems. this is much higher than the prevalence found in CPA's own analysis of Bupa care home resident census data which set the level at about 50% but with regional variations and variations with age. The CPA analysis found, surprisingly, that, unlike in the community, the prevalence of dementia in care home does not increase consistently with the age of the resident. The oldest care home residents are often admitted because of frailty and an inability to cope at home, but without a specific health condition, including dementia.
The Alzheimer's Society report indicates that expections for dementia care are low. While 68% of respondents feel the quality of care is good, only 41% feel the quality of life for the resident is good. The Alzheimer's Society report re-enforces other research findings that the level of activity for residents with dementia in care homes leaves room for improvement with only 41% saying opportunities for activity are good.

Care Quality Commission - 'Not Just a Number' - A national overview of the home care inspection programme

13 February 2013

The Care Quality Commission report 'Not Just a Number' reports on the results of a CQC inspection of a sample of 250 out of 6,830 registered home care agencies carried out from April 2012. These were agency office based inspections and there was no consistent attempt to capture the views of the person cared for or their relatives and friends.
Roughly three quarters (74%) of agencies met all five CQC standards in relation to respecting and involving people who use services, the care and welfare of care recipients, safeguarding care recipients from abuse, support for staff and the assessment and monitoring of service quality.
Key issues raised in the report included late and missed visits, a lack of consistency and continuity in care workers, a lack of support for staff and failure to address issues around travel time, poor care planning and a lack of regular reviews of care and poor staff understanding of their safeguarding and 'whistleblowing' responsibilities.
The report noted a reluctance, on the part of care recipients, to complain for fear of getting a regular carer into trouble or potential reprisals against the care recipient themselves.
A summary document and large print and easy read versions of the report are also available.

Government response to the Dilnot Commission proposals for the funding of social care in older age.

12 February 2013

The Government Policy statement on care and support funding reform accepts the principle of the Dilnot Commission proposals that there should be a maximum value for the social care costs that would need to be met by an individual in their life time.
The government proposals, most of which will not be implemented until April 2017, set the cap at £75,000 at 2017 prices compared with the Dilnot Commission suggested level of £35,000 (approx £43,000 at 2017 prices).
The proposals also increase the means-tested threshold beyond which financial help with residential care costs is no longer received from £23,250 to £123,000. The threshold for other types of care will be at an unspecified lower level.
The proposals apply only to care costs and exclude 'hotel' costs (food and accommodation) towards which someone in residential care will be expected to pay £12,000 annually (at 2017 prices). Care support payments will be at assessed fair and reasonable levels, rather than the actual cost of care, so full care costs will not necessarily be met.
A record of ongoing care costs towards the cap will be maintained in a 'Care Account' which is transferable between authorities.

The Francis Report - final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry

6 February 2013

The final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry chaired by Robert Francis QC, followed an earlier independent inquiry on the failings in the Mid Staffordshire NHS Foundation Trust between 2005 and 2009.
This final 'Francis Report' and the earlier inquiry report revealed a catalogue of failings in the care of older patients.
"There was a lack of care, compassion, humanity and leadership. The most basic standards of care were not observed, and fundamental rights to dignity were not respected. Elderly and vulnerable patients were left unwashed, unfed and without fluids. They were deprived of dignity and respect. Some patients had to relieve themselves in their beds when they offered no help to get to the bathroom. Some were left in excrement stained sheets and beds. They had to endure filthy conditions in their wards. There were incidents of callous treatment by ward staff. Patients who could not eat or drink without help did not receive it. Medicines were prescribed but not given. The accident and emergency department as well as some wards had insufficient staff to deliver safe and effective care. Patients were discharged without proper regard for their welfare."
The inquiry found "an institutional culture in which the business of the system was put ahead of the priority that should have been given to the protection of patients and the maintenance of public trust in the service".
The inquiry made a number of recommendations intended to achieve "a real change in culture, a refocusing and recommitment of all who work in the NHS - from top to bottom of the system - on putting the patient first".

ONS, release of ethnicity data from 2011 Census

11 December 2012

The first wave of Ethnicity data from the 2011 Census was released by ONS on 11th December 2012. The data revealed that, in 2011, just under one fifth (19.5%) of the population of England and Wales were from Black and Minority Ethnic groups. This was in line with CPA's projections in their report The Future Ageing of the Ethnic Minority Population of England and Wales, based on the 2001 census, which projected 21.4% by 2016. The latest data was included in a presentation by CPA's Nat Lievesley to the Runnymede / Age UK Ageing and Ethnicity Conference on December 13th which included CPA's projections of the ageing of the ethnic minority population, the incidence of dementia among BME groups and increases in the BME care home population.

Housing Learning and Improvement Network Resource Packs - "Hospital to Home" and "Strategic Housing for Older People"

26 October 2012

The Housing Learning and Improvement Network Hospital to Home Resource Pack contains essential information for all professionals that have a role in hospital discharge for older people in England. The pack, which aims to improve the integration of housing and support into the process for discharging older people, contains information, suggestions for action, case studies and checklists for considering older patients’ housing situations as part of hospital discharge and the transfer of care.
The Strategic Housing for Older People (SHOP) Resource Pack, helps with the 'Planning, designing and delivering of housing that older people want'. It is designed to help understand the current and future demand trends in housing with care and set out desired outcomes for local authorities and their partners.

Government White Paper "Caring for our future"

11 July 2012

The Department of Health has published Caring for our future, the government white paper on proposed changes to the care and support system.

The coalition government's proposed changes are said to be the most comprehensive overhaul of the care and support system since 1948.

The ‘Caring for our future’ White Paper sets out the vision for the reformed care and support system, the draft Care and Support Bill sets out social care legislation rationalising many statutes from the last 60 years, while the progress report on funding reform sets out the government’s position on social care funding.

Various organisations have published their responses and briefings to the White Paper including by Carers UK, part of the Care and Support Alliance, a policy briefing on the White Paper, along with briefings on the draft Care and Support Bill and the progress report on funding reform. See also, for example, the response from AgeUK.

Government Equalities Office response to its consultation on exceptions to age discrimination in the Equality Act 2010

12 June 2012

The Government Equalities Office has published its response to the consultation on exceptions to age discrimination in the Equality Act 2010.

The Government Equalities Office claim to have taken a proportionate approach, ensuring that the Equality Act 2010 prohibits only harmful or unjustifiable treatment that results in genuinely unfair discrimination and harassment because of or related to age.

The GEO has sought no exceptions in health and social care so all medical decisions based on age must be objectively justifiable. Financial services, on the other hand, have a blanket exception from the Act, although when age is used in decision making this must be made clear and, if cover is refused, signposts to alternative providers must be given.

Other exceptions include age based concessions, group holidays, immigration, sport, residential park homes and age verification schemes to control the purchase of age restricted products.

Health and Social Care Act (2012)

27 March 2012

On 27 March 2012 the Health and Social Care Bill gained Royal Assent to become the Health and Social Care Act (2012). This controversial act is likely to have a profound effect on the workings of the National Health Service. Supporters of the act argue that the act will deliver more power to clinicians, will put patients at the heart of the NHS, and will reduce the costs of bureaucracy. Opponents argue that it will lead to the fragmentation and marketisation of the health service.

Coalition Budget 2012

21 March 2012

The coalition government's 2012 budget delivered on 21st March 2012 included three key elements specifically affecting older people
  • The phasing out of age related tax allowances from April 2013
  • A statement of the intention to introduce a single tier state pension, above minimum income guarantee levels but based on contributions
  • State pension age to be automatically reviewed as life expectancy improves

The most contentious budget proposal was the phasing out of age related tax allowances, introduced by Winston Churchill in 1925, in recognition of the financial pressures on older people. This additional allowance, for people aged 65 and over was a tapering allowance which became less as income increased and disappeared completely for incomes of £29,000 and above. The withdrawal of the allowance has been labelled by many commentators as a 'Granny Tax'.

The single tier state pension can be seen as part of a move towards a 'citizens pension', above means tested benefit levels, not based on contributions and is to be welcomed. The detailed implementation of this and any future 'citizens pension' will need careful consideration to avoid any sense of unfairness by older people who have made differing contributions and must also ensure that, after taking into account SERPS and S2P, no individual receives a lower state pension provision overall as a result of the measure.

Although it is desirable that increased longevity should result in older people spending a longer time in healthy and happy retirement, it has to be accepted as inevitable that the state retirement age should reflect improvements in life expectancy.

Further comment on the age related issues in the budget are available from Joseph Rowntree Foundation, National Pensioners Convention and Age UK.

The NHS Confederation, Age UK and the Local Government Association - Delivering Dignity - draft report for public consulation

29 February 2012

The NHS Confederation, Age UK and the Local Government Association established the Commission on improving Dignity in Care for Older People in July 2011 to identify the underlying causes of persistent failings and shortcomings in the care of older people. A draft report recommending fundamental changes to the culture, leadership, management, staff development, clinical practice and service delivery of care homes and NHS hospitals was published for public consultation in February 2012. The period of public consultation runs until Tuesday 27th March 2012.

Royal College of Psychiatrists - National Audit of Dementia


16 December 2011

The Royal College of Psychiatrists has published the full report and executive summary of its 2010 audit of dementia care in hospitals. The audit includes hospital policies and governance that recognise and support the needs of people with dementia, elements of comprehensive assessment, the involvement of carers, discharge planning, and identified changes to support needs during admission.
The audit highlights issues such as poor communication with families and a lack of personal care for patients. Patients with dementia tend to fare worse than other patients when they enter hospital and basic needs such as eating are often not properly attended to. There are issues with access to specialist services, and preparation for discharge from hospital through proper liaison with community services.

Equality and Human Rights Commission Report - Close to Home: An inquiry into older people and human rights in home care

23 November 2011

The Equality and Human Rights Commission has published both a full report and executive summary of it's inquiry into the human rights of older people receiving care at home.
Around half of the older people, friends and family members who gave evidence to the inquiry expressed real satisfaction with their home care but the inquiry revealed evidence that the poor treatment of many older people is breaching their human rights.
The inquiry highlighted a number of issues including:

  • the low pay and status of care workers does not match the level of responsibility or the skills they need to provide quality home care.
  • a high turnover of staff as a result of these factors has a negative impact on the quality of care given to older people.
  • age discrimination is a significant barrier to older people getting home care.
    • people over the age of 65 are getting less money towards their care than younger people with similar care needs, and are offered a more limited range of services in comparison.
    • local authority phone contact lines can screen out older people needing home care without passing them on for a full assessment
Full details of the inquiry findings are available on the EHRC website.

Care Quality Commission to inspect Home Care companies

22 November 2011

The Care Quality Commission has announced that, from April 2012, it will inspect companies providing care (help with washing dressing etc) for elderly and disabled people in their own homes. This announcement is ahead of an Equality and Human Rights Commission report, due out on Wednesday 23rd November, which is expected to be critical of these services.

Care Quality Commission - National report on dignity and nutrition

13 October 2011

The Care Quality Commission has published its Dignity and nutrition inspection programme (DANI) National overview and reviews of individual NHS Trusts.
The report on Dignity and nutrition for older people, gives the findings of a series of 100 unannounced inspections of acute NHS hospitals in England between March and June 2011. The report reveals a catalogue of poor care and a need to change the culture on many wards with older people.
CQC checked two ‘outcomes’ during each inspection: Outcome 1, ‘respecting and involving people who use services,’ and Outcome 5, ‘meeting nutritional needs’. Of the 100 hospitals inspected:

  • 45 hospitals met both standards (they were ‘fully compliant’).
  • 35 met both standards but needed to improve in one or both (they were ‘fully compliant, with improvements suggested’).
  • 20 hospitals did not meet one or both standards (they were ‘non-compliant, with improvements required’).
The problems often seemed to lie at ward level with variations between individual wards in the same hospital. CQC blame poor leadership with a culture of disrepect for patients being allowed to develop. CQC noted that one in five of its inspections had picked up care that posed risks to older people’s health and wellbeing.

The state of health care and adult social care in England

15 September 2011

The Care Quality Commission has published its annual review of state of health care and adult social care in England for 2010-11.
The report has four main sections dealing with: the shape of care provision; access to care and services; choice and control; and quality and safety. CQC note that, because of changes in the legal requirements for registration, it is not possible to make direct comparisons with figures about provision and capacity from previous years.
You can view the full report here or download the full report and summaries from the CQC website.

Caring for our future

15 September 2011

The Caring for Our Future engagement exercise aims to pinpoint the priorities that the Government needs to focus on to inform its formal plans to improve the care system. This consultation follows on from the report by the Dilnot Commission on Funding of Care and Support and the Law Commission report of its project to promote far-reaching reform of adult social care law.

The engagement exercise is led by a number of experts in the field:

  • Quality - Imelda Redmond (Carers UK)
  • Personalisation of Care - Jeremy Hughes (Alzheimer’s Society)
  • Shaping local care services - Peter Hay (ADASS)
  • Prevention - Alex Fox (NAAPS)
  • Integration (in partnership with the NHS Future Forum) - Geoff Alltimes (Hammersmith and Fulham Council) and Dr Robert Varnam (Practising GP, Manchester)
  • Role of financial services - Nick Kirwan (ABI)

...and will complete in December 2011.

Consultation on Dignity in Care

consultation closes
19 September 2011

The Commission on improving dignity in care - established as part of a joint initiative from the NHS Confederation, Age UK and the Local Government Group (LG Group), called Partnership on dignity in care - has been set up to improve dignity in care provided to older patients in hospitals and care homes.
The Commission is carrying out a consultation to gather evidence from people across health and socal care who understand the day to day pressures of providing care for older patients with complex needs. The consultation closes on 19 September 2011.

Dilnot Commission on Funding of Care and Support

04 July 2011

The Dilnot Commission has published Fairer Care Funding, its proposals for the future funding of the long term care of older people.
The commission's recommendations include

  • no individual should pay more than £35,000 towards the health costs of their own long term care after which they would be eligible for full state support. This would, in adition, give individuals the opportunity to take out private insurance against a known risk.
  • the present means tested income limit of £23,250, above which an individual has to pay for their own care, should be raised to £100,000.
  • national eligibility criteria and portable assessments should be introduced to ensure greater consistency
  • all those who enter adulthood with a care and support need should be eligible for free state support immediately rather than being subjected to a means test.

The Care and Support Alliance, a group of 26 charities of which CPA is a member, is supporting the commissions proposals

Equality and Human Rights Commission - Inquiry into home care of older people - interim findings

20 June 2011

The Equality and Human Rights Commission has published interim findings from its inquiry into home care of older people which reveal that older people’s basic human rights are being overlooked in the provision of care at home.

Major problems in the home care system that have been brought out by this inquiry include: inadequate time to deliver care; lack of control over timing of care visits; failure to deliver adequate homecare; lack of staff awareness and training; high staff turnover; low expections, passive acceptance and an unwillingness to complain on the part of care recipients.

The study has revealed a number of worrying cases including:

  • people being left in bed for 17 hours or more between care visits
  • failure to wash people regularly and provide people with the support they need to eat and drink
  • people being left in soiled beds and clothes for long periods
  • a high staff turnover meaning some people have a huge number of different carers performing intimate tasks such as washing and dressing. In one case a woman recorded having 32 different carers over a two week period.

Law Commission recommends reform of adult social care law

11 May 2011

The Law Commission has published the final report of its project to promote far-reaching reform of adult social care law.
The Commission's recommendation is for a single, clear, modern statute and code of practice that would pave the way for a coherent social care system. The intention is that older people, disabled people, those with mental health problems and carers will be clear about their legal rights to care and support services. Local councils in England and Wales will have clear and concise rules to govern when they must provide services.
The recommendations include putting the individual's wellbeing at the heart of decision-making, using new statutory principles; giving carers new legal rights to services; placing duties on councils and the NHS to work together; building a single, streamlined assessment and eligibility framework; protecting service users from abuse and neglect with a new legal framework, and giving adult safeguarding boards a statutory footing.
Report and summary report.

Consultation on the Government's proposals for simplifying the State Pension system

4 April 2011

The Government has launched a Consultation on its proposals for simplifying the State Pension system.
The consultation includes two options:

  • to speed up the transition to a two tier flat rate pension; or
  • to create a single tier flat rate pension above the Pension Credit standard minimum guarantee.
The consultation also seeks views on the most appropriate mechanism for determining future changes to State Pension age.
The consultation document is available as both pdf and rtf files, and a contact is provided for alternative formats.
The period of the consultation is from 4 April 2011 to 24 June 2011.

Analysis of The Law Commission's consulation on a legistlative framework for Adult Social Care

31 March 2011

The Law Commission has published an analysis of the responses to its consultation on a legislative framework to cover all aspects of Adult Social Care including assessment, eligibility for services, joint working and the safeguarding of vulnerable adults.
The analysis is available as a single document or in parts.

Review of statutory duties placed on local government

10 March 2011

The Department for Communities and Local Government is undertaking a comprehensive review of all statutory duties place on local government. Local Authorties are subject to many statutory duties in relation to older people including the duty to support frail older people in their own homes, to assess vulnerable people who appear to be in need and to co-ordinate appropriate care services to help them live as independently as possible,and the duty to carry out funerals for people who pass away alone, without any friends or family.
DCLG is seeking views on what duties are vital to keep, what duties should be repealed and what burdens have been created through particular duties, and associated regulations and guidance?
The informal consultation exercise will remain open for six weeks, closing 25 April 2011.

Independent Public Service Pensions Commission - final report

10 March 2011

The Independent Public Service Pensions Commission, chaired by John Hutton (Lord Hutton of Furness), has published its final report on public service pension provision setting out its recommendations to the Government on pension arrangements that it believes are sustainable and affordable in the long term, fair to both the public service workforce and the taxpayer and consistent with the fiscal challenges ahead, while protecting accrued rights.

Department of Health
Paul Burstow announces DH will not seek any exceptions to the Equalities Act 2010 for Health and Social Care

03 March 2011

"The NHS must never discriminate based on age" was the message given by Care Services Minister Paul Burstow announcing that the Department of Health will not be seeking any exceptions to the planned implementation of the Equality Act 2010. "As part of its commitment to a personal, fair and diverse service that protects patients’ dignity and ensures that all patients receive the best possible treatment regardless of their age, the Department of Health will not be seeking any exceptions."

Government Equalities Office
Consultation on exceptions to the Equalities Act 2010

03 March 2011

The Government has commenced a consultation in relation to age discrimination in the provision of services and public functions.
The consultation 'Equality Act 2010: Banning age discrimination in services, public functions and associations - A consultation on proposed exceptions to the ban' sets out the specific exceptions where the government believes that different treatment of people of various ages is justified or beneficial and where legislation will help clarify that these practices can continue; and proposes how the legislation will be drafted to take account of these. A link to the consultation document and other supporting information can be found on the Government Equalities Office website.

Care and Compassion?:
Report of the Health Service Ombudsman on ten investigations into NHS care of older people

14 February 2011

'Care and Compassion?', a report presented to Parliament by the Health Service Ombudsman for England, Ann Abraham, describes ten investigations into complaints about the standard of care provided to older people by the NHS.
The complaints were made about NHS Trusts across England, and two GP practices. Each investigation was conducted independently in 2009 and 2010 and collated together because of the common experiences of the patients concerned and, as the Ombudsman states, because of the stark contrast between the reality of the care they received and the principles and values of the NHS. The findings show that the reasonable expectation that an older person or their family may have of dignified, pain-free end of life care, in clean surroundings in hospital, is not being fulfilled. The investigations reveal an attitude - both personal and institutional - which fails to recognise the humanity and individuality of the people concerned and to respond to them with sensitivity, compassion and professionalism.
Printable (pdf) version.

No health without mental health: a cross-government mental health outcomes strategy for people of all ages.

2 February 2011

This cross Government mental health outcomes strategy No Health Without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages sets out six shared objectives to improve the mental health and well-being of the nation, and to improve outcomes for people with mental health problems. It takes a life course perspective covering children to young adults, adults to older people in order to:

  • improve the mental health and wellbeing of the population and keep people well, and
  • improve outcomes for people with mental health problems through high quality services that are equally accessible to all.

The aim is to mainstream mental health so that it becomes as important to people as their physical health.

Key to reducing the estimated £105 billion annual cost of mental ill-health to the economy is to intervene early to stop problems developing and to prevent illness through public mental health and well-being actions across the board.

Health and Social Care Bill 2011

19 January 2011

The Health and Social Care Bill, introduced into Parliament on 19 January 2011, is a crucial part of the Government's vision to modernise the NHS so that it is built around patients, led by health professionals and focused on delivering world-class healthcare outcomes.

The Bill takes forward the areas of Equity and Excellence: Liberating the NHS (July 2010) and the subsequent Government response Liberating the NHS: legislative framework and next steps (December 2010), which require primary legislation. It also includes provision to strengthen public health services and reform the Department's arm's length bodies.

The Bill contains provisions covering five themes:

  • strengthening commissioning of NHS services
  • increasing democratic accountability and public voice
  • liberating provision of NHS services
  • strengthening public health services
  • reforming health and care arm's-length bodies.

End of the line for the default retirement age

13 January 2011

The Government confirmed that it will remove the Default Retirement Age (DRA) so that people have more choice when to stop working. The Government claim that, as well as benefiting individuals, the freedom to work for longer will provide a boost to the UK economy.

Ministers have decided to proceed with their plan to phase out the DRA between 6 April and 1 October 2011. The Government's written response to its recent consultation on the issue, and new ACAS guidance to help businesses adapt to the removal of the regulation, have also been published.

Currently the DRA enables employers to make staff retire at 65 regardless of their circumstances, but the Government feels the rules must change as people are living longer, healthier lives.

Liberating the NHS: Legislative framework and next steps

14 December 2010

Liberating the NHS is the government's response to the consultation period following the launch of the white paper Equity and Excellence: Liberating the NHS published in July 2010. In this response the Government sets out the next steps and timetable in its plan to reform the NHS and announces that £89 billion will go direct to PCTs for frontline services - equivalent to a 3% increase in funding for the NHS. The reforms are designed to put patients at the heart of the NHS. Also published are the PCT Allocations and NHS Operating Framework for 2011/12.

The Operating Framework sets out what NHS organisations must focus on in 2011/12 to prepare for transition to the new system of GP commissioning and includes:

  • the need to continue to improve performance, for example on waiting times
  • Primary Care Trusts (PCTs) streamlined into clusters, working with GP practices and emerging GP consortia on commissioning as well as reducing running costs
  • the role of the NHS Commissioning Board, which will operate in shadow form from next year to ensure an efficient and effective transition.

To date 52 GP consortia have signed up as pathfinders to manage their local budgets and commission services for patients. In total, the pathfinders involve 1860 GP practices and cover around 25% of the population - some 12.8 million people.

The Localism Bill

13 December 2010

The Localism Bill contains a package of reforms designed to devolve greater power and freedoms to councils and neighbourhoods, establish new rights for communities, change the planning system and give communities control over housing decisions. The Government's intention is that the legislation will help build the Big Society by radically transforming the relationships between central government, local government, communities and individuals.

Summary of the Bill: To make provision about the functions and procedures of local and certain other authorities; to make provision about the functions of the Local Commission for Administration in England; to enable the recovery of financial sanctions imposed by the Court of Justice of the European Union on the United Kingdom from local and public authorities; to make provision about local government finance; to make provision about town and country planning, the Community Infrastructure Levy and the authorisation of nationally significant infrastructure projects; to make provision about social and other housing; to make provision about regeneration in London; and for connected purposes.

The Government has today also published Decentralisation and the Localism Bill: an essential guide. Its sets out six actions central government will need to take to achieve and maintain the radical shift in power, - in behaviour, expectation, and culture - which must go alongside the changes in law proposed in the Bill.

Healthy lives, healthy people: our strategy for public health in England

30 November 2010

Deadline for responses to consultation March 8th 2011

The public health White Paper 'Healthy lives, healthy people' casts the Government's long-term vision for the future of public health in England, aiming to create a 'wellness' service, a new integrated public health service, (Public Health England) and to strengthen both national and local leadership. It responds to Professor Sir Michael Marmot's Fair Society, Healthy Lives report and adopts a life course framework for tackling the wider social determinants of health. The aim is to build people's self-esteem, confidence and resilience right from infancy - with stronger support for early years. It complements A Vision for Adult Social Care: Capable Communities and Active Citizens in emphasising more personalised, preventive services that are focused on delivering the best outcomes for citizens and that help to build the Big Society. There is a specific focus on ageing well (see e.g. p47-50).

The White Paper includes consultation questions - the closing date is March 8th 2011.

Recognised, supported and valued: Next Steps for the 'Carers Strategy'

25 November 2010

This is a cross-government document setting out how the government will prioritise actions over the next four years to ensure the best possible outcomes for carers and those they support. The strategy identifies the actions that the Government will take to support these priorities.  These include: (1) providing £400m additional funding over the next four years for breaks, and further resources for GP training, to increase GPs’ awareness and understanding of carers’ needs for support;  (2) the Department for Education will make a new early intervention grant available to local government from April 2011-12, bringing together a range of funding streams for early intervention services for young people and families, including young carers; (3) the Department for Business, Innovation and Skills will issue a consultation document next year to consult with business on how best to take forward the Coalition commitment to extend to all employees the right to request flexible working; (4) the Department of Health and the Department for Business, Innovation and Skills will examine how small local enterprises can be encouraged to provide good quality, reliable and consistent replacement care either to give carers a break from caring responsibilities or to enable them to work alongside caring responsibilities; and (5) the Department of Health and the Department for Business, Innovation and Skills will work with  industry and statutory and voluntary sector stakeholders to identify the barriers and enablers to market growth in assisted living technologies, and to support further uptake and boost innovation.

Read the Carers Strategy here.

Carers and Personalisation: Improving Outcomes

Department of Health

The Department of Health has produced a guide exploring personalisation in relation to carers, Carers and Personalisation: Improving Outcomes. It presents emerging evidence with examples to illustrate how the principles of personalisation have been applied, emphasising the value of finding ways forward that make sense and work best locally. Read the evidence guide here.

Local Delivery of Joined-Up Services

Department for Work and Pensions

24 November 2010

This research builds on the lessons of LinkAge Plus in looking at other Local Authority areas that had developed a similar approach to joining-up services or adopting similar principles to LinkAge Plus. Some of these were influenced directly, e.g. Lancashire County Council has taken forward many of the principles of the LinkAge Plus pilot in Lancaster. Others have come to many of the same principles of LinkAge Plus in different or innovative ways. Drawing on case study participants’ experience, a framework has been developed for implementing and sustaining more joined-up working.

Read the research and case studies here.

The Forgotten Age: Understanding Poverty and Social Exclusion in Later Life (Interim Report)

The Centre for Social Justice

23 November 2010

The Forgotten Age documents levels of poverty and social exclusion facing many people in older age challenged in terms of money, health, lifestyle, communities, housing and care. The report identifies two key threats to the well-being of older people - the crisis in social care where demand is set to rise sharply against the background of continuing public spending constraints, the absence of any clear policy remedy from government and a projected severe fall in the number of unpaid carers currently looking after millions of vulnerable old people; and the high and rising levels of family breakdown is impacting the old as well as the young, meaning that in the future fewer old people will have adult children and spouses and partners to turn to when they need help with the simple essentials of everyday life, such as washing, dressing, travelling to the shops and cooking.

Read The Forgotten Age here and access background information via the Centre for Social Justice website.

A Vision for Adult Social Care: Capable Communities and Active Citizens

Department of Health

16 November 2010

The vision sets out a new agenda for adult social care in England that provides more control to individuals and their carers. It is built on seven principles: Prevention; Personalisation; Partnership; Plurality; Protection; Productivity; and People.

Reform of the system of social care in England focuses on the government commitment to:
- break down barriers between health and social care funding to incentivise preventative action in local communities
- extend the greater rollout of personal budgets to give people and their carers more control and purchasing power;
- use direct payments to carers and better community-based provision to improve access to respite care.
- encourage care and support to be delivered in a partnership between individuals, communities, the voluntary sector, the NHS and councils - including wider support services, such as housing.

Launching the vision, Paul Burstow, Minister for Care Services, announced that everyone eligible will receive a personal budget, preferably as a direct payment, by 2013.

Read A Vision for Adult Social Care here.

Transparency in Outcomes: A Framework for Adult Social Care

A Consultation on Proposals,
16 November 2010-9 February 2011.

This consultation document proposes a new strategy for transparency, quality and outcomes in adult social care. It sets out an enabling framework which aims to empower councils, local people and the wider social care sector to take new leadership roles. It provides a support to the critical link between adult social care and other local partners, such as the NHS, as well as demonstrating social care’s important contribution to the Government’s new Transparency Framework. The document includes specific questions as part of the consultation and the government will publish its response by April 2011.

Read the consultation document here.

Inquiry into Home Care of Older People

Equality and Human Rights Commission (EHRC)

Launched 10 November 2010

The EHRC has begun an Inquiry into the protection and promotion of human rights of older people in England who require or receive home-based care and support.
The inquiry will investigate the experiences of, and as a result confidence in, the system to protect human rights of older people and their families. It will explore the legal obligations of different groups, including care providers, local authorities, the Care Quality Commission and central government.
It will specifically look at whether obligations are being discharged effectively in the context of reforms to the care and support system and evidence of good practice in this area. Finally the Inquiry will look at the case for legislative reform to ensure that the human rights of vulnerable older people are comprehensively and robustly protected.
The Inquiry will publish its findings and recommendations in December 2011.

A Call for Evidence is asking for good or unsatisfactory experiences of homecare from older people, their family and friends and from home care staff and organisations.

Access Inquiry details and how to contribute to the call for evidence via the EHRC website here.

Think Local, Act Personal: Next Steps for Transforming Adult Social Care

4 November 2010

Think Local, Act Personal is a proposed sector-wide partnership agreement to moving forward with personalisation and community based support. The agreement draws on learning from implementing Putting People First across England over the past three years and focuses on areas where further action is required. The agreement: (1) Underlines the necessary connection between preventative, community-based approaches and personalised care and support; and (2) Provides a general framework for action; supported in the next few months by examples to assist partners in benchmarking progress, and by co-designed tools to aid delivery.

Read Think Local, Act Personal here.
Access best practice guidance via the DH website here.

Universal Credit: Welfare That Works, White Paper,
Department for Work and Pensions
11 November 2010

Secretary of State for Work and Pensions, Iain Duncan Smith announced today welfare reforms moving towards a universal credit intended to replace work-related benefits and simplify the benefits system. He proposed a 'comprehensive system of support' to help people back into employment, and sanctions for those who refuse to take up work offered.

The new Credit will provide a basic amount with additions for those with children and other caring responsibilities, people with disabilities and those with housing needs.   It will be available for people both in and out of work and will replace the existing support including: Working Tax Credit, Child Tax Credit, Housing Benefit, Income Support, income-based Jobseeker’s Allowance and income-related Employment and Support Allowances. Read the White Paper here and the Executive Summary here.

An Age Old Problem

National Confidential Enquiry into Patient Outcome and Death (NCEPOD)

11 November 2010

This new study from NCEPOD investigated all the deaths of patients over 80 that took place in hospitals within 30 days of surgery over a three-month period of 2008, questioning medical staff and examining case notes. Less than one third of patients (225/965) were reviewed by specialist elderly care teams before surgery. 'Most patients were admitted as emergencies by very junior doctors without timely input of senior care of the elderly clinicians.' Read the full report here.
Key findings
• Just over 1/3 of patients surveyed (38%, 295/786) received good care.
• Poor nutrition and serious associated illness were very common in the group
studied.
• In over two-thirds of cases (67.7%, 653/965), patients were not reviewed by
specialists in Medicine for the Care of Older People.
• Clinically significant delays occurred in 1 in 5 patients between admission and
their operation.
• 1/4 of hospitals had no acute pain service.

See the Centre for Policy on Ageing's reviews on age discrimination in health and social care services.

Independent Public Service Pensions Commission chaired by Lord Hutton

Call for evidence 1 November-17 December 2010

Lord Hutton has issued a call for evidence to feed into his final report on restructuring public service pensions, due to be published before Budget 2011. The Call asks specific questions around design of pension scheme, risk-sharing and adequacy. Read the Call for Evidence here.

Financial Management of Personal Budgets: Challenges and Opportunities for Councils

Audit Commission

28 October 2010

In May 2010, the Coalition Government re-stated its commitment to personal budgets. This report reviews progress of people taking control of their own social care. It fnds that some councils are falling behind in providing personal budgets and will need to make 'a significant effort' to achieve the milestones agreed in 2009 between the Association of Directors of Adult Social Services, the Local Government Association and Department of Health that at least 30 per cent of eligible social care users, or their carers, should have a personal budget by April 2011. Only six of the 152 councils are currently meeting it. In addition, a survey earlier in 2010 showed only 6% of total spending on adult social care had so far been allocated to personal budgets.

The report also reveals that councils have less well-developed personal budget approaches for people with mental healthcare needs. Several did not provide them at all, despite evidence that mental health service users would be major beneficiaries of the policy. It suggests that existing joint arrangements are not flexible enough to adapt to personal budgets.

Read the full report and summary report.

HM Treasury Spending Review

20 October 2010

Full details of the comprehensive spending review can be accessed here.

The Spending Review confirms key components of the Coalition Agreement setting out the Government’s objectives and priorities for the Parliament, including commitments to:
•• provide an NHS that is free at the point of use and available to everyone based on need not the ability to pay, with total NHS spending increasing in real terms in each year of the Parliament;
•• uprate the basic State Pension by a triple guarantee of earnings, prices or 2.5 per cent, whichever is highest, from 2011, while bringing forward the date at which the State Pension Age will start to rise to 66 to 2018 in order to ensure this is fiscally sustainable.

Section 1.63. Key benefits for older people:
“The Government is preserving key benefits for older and vulnerable people, including Winter Fuel Payments, free eye tests, prescriptions and TV licences. In addition, the Government will:
•• allocate £2 billion of additional funding a year by 2014-15 to social care to support some of the most vulnerable people in society;
•• make permanent the temporary increases to Cold Weather Payments provided in the past two winters, at a cost of £50 million a year, so that eligible households receive £25 for each seven day cold spell recorded or forecast where they live; and
•• protect the statutory entitlement for concessionary bus travel, ensuring that older people can maintain greater freedom and independence.”

Building a Stronger Civil Society: A strategy for voluntary and community groups, charities and social enterprises

14 October 2010

Deadline for responses to consultation 6 January 2011

Together with citizens and communities, the voluntary and community sector sits at the heart of the government's ambitions to create a Big Society. Proposed reforms will re-caste the relationship between the state and the sector, giving it opportunities to shape and provide innovative, bottom-up services where state services have failed. The strategy outlines the sector's potential role in empowering communities, opening up public services and promoting social action. It highlights a range of existing policies and some new initiatives for supporting civil society organisations at a challenging time. Read the strategy here.

As part of this new strategy, the Government has launched a consultation in which it is seeking views on how it can improve the effectiveness of the advice and support that is available to frontline organisations. Read the consultation document here.

21st Century Welfare
DWP
30 July 2010

Consultation 30 July-1 October 2010

The DWP discussion document provides a framework to reform the benefits system, maximising work incentives while continuing to protect those most in need. The proposals for a simpler benefit system could: bring together parts of the current benefits and tax credit syste; simplify the financial help available to people both in and out of work; and allow extra support for housing, children and disability. A consultation paper on changes proposed ran from 30 July until 1 October 2010. Read the full document and summary here.

Phasing Out the Default Retirement Age: Consultation Document,
29 July 2010

Deadline for responses
21 October 2010

The government is committed to phasing out the default retirement age (DRA). The consultation document sets out the background to the DRA and explains how the government is proposing to remove it. Reasons given for removing the DRA include demographic change; the financial benefits to the individual and the wider economy; and the health and social benefits people gain from working later in life. The consultation asks questions on the specific proposals the government has for phasing out DRA and on the support individuals and businesses might need to manage in its absence. Deadline for receipt of responses is 21 October 2010. Read the consultation document here. Access futher information from the Department of Business Innovation and Skills website.
Commission on the Funding of Care and Support
20 July 2010

The Commission on the Funding of Care and Support set up by Health Secretary Andew Lansley will 'make recommendations on how to achieve an affordable and sustainable funding system for care and support, for all adults in England, both in the home and other settings. The Commission should build on the extensive existing body of work in this area and provide advice on how to implement its chosen option.' Andrew Dilnot is chair of the Commission; two other Commissioners are Dame Jo Williams and Lord Norman Warner. The Commission wants to work with all users of care and support, the public, stakeholders and experts. The focus is on working collaboratively with all stakeholders and to gather the evidence, input and advice of others. This will be through an external reference group and by drawing on the expertise of two expert independent panels, one comprising of academics and the other of experts drawn from the financial services industry. The Commission is to present its findings to the government by the end of July 2011.

Further details on the terms of reference of the Commission, the Commissioners and reasons for reform are given on the DH website - click here to access

Call for Evidence on the future funding of care and support
1 December 2010

Deadline for responses
28 January 2011

The Call for Evidence paper seeks suggestions on the future funding of care and support in England and forms one part of the wider engagement work - click here to access

Equity and Excellence: Liberating the NHS
DH White Paper
12 July 2010

A consultation on proposals was launched on 18 October, closing on 14 January 2011


The White Paper sets out the government's long-term vision for the future of the NHS. It asserts patients will have greater choice and control including a focus on personalised care that reflects individuals' health and care needs, supports carers and encourages strong joint arrangements and local partnerships. Access the White Paper and supporting documents here.

The NHS will focus on outcomes and the quality standards that deliver them to improve patient experience. Reforms are intended to empower professionals and providers, giving them more autonomy and making them more accountable to the public at local level. In particular, power and responsibility for commissioning services will be devolved to GPs and their practice teams working in consortia. To achieve savings for reinvestment in front-line services the NHS will need to cut bureaucracy and improve efficiency.
The role of the DH itself will change. Its NHS role will be reduced and it will focus more on strategy to improve public health, tackle health inequalities and reform adult social care. More powers around public health improvement will be transferred to local authorities. Read the consultation document.

The DH will maintain its vital role in setting adult social care policy to provide a sustainable system that gives people support and freedom to live with dignity. It will seek to break down barriers between health and social care funding to encourage preventative action. The government's vision for social care will be set out later in 2010 (published November 2010, see above). The DH will establish a commission on the funding of long-term care and support to report within a year. The government will bring together the conclusions of the Law Commission and the Commission on funding of long-term care, along with its vision, into a White Paper in 2011, with a view to introducing legislation in the second session of this Parliament to establish a sustainable legal and financial framework for adult social care.

Ageing Well programme launched by DWP on 12 July 2010 Ageing Well is a new programme designed to support local authorities to improve their services for older people. The key aim of the programme is to provide a better quality of life for older people through local services that are designed to meet their needs and recognise the huge contribution that people in later life make to their local communities. It is a sector led programme which consolidates current best practice from local authorities, the findings of wider research and the lessons learned from earlier pilot activities. This combined body of evidence shows that strong leadership, working in partnership, joining up services and including older people in service design and delivery, leads to more cost effective services with better outcomes for older people.

Two Reviews on Pensions announced 24 June 2010

Increasing the state pension age to 66

 

Enrolment into workplace pensions

The coalition government announced two reviews on pensions on 24 June 2010. 
A review has been established into the timing of the increase in state pension age to 66.  A Call for Evidence is inviting people and organisations to submit evidence on the following:
·       Changes in life expectancy and the changed economic context
·       The notice period for individuals affected
·       Ensuring no group is disproportionately impacted
The Call closed on 6 August and the Government response to the call for evidence was published 3 November 2010 - click here to read.

The second review focused on how best to support the implementation of automatic enrolment into workplace pensions, reporting by end September 2010 (panel: Paul Johnson; David Yeandle OBE; Adrian Bolding).  On 27 October 2010 the Government published the outcomes of the independent review into how to make automatic enrolment work - click here to read.
Access further information via the DWP's website.

The government is restoring the link between the state pension and earnings from 2011 and consulting on how to phase out quickly the Default Retirement Age.

Independent Public Service Pensions Commission
Chaired by Lord Hutton

June 2010

Interim report published 7 October 2010

Ex-Labour cabinet minister John Hutton has been appointed to head a commission into public sector pensions. The commission will undertake a fundamental structural review of public service pension provision by Budget 2011. It will produce an interim report in September 2010 ahead of the Spending Review. The Commission is extending an invitation to all interested groups to submit their views and comments directly and has requested all responses by end July 2010. Access the terms of reference here

An interim report was produced on 7 October outlining progress to date on undertaking a structural review of public service pensions. Read the report.

Social Care Commission announced in the Queen's Speech 25 May 2010

'The government recognises that urgent reform of the social care system is needed to provide much more control to individuals and their carers, and to ease the cost burden that they and their families face.  This is one of the biggest challenges faced by society today. The government will establish an independent Commission to consider how we ensure responsible and sustainable funding for long-term care. It will ensure that there is a fair partnership between the state and the individual, which takes into account the vital role of families and carers.  The commission will report within a year.'

The Personal Care at Home Act
8 April 2010

The Personal Care at Home Act amends section 15 of the Community Care (Delayed Discharges etc.) Act 2003 so as to remove the restriction on the period for which personal care may be provided free of charge to persons living at home; and to make consequential provision. Both Houses of Parliament have to approve implementation of the measure in a vote and the coalition government has announced that it will not be commencing the provisions in the Act relating to free care at home.

The Equality Act 2010
8 April 2010

The Equality Act is due to come into force in October 2010, with the public sector equality duty due to come into force on April 2011 and age protection outside the workplace in April 2012. Access further details via the Government Equalities Office (GEO) website.

Building a National Care Service - White Paper
30 March 2010

The Labour government proposed fundamental reform of the care and support system for all adults in England building a new National Care Service.
Read the White Paper and supporting documents here.

Reshaping Care for Older People

The Scottish Government,
24 March 2010

Reshaping Care for Older People engages all sectors in a programme to explore how older people's care can be delivered over the next two decades. If current models of care in Scotland are sustained, the present care budget of £4.5 billion will need to rise by £1.1 billion by 2016 and £3.5 billion by 2031. In partnership with Scotland's local authorities and involving the voluntary and private sectors, the programme will include a series of public meetings around Scotland to share the future challenges and possible solutions with a wide audience. There are eight primary work streams. Access developments through the Scottish Government website here.

Securing Good Care for More People: Options for Reform

The King's Fund (Richard Humphries, Julien Forder, Jose-Luis Fernandez)
16 March 2010

In light of changing circumstances and increasing demand for social care, this report takes forward the 2006 review of social care by the King's Fund (Wanless report) to provide fresh evidence of the 'compelling need for reform' with projections drawing on revised modelling. The analysis looks at three funding options over 2015-2026: the existing system with no reform; free personal care; and a revised version of the partnership model put forward in the original review in which the state funds 50% of everyone's care and support costs, and matches every £2 contributed by the individual with a further £1. A key principle of reform is that costs of care need to be shared responsibly between the individual and the state. While each option modelled calls for an increase in public funding, the report suggests a revised version of the original partnership model offers the best outcomes. Read the full report here.

Social Care: Third Report of Session 2009-10

House of Commons Health Committee
12 March 2010

The House of Commons Health Committee report on adult social care provides a wide ranging analysis of the current status of social care, shortcomings of the existing system and requirement for fundamental and lasting reform. The Committee cautions against creating an atmosphere of 'demographic despair and alarmism' in the face of changing demographics as society must not underestimate its ability to be productive and create wealth, nor underestimate the contribution of older people. However, in the face of unmet need, increased demands and perceived unfairness in people accessing social care support, the Committee calls on all political parties to come together to map out sustainable reform. Read the full report here or browse through individual sections here.

Age Equality in Health and Social Care: A Report on the Consultation

Department of Health
9 March 2010

This is a report on the consultation that the DH conducted from November 2009 to February 2010 on age equality in health and social care. It summarises responses to questions and details the position of the DH on each issue and further actions. Annex A of the report provides a summary of the DH position in relation to specific issues, including timing of the ban on age discrimination, exceptions, QALYs, upper limit for the breast screening programme, age specific datasets, and more. Read the full report, summary document and original consultation questions here.

Law Commission, Adult Social Care: Consultation
24 February - 1 July 2010

The Law Commission, which advises the Government on law reform, has proposed to replace existing laws and policy guidance for adult social care with a single, modern statute in England and Wales.  The legislative framework for adult residential care, community care, adult protection and support for carers is inadequate, often incomprehensible and outdated. Provisional proposals include:
• establishing a core set of overarching principles to guide social care decisions;
• introducing a single and explicit duty to assess individuals’ needs;
• a duty on local authorities to provide community services for all those eligible;
• the introduction of a single duty to assess the needs of any carer;
• a statutory duty on local authorities to investigate when they suspect that
vulnerable adults are being abused or neglected.

Read the consultation paper and related information here. The Commission has agreed to publish the final report by April 2011.

Under Pressure: Tackling the Financial Challenge for Councils of an Ageing Population

Audit Commission
18 February 2010

The Audit Commission report on local government examines the issues facing councils with an ageing population requiring a range of services as public spending reduces. It suggests that councils are not planning strategically for an ageing population and do not know enough about the costs. In addition, cost savings that could arise from preventive services and better work with other organisations are not being explored fully by councils.
Read the summary report, full report and associated documents here.

Fair Society, Healthy Lives

The Marmot Review
11 February 2010

The aim of the Review was to propose an evidence based strategy for reducing health inequalities from 2010. The strategy includes policies and interventions that address the social determinants of health inequalities.The starting point for the Review is that health inequalities that are preventable by reasonable means are unfair, and putting them right is a matter of social justice. Key messages from the Review include: there is a social gradient of health - the lower a person's social position, the worse his or her health. Action should focus on reducing the gradient in health. Health inequalities result from social inequalities. Action on health inequalities requires action across all the social determinants of health. Universal action is required but with a scale and intensity that is proportionate to the level of disadvantage - called 'proportionate universalism'. The fair distribution of health, wellbeing and sustainability are important social goals. Read the Executive Summary here. Access the full report and supporting documents here.

The State of Health Care and Adult Social Care in England: Key themes and quality of services 2009

Care Quality Commission
10 February 2010

The Care Quality Commission (CQC) published its first report annual report to Parliament on the state of health care and adult social care in England. The future presents a major challenge with increasing demand for care at a time when public finances will be stretched. The CQC calls for faster progress in joining up health and social care with better care in the community. Also a fundamental cultural shift is required to enable people to have more choice and control over their care. This includes providing better information about care options, widening access to care and challenging discrimination and promoting human rights within services. Read the full report here. Access a summary of the report and further information from the CQC here.

Equality Bill: Making it work. Policy proposals for specific duties

Ending age discrimination in services and public functions
25 and 27 January 2010

The Government Equalities Office (GEO) published two policy statements relating to work around proposed implementation of the Equality Bill.
'Policy proposals for specific duties' provides the response to the consultation on proposals for the specific equality duties and 'Ending age discrimination in services and public functions' summarises the consultation responses and sets out plans for specific exceptions from the age discrimination ban. The GEO is requesting feedback on whether to create specific exceptions around age for health and social care within the legislation, with the request to send comments by 30 April 2010 to age@geo.gsi.cog.uk as noted in the policy statement. Read the Centre for Policy on Ageing's response on exceptions and related issues here.

National Evaluation of Partnerships for Older People Projects: Final Report
18 January 2010

The Partnership for Older People Projects (POPP) were funded by the Department of Health to develop services for older people, aimed at promoting their health, well-being and independence and preventing or delaying their need for higher intensity or institutional care. The evaluation found that a wide range of projects resulted in improved quality of life for participants and considerable savings, as well as better local working relationships. Read the executive summary here or access the full report via the DH website here.

Four reviews from the literature on ageism and age discrimination in secondary health care, primary and community health care, mental health care and social care in the United Kingdom

Centre for Policy on Ageing
21 December 2009

The Centre for Policy on Ageing published on 21 December 2009 four reviews from the literature to provide evidence of ageism and age discrimination in primary and community health care, secondary health care, mental health care and social care in the UK. Access the four reviews via the CPA website here.
The four reviews were commissioned by the Department of Health to support the national review of age discrimination and age equality in the health and social care sector and help health and social care organisations meet the new public sector equality duty in the Equality Bill.
This recent work complements earlier work consisting of two literature reviews and two research studies on the costs and benefits of eliminating age discrimination in the provision of health and social care commissioned by the Department of Health and released on 26 June 2008 to coincide with the launch of the first draft of the Equality Bill in the House of Commons.
The review of the likely costs and benefits of legislation to outlaw age discrimination in health and social care was carried out by the Centre for Policy on Ageing. View the CPA report | Link to all four reports on DH website

The Personal Care at Home Bill
25 November 2009

The Personal Care at Home Bill, announced in the Queen's Speech on 18 November, was introduced to Parliament on 25 November 2009. The Bill offers free personal care at home for those with the highest needs, regardless of means, such as those with serious dementia and with Parkinson's Disease. It includes provision to invest in re-ablement and prevention to help people live at home for longer.

Achieving Age Equality in Health and Social Care

A Report to the Secretary of State for Health by Sir Ian Carruthers OBE and Jan Ormondroyd
22 October 200

 

The national review of age discrimination and age equality in the health and social care sector was set up to help health and social care organisations meet the ban on age discrimination and the new public sector equality duty in the Equality Bill. The review analysed evidence about the nature, extent and variability of age discrimination in health and social care services.  Read the report of the national review here. An annex of working papers to support 'Achieving Age Equality in Health and Social Care' is available to read here.

The DH commissioned a resource pack including audit tools and practice guides, to be available from April 2010, to assist with the elimination of ageist and discriminatory practice at local levels.

Shaping the Future of Care Together -Green Paper
14 July 2009

 

The Green Paper set out the Labour government's vision for a new care and support system based on a National Care Service that is fair, simple and affordable. It outlines six elements that people should be able to expect from the new service: prevention services; national assessment; a joined-up service; information and advice; personalised care and support; and fair funding. Three key changes are required to help meet these six objectives: more joined-up working; a wider range of services in care and support; and better quality and innovation. To read the Green Paper click here. A national debate on the reform of adult care and support in England - the Big Care Debate - closed on 13 November 2009.

Building a Society for All Ages
13 July 2009

Response to consultation published 2 Feb 2010

Building a Society for All Ages builds on the cross-government Opportunity Age strategy to meet the challenges and realise the opportunities of an ageing population. To read the report click here. The government invited views on proposals to continue this work as part of a formal consultation process. The consultation questions and reports supporting the strategy, including the final report Working Together for Older People in Rural Areas, are available via the government website - click here to access. Read the consultation response report here or access via the government website.

National Review of Age Discrimination in Health and Social Care
May - October 2009

A national review of the actions required to implement the provisions in the Equality Bill relating to age discrimination in health and adult social care was led by Sir Ian Carruthers, Chief Executive of the South West Strategic Health Authority, and Jan Ormondroyd, Chief Executive of Bristol City Council. 

The Equality Bill

Introduced 24 April 2009 - Completed 7 April 2010

The Equality Bill had its First Reading on 24 April 2009. Age discrimination was banned in the workplace in 2006 and the Equality Bill will make it unlawful to discriminate against someone aged 18 or over because of age when providing services or carrying out public functions. It will not affect products or services for older people where age-based treatment is justified or beneficial. The law will only stop age discrimination where it has negative or harmful consequences. The new law will be implemented in phases, with main provisions in October 2010 and the ban on age discrimination in provision of goods, facilities, services and public functions in 2012. The government has initiated a review of the practical action that is needed to tackle age discrimination in health and social care, which will report in October 2009. Access the Equality Bill and associated documents here.

Living Well with Dementia: A National Dementia Strategy

Department of Health
3 February 2009

 

The NDS Joint Commissioning Framework (added 15 June 2009)

 

Dementia Gateway

The Use of Antipsychotic Medication for People with Dementia: Time for action
12 November 2009

The first National Dementia Strategy sets out initiatives designed to improve the lives of people with dementia, and their carers and families. The Strategy aims to increase awareness of dementia, ensure early diagnosis and intervention and radically improve the quality of care that people with the condition receive. Proposals include the introduction of a dementia specialist into every general hospital and care home and for mental health teams to assess people with dementia, with memory clinics to be established throughout England. To read the National Dementia Strategy click here. The strategy draws on the results of a public consultation.

The NDS Joint Commissioning Framework, a new resource to support implementation of the National Dementia Strategy, provides best practice guidance for commissioning dementia services. The Framework includes: a Joint Strategic Needs Assessment template; a summary of NICE and SCIE evidence for dementia services; commissioning levers against each of the NDS Objectives. To access the Framework click here

A Dementia Gateway was launched on 6 November 2009 by the Social Care Institute for Excellence to provide practical tips, tools and activities to help people in their work with dementia. You can visit the gateway at www.scie.org.uk/dementia.

An independent report commissioned by the DH concludes that inappropriate prescribing of antipsychotic drugs for people with dementia is widespread. The author, Dr Sube Banerjee, states 'It is clear from this review that the current level of use of antipsychotics for people with dementia presents a significant issue in terms of quality of care, with negative impacts in patient safety, clinical effectiveness and the patient experience.' Read the report here.

Empowering Engagement: a stronger voice for older people

The Government response to John Elbourne's review
3 February 2009

The government has broadly supported the recommendations made by John Elbourne in his report examining older people's engagement with government at all levels, published 18 November 2008. It proposes to set up national leadership for older people in a UK Advisory Forum on Ageing to provide advice and support on the implementation and development of the Government's strategy for older people and an ageing society. It will also create a new structure with a designated lead regional coordinator for older people's engagement in each English region to help set up Regional Forums on Ageing where they do not already exist and it will continue to support OPAGs and other forums through Government Offices. To read the government response and proposals click here.

The State of Social Care in England 2007-08

CSCI report
27 January 2009

The Commission for Social Care Inspection (CSCI) issued on 27 January 2009 its fourth and final report on the state of social care in England. The CSCI found that a year on from the publication of 'Putting People First' most people still experience a 'one-size-fits-all' model of care that is not geared towards people's individual needs. While there have been some tentative steps to address the new personalisation agenda, developments in social care are patchy and vary between different groups of people. Concerns remain about people who are 'lost to the system' because they are ineligible for publicly funded support or are 'self funders'. There continues to be tension between resourcing support for those with the highest levels of need and investing in a range of services which can maintain people's independence and improve their quality of life. To read the full report click here.

Common Assessment Framework (CAF) for Adults

Demonstrator sites and results of consultation (updated 19 June 2009)

The Department of Health held a consultation (22 January-17 April 2009)on improving the quality and efficiency of care and support for adults through improvements in the sharing and use of information. Topics covered the rationale for improving information, how assessment and care planning should be undertaken (the principles), what information should be commonly shared and with whom and the IT approaches that would enable this to take place within appropriate arrangements for consent, confidentiality and security.  To access information on CAF for adults including information on demonstrator sites and results of the consultation click here.

Strategy for Older People in Wales 2008-2013

Welsh Assembly Government

Building on the achievements of the Strategy for Older People in Wales 2003-2008, phase 2 focuses on economic status, general well-being and independence of older people, around four themes:
- Valuing Older People - Maintaining and Developing Engagement. Promote positive images of ageing and ensure that the over 50s are able to participate as fully as they wish in their communities, giving them a stronger sense of engagement and influence.
- Changing Society - The Economic Status and Contribution of Older People. Develop policies to increase the capacity of the over 50s to continue to work, learn, volunteer and care, making an active contribution for as long as they wish, and ensure that older people do not live in poverty.
- Well Being and Independence. Improve the health and well being of older people through initiatives to promote health, as well as high quality, responsive and appropriately regulated health, social care and housing services.
- Making it Happen - The Implementation of the Strategy. Implement the Strategy for Older People in Wales with support funding to ensure that it is a catalyst for change and innovation across all sectors, improving services for older people, providing the basis for effective planning for an ageing population and reflecting the concerns of older people.
Access the Strategies via the Welsh Assembly Government website here.

Preparing for Our Ageing Society: a discussion paper
25 November 2008

This discussion paper, and a series of associated public discussion events, are part of the first stage of a review of the government’s strategy for meeting the challenges of our ageing society. A consultation process to discuss the issues to be addressed in the strategy ran from 25 November 2008 to 20 January 2009 and responses to the discussion paper were published on 9 June 2009. To read the discussion paper and responses click here.

Cutting the Cake Fairly

CSCI review of eligibility criteria for social care
22 October 2008

The Commission for Social Care Inspection (CSCI) issued on 22 October 2008 a report on eligibility criteria for social care. Tensions have developed between new approaches to personalisation and prevention and implementing the Fair Access to Care Services (FACS) framework, alongside councils' increasing tightening of their eligibility criteria. CSCI makes a series of recommendations to improve access to support consistent with 'Putting People First' and to provide some level of assistance and advice to everyone seeking care and support underpinned by the notion of progressive universalism. Click here to read the full report.
 

Evaluation of the Partnerships for Older People Project (POPPs) programme
October 2008

The POPPS programme was launched in March 2005 by the Department of Health. The aim of the programme is to deliver and evaluate (through 29 Local Authority led pilots), locally innovative approaches aimed at creating a sustainable shift in resources and culture away from institutional and hospital-based crisis care for older people towards earlier, targeted interventions that emphasise healthy and independent living, including supporting older people in their own homes, active rehabilitation and health promotion such as falls prevention. The evaluation of the pilot sites is ongoing with interim progress reports available from the DH website. Final findings are due to be reported in autumn 2009. To access progress reports click here.

Evaluation of the Individual Budgets Pilot Programme: Final Report
21 October 2008

The Individual Budgets (IB) pilot programme was a cross-government initiative led by the Department of Health with the Department for Work and Pensions, and Communities and Local Government. The pilot was conducted over two years 2006-2007 involving 13 local authorities. The programme tested new ways of giving people who use social care services a greater say in the assessment of their needs; better understanding of how resources are allocated to meet those needs; and greater flexibility in using resources to meet individual needs and priorities. The evaluation found that IBs were generally welcomed by users because they gave them more control over their lives, but there were variations in outcomes between user groups. Read the full report here and the DH's response. More information on the IB pilot programme is available at SPRU, University of York website - click here to access.

Safeguarding Adults

A Consultation on the Review of the ‘No Secrets’ Guidance
16 October 2008-31 January 2009

The Department of Health, the Home Office and the Ministry of Justice launched on 16 October 2008 the national consultation on the review of the No Secrets guidance. Read the consultation document here. Responses should be submitted to the DH by 31 January 2009. Further information on the consultation is available from the DH website.

Action on Elder Abuse, the national charity working to protect, and prevent the abuse of, vulnerable people has issued documents and briefings on No Secrets. Click here to access.

 

Never Too Late for Living Inquiry into services for older people
22 July 2008

The All Party Parliamentary Local Government Group launched on 22 July 2008 the results of its inquiry into services for older people. The inquiry focused on the key role and contribution of local authorities in promoting the quality of life of older people. Eleven key recommendations are made to address what the Group called 'a crisis in services for older people'. Read the recommendations and the full report of the inquiry here.

 

Health and Social Care Act 2008
21 July 2008

 

 

The Health and Social Care Act,which aims to enhance the safety and quality of care and improve public health, received royal assent on 21 July 2008. Specific measures include: establishing the Care Quality Commission, a new health and adult social care regulator with powers to inspect, investigate and intervene where care providers are failing to meet safety and quality requirements; reforming professional regulation; updating existing public health protection legislation; and strengthening the protection of vulnerable people using residential care by ensuring that any independent sector care home providing care on behalf of a local authority is subject to the Human Rights Act. Read more details here.
 

Don't Stop Me Now: Preparing for An Ageing Population

Local government national report 2008
17 July 2008

The Audit Commission issued a review of local government services for older people on 17 July 2008. It aims to help local public services adapt to the needs of an older and more diverse society, and identifies solutions that can be implemented quickly, as well as exploring how councils should plan strategically for the wider challenges ahead. The Commission found that most councils should do more to create an environment in which people thrive as they age. It recommended that all councils should work with older people to age-proof mainstream services and that they should target services to tackle social isolation and support independent living. Read the report here.
 

End of Life Care Strategy - promoting high quality care for all adults at the end of life
16 July 2008

The Department of Health issued guidance on end of life care, 16 July 2008. Its aim is to provide people approaching the end of life with more choice about where they would like to live and die. It encompasses all adults with advanced, progressive illness and care given in all settings. The new ten year strategy will focus on: improved community services that will enable people to die at home if they wish; workforce training and development; development of specialist palliative care outreach services; setting up a national End of Life Research initiative; and quality standards against which PCTs and providers can assess themselves. Read the End of Life Care Strategy here.
Access the National Council for Palliative Care here for more information on end of life care.

 

Framework for a Fairer Future - The Equality Bill

26 June 2008

On 26 June 2008, the Government Equalities Office announced new measures to streamline and strengthen discrimination legislation, including banning age discrimination. The proposals include making age discrimination illegal in the provision of goods, facilities and services and extending the public sector equality duty to include age so that older people's needs are taken into account in public services. A comprehensive paper on the content of the Equality Bill will be published later this summer, which will include the response to the Discrimination Law Review: A Framework for Fairness consultation. The Bill is expected to be introduced in the next Parliamentary session, which starts in December 2008. Read Framework for a Fairer Future - The Equality Bill here.
 

Transforming the Quality of Dementia Care

Consultation on a National Dementia Strategy
19 June -11 September 2008

The Department of Health launched on 19 June 2008 a consultation on a national strategy for dementia services. The consultation document draws on evidence obtained from a wide range of organisations, practitioners and service users. The DH is inviting everyone to give their views on the ideas set out in the document as well as contributing new ideas to the debate. Responses should be submitted to DH by 11 September 2008. Read the consultation document.
 

Independent Review of Older People's Engagement with Government
22 May 2008-9 January 2009

The Department for Work and Pensions announced on 22 May 2008 that John Elbourne had been asked to: 'Examine the current arrangements for the engagement of older people and the ability of those arrangements to inform policy and actions of Government at all levels.' John Elbourne produced his preliminary findings on 9 October 2008 and a final report was given to the government on 18 November 2008.

National Debate on the Future of Care and Support Services
12 May 2008

On 12 May 2008 the government launched a six month debate about the future shape of care and support services in England. During this period it will hold a series of regional events to ask the public and stakeholders for their views about care and support to create a new system. The Department of Health also launched a £31million programme to test the potential of innovative technologies like telecare in supporting care for those with complex health and social care needs. For more details visit the national website www.careandsupport.direct.gov.uk and read the consultation document The case for change - Why England needs a new care and support system.

 

Independent Living

A cross-government strategy about independent living for disabled people
3 March 2008

The Independent Living Strategy was launched on 3 March 2008 by the Office for Disability Issues. The five-year strategy joins current and new policy initiatives to provide a coherent framework for making progress towards independent living for disabled people, including older disabled people. 'Independent living' means not necessarily doing things for oneself, but having choice over support and equipment, and equal access to public services and opportunities. The strategy aims to give disabled people more choice and control over the support they need and greater access to employment, transport, health and housing opportunities. The strategy makes a series of new commitments involving six government departments.
 

Lifetime Homes, Lifetime Neighbourhoods

A national strategy for housing in an ageing society
25 February 2008

The cross-government housing strategy published 25 February 2008 sets out a plan to provide better homes for older people and increase their housing options beyond care homes and sheltered housing. To help older people live independently in their own homes, the government aims to provide a national housing and advice information service linked with local housing information services; introduce new rapid repairs and adaptation services; and increase funding for the Disabled Facilities Grant. All publicly funded homes will have to be built to Lifetime Homes Standards by 2011, with the expectation that all new homes will be built to LTHS by 2013; there will be improved joined-up assessment, service provision and commissioning across housing, health and care; and the government will work towards a new positive vision for specialised housing. Read the strategy here. For more details of the strategy and accompanying documentation click here.

Read CPA Press Release.

 

The State of Social Care in England 2006-07

The Commission for Social Care Inspection's annual report to Parliament
29 January 2008

The third annual report on the state of social care published 29 January 2008 reveals there is a sharp divide between people who do and do not qualify for social care. People who are not receiving support from local authorities are struggling with a poor quality of life. People who do qualify for council support are having a better experience than before. People who only five years ago qualified for council-arranged help are today excluded by the system and left to fend for themselves. The report includes new research which shows that who does or doesn’t get help varies not only between but also within the same council. In practice the criteria can be interpreted in different ways by local staff.
 

Transforming Social Care
January 2008

The Department of Health has issued (January 2008) a circular to local authorities which sets out information to support the transformation of social care as signalled in the Department of Health's social care Green Paper, 'Independence, well-being and choice' (2005) and reinforced in the White Paper, 'Our health, our care, our say: a new direction for community services' in 2006.  It describes the vision for development of a personalised approach to the delivery of adult social care and context in which this policy is grounded.  Read the circular here.
 

Putting People First

A shared vision and
commitment to the
transformation of
Adult Social Care
December 2007

This ministerial concordat, published in December 2007, sets out the shared aims and values which will guide the transformation of adult social care, and recognises that the sector will work across shared agendas with users and carers to transform people’s experience of local support and services. It establishes the collaboration between central and local government, the sector's professional leadership, providers and the regulator to put people first through a reform of public services, enabling people to live their own lives as they wish and promote their own individual needs for independence, wellbeing and dignity. Read the concordat here.

 

Meeting the Aspirations of the British People

2007 Pre-Budget Report and Comprehensive Spending Review, October 2007

The full 2007 Pre-Budget Report can be accessed here. The government identifies demographic and socio-economic change, with rapid increases in old age dependency ratio and rising consumer expectations of public services as one of the long-term challenges it must respond to. The government proposes to fund the delivery of more personalised adult social care that will give people greater choice and control, empowering people to live independent lives and announces plans to consult on the reform of adult care and support systems. For more details of the proposals relating to older people, click here.

 

Tackle Poverty and Promote Greater Independence and Well-being in Later Life
October 2007

Public Service Agreement (PSA) 17 issued by the Department for Work on Pensions in October 2007 seeks to ensure that the specific needs of the older population are given due priority. It sets out the outcomes the government seeks to achieve in the Comprehensive Spending Review period to promote improvements in independence and well-being in later life for the longer term. Read the report here. For more details of the PSA click here.

 

UK Study of Abuse and Neglect of Older People

Prevalence Survey Report
14 June 2007

 

This is the first dedicated study of its kind in the UK, and its aim is to provide nationally representative prevalence estimates on elder abuse and neglect in the UK. Published on 14 June 2007, it was commissioned by Comic Relief and the Department of Health, and the work was carried out by the National Centre for Social Research (NatCen) and King's College London (KCL). Over 2,100 people in England, Scotland, Wales and Northern Ireland took part in the survey between March and September 2006. The survey included people aged 66 and over living in private households (including sheltered accommodation).

See CPA Press Release on financial abuse.

 

Independence, Choice and Risk

A guide to best practice in supported decision making
May 2007

This best practice guide, published in May 2007 by the Department of Health, aims to support the principle of empowerment through managing choice and risk transparently in order to enable fair appraisal of the decision process, should it become necessary. It can be used to promote choice, while managing risk proportionately and realistically. Read the full report here.

 

Caring Choices

Who will pay for long term care?
April-November 2007

‘Caring Choices: Who will pay for long-term care?’ is a nationwide initiative to raise awareness of and help shape future policy on long-term care for older people. The debate will explore three big questions that relate to the future funding of long-term care for older people: Who should pay for personal care? How do we encourage people to contribute to care costs? How do we support the provision of informal care? Opinions from older people and individuals who are involved in the care system are being gathered at a series of events from April to November 2007. For more information visit the The Caring Choices website.

 

A Recipe for Care - Not a Single Ingredient

Clinical case for change: Report by Professor Ian Philp, National Director for Older People
29 January 2007

In this report, published 29 January 2007, Professor Philp identifies how services for older people can be reconfigured bringing them closer to home. He offers a five-point plan to improve older people's care: (1) early intervention and assessment of old age conditions; (2) long-term conditions management in the community, integrated with social care and specialist services; (3) early supported discharge from hospital and whenever possible delivering care closer to home; (4) general acute hospital care whenever needed, combined with quick access to new specialist centres; (5) partnerships built around the needs and wishes of older people and their families. The end result will be reduced need for acute hospital care and increased investment in preventive services and community based health and care services.

 

The State of Social Care in England 2005-06

The Commission for Social Care Inspection's annual report to Parliament
10 January 2007

The State of Social Care report, published on 10 January 2007, describes how far trends in social care have changed over the last year; looks in more depth at commissioning by councils and support provided by carers; and provides an overview of the current state of social care across public, voluntary and private sectors. The report concludes that despite progress and some real success stories, there is a pressing agenda of change to close the gap between government policy aims and the reality of many people's experiences.

 

Common Assessment Framework (CAF)
October 2006

 

On 11 October 2006, the Department of Health Care Services Improvement Partnership (CSIP) launched an 'Assessment and Care Planning Collaborative' to support the development of a Common Assessment Framework for Adults and Guidance on Personal Health and Social Care Plans, commitments given in the White Paper 'Our Health, Our Care, Our Say'. The aim of adopting a common framework is to remove the artificial boundary of 'older age', and provide continuity of a person-centred approach throughout adult life, geared towards self-determination and planning for independence. In developing CAF it is intended to build on experience to date from implementing the Care Programme Approach (CPA), the Single Assessment Process (SAP) for Older People and person centred health and social care planning.

 

Strong and Prosperous Communities - The Local Government White Paper
26 October 2006

 

The White Paper published on 26 October 2006 aims to give local people and local communities more influence and power to improve their lives and deliver better public services through a rebalancing of the relationship between central government, local government and local people. Volume 1 sets out the government's proposals and Volume 2 describes how these proposals will enable local authorities, their partners and local communities to respond to challenges for local services: community safety; health and well-being; vulnerable people; children, young people and families; economic development, housing and planning; climate change; and the role of the third sector. Read the executive summary.

 

Our Health, Our Care, Our Say

Making it happen
18 October 2006

 

An update on progress on implementation of the White Paper, 'Our Health, Our Care, Our Say' was published by the Department of Health on 18 October 2006. The report sets out a roadmap to achieving the White Paper’s objectives, and priorities for action. It details some of the progress being made, such as trialling individual budgets for social care users, developing new approaches to prevention, and shifting care. Also included are tools and products, and key actions that can be undertaken locally to support implementation. A separate document, 'Making it Happen: pilots, early implementers and demonstration sites', provides information on projects currently testing and developing new approaches to the delivery of care services. This document will be periodically updated.

 

Time to Care? An overview of home care services for older people in England, 2006

A Report from the Commission for Social Care Inspection
18 October 2006

 

Time to Care?, published on 18 October 2006, recommends that local authorities should re-think the way they organise home care services for older people. The report sets out how agencies are meeting government standards, while examining the experiences of people who receive care at home. It states that home care is an essential service, which is enabling thousands of older people to remain safely at home, however, there is evidence that the current arrangements for commissioning and providing home care are likely to be unsustainable for a number of reasons. Read the executive summary More details of the report are given here.

 

A New Ambition for Old Age: Next steps in implementing the National Service Framework for Older People

A report from Professor Ian Philp, National Director for Older People, DH
20 April 2006

A New Ambition for Old Age, published on 20 April 2006 by the Department of Health, sets out the priorities for the second phase of the government’s ten-year National Service Framework (NSF) for Older People under three themes: dignity in care, joined-up care and healthy ageing. Plans include enhancing the role mental health nurses can play in improving dignity in care for older people, and relaunching the Older People’s Champion Network to address age discrimination in the NHS. The report acknowledges there are still deep-rooted negative attitudes and behaviours towards older people which impact on their experience of and quality of care.
More details of the next steps for action and links to further information from the DH are given here

 

Securing Good Care for Older People: Taking a long-term view

The Wanless social care review
30 March 2006

 

The final report of the Wanless social care review team, led by Sir Derek Wanless and commissioned by the King's Fund, was published on 30 March 2006. The review team examined social and health care policy, services and spending as well as demographic, social and technological trends in order to consider the potential demands on social care now and in the future. It estimated the contribution of demographic pressures and the need to improve outcomes would increase the costs of older people's social care to £29.5 billion in 2026. Funding proposals include restricting means-testing for personal care and putting in place a free package of basic care, topped up by personal contributions matched by the state. Read the full report here or access a summary of the report here. See CPA Press Release.

 

Living Well in Later Life

A review of progress against the National Service Framework for Older People 27 March 2006

 

The Healthcare Commission, the Audit Commission and the Commission for Social Care Inspection published on 27 March 2006 a joint report assessing progress in improving health, social care and local council services for older people in line with standards set out in the National Service Framework (NSF) for Older People and taking into account subsequent policy developments. The review concludes that in order to achieve sustainable improvement in the experiences of older people using public services further action is required in three key areas: tackling discrimination through ageist attitudes; ensuring all the standards in the NSF are met; and strengthening working in partnership between all the agencies that provide services for older people. More ...

 

Handled with Care? Managing medication for residents of care homes and children's homes - a follow up study
6 February 2006

 

The Commission for Social Care Inspection report published on 6 February 2006 draws the conclusion that care homes are failing on medication standards. The medication older people receive can make a huge difference to their quality of life. Nearly half (5,000 out of 11,500) of all nursing and care homes fail to meet national minimum standards for how they give people medication prescribed by their doctors to treat serious and other illnesses. Often people are given the wrong medication, wrong doses or no medication at all, the report finds. Staff are poorly trained and records are not kept properly. The CSCI notes that homes have already had professional guidance and support with training, but it does not appear to be making a difference.

 

White Paper - Our Health, Our Care, Our Say: A new direction for community services
30 January 2006

 

On 30 January 2006 the Department of Health published the White Paper on future plans for the whole health and social care system It proposes a radical and sustained shift in the way in which services are delivered. Four main goals are outlined: health and social care services will provide better prevention services with earlier intervention; people will have more choice and a louder voice; more will be done to tackle inequalities and improve access to community services; and there will be more support for people with long-term needs. See Press release

 

A Sure Start to Later Life:Ending inequalities for older people
26 January 2006

 

The final report from the Social Exclusion Unit, published on 26 January 2006, details government plans to mitigate the exclusion, poverty and isolation experienced by older people based on the Sure Start model created for children and families. The aim is to locate a single, accessible gateway to wide ranging services in the community, where potential problems are identified quickly and prevented from becoming worse. A pilot programme called 'Link-Age Plus' will test out the Sure Start approach for older people.
More
details of the actions proposed in the report and documents linked to the SEU report which provide further information on social exclusion.
See also Press release

 

A New Pension Settlement for the Twenty-First Century: The second report of the Pensions Commission [The Turner Report]
30 November 2005

 

The Pensions Commission's report published on 30 November 2005 states that the current system of private funded pensions combined with the current state system will deliver increasingly inadequate and unequal results. Long-term pension policy needs to be robust in the face of rising life expectancy. Given these conditions the Commission believes that major reform of the UK pension system is needed to create a new settlement for the 21st century. Details of the reforms proposed in the report and the final Pensions Commission contribution to that debate, Implementing an integrated package of pension reforms, were published on 4 April 2006.

 

Independence,Well-being and Choice: Our vision for the future of social care for adults in England
21 March 2005

 

The long-awaited Green Paper on the radical reform of adult social care was published by the Department of Health on 21 March 2005. Older people using social care and other local authority services will be given individual budgets so that they can buy in the services they need. More information on the content of the Green Paper, responses to the Green Paper consultation, and the public consultation process Your Health, Your Care, Your Say leading to the publication of the White Paper on improving community health and care services due to be published in early 2006.

 

Opportunity Age: Meeting the challenges of ageing in the 21st century

23 March 2005

The first ever cross-government strategy that looks specifically at the issues facing British society as people live longer, healthier lives was presented by the Department for Work and Pensions on 23 March 2005. It addresses extending people's working lives, supporting active ageing in the community and giving people more choice and independence, especially 'shedding the stereotypes' that surround older people. In October 2008 the DWP announced plans to refresh the strategy and on 25 November issued a discussion paper Preparing for our Ageing Society - see above to access the paper. More ...

 

Excluded Older People:Social Exclusion Unit interim report

15 March 2005

The continued importance of addressing pensioner poverty is one of the issues highlighted in the interim report on social exclusion, which was produced after consultation with older people, service providers, and academics by the Office of the Deputy Prime Minister on 15 March 2005. More ...

 

National Service Framework for Long Term Conditions

March 2005

This NSF sets 11 quality requirements to transform the way health and social care services support people with long-term neurological conditions to live as independently as possible. Although the NSF focuses on people with long-term neurological conditions, much of the guidance it offers can apply to anyone living with a long-term condition. More ...

 

Equality and Diversity: coming of age

Final consultation ended 15 October 2005

The final consultation on the draft Employment Equality (Age) Regulations 2006, was issued by the DTI in July 2005. In October 2006 the government introduced legislation outlawing age discrimination in employment and vocational training. The Age Regulations came into force on 1 October 2006. More ...

 

SPAIN (the Social Policy on Ageing Information Network) published a report What Price Care in Old Age? (July 2005) to examine what has changed three years on from its paper 'Underfunding of social care'. It argues that although the government has taken steps to address the failing system of social care for older people, rising costs have meant there is little sign of a reversal in the trend towards targeting care at ever fewer people with very high care needs. And little progress has been made in closing the gap between funding for older care recipients as compared to others.

The Wanless Review Team at the King's Fund produced Social Care Needs and Outcomes: A Background Paper for the Wanless Social Care Review. A preliminary paper to the final report, published in spring 2006, it offers an insight into the principles on which the Wanless Social Care Review is based. It scans relevant evidence around the demographic, economic and social factors which will affect social care for older people over the next twenty years; and the finances and resources which will be required to ensure comprehensive, high-quality care.

The Local Government Association's and the Association of Directors of Social Services' vision for the delivery of better social care services for older people are outlined in two important documents 'Our future in our hands: putting people at the centre of social care' and 'All our tomorrows: inverting the triangle of care'. Both these documents argue for a whole systems approach to care and a shift from acute services to a focus on prevention.

Carers UK has a range of policy briefings, practice guides and policy resources relating to key issues such as benefits and breaks for carers; and a digest of facts and figures about carers drawn from various surveys and research looking at who carers are across the UK, employment, health, age, tasks, finances and poverty, and rights. The care provided by family, friends and relatives is worth an estimated £57 billion per year - the equivalent of UK spending on the NHS.

 

Links to facts and figures about the UK ageing population:

 


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