LGA responds to latest delayed discharges figures

“No one’s elderly parent, grandparents or friends should be left unnecessarily in a hospital bed, when they could be treated in the comfort and dignity of their own home.”

Responding to delayed discharges figures for February 2017 published today by NHS England, Vice Chair of the Local Government Association’s Community Wellbeing Board, Cllr Linda Thomas, said:

“No one’s elderly parent, grandparents or friends should be left unnecessarily in a hospital bed, when they could be treated in the comfort and dignity of their own home.

“Councils are absolutely committed to reducing the level of delayed transfers of care from the NHS and are working with providers and hospitals to help reduce pressures on health services.

“Across the country nearly six out of 10 people delayed in hospital are unable to leave because they require further NHS services, with around a third awaiting support from council social care.

“The scale of underfunding councils have faced in recent years is placing the care provider market under huge pressure, making it more difficult to discharge people from hospital back to their homes and communities.

“But while reducing delayed transfers of care is a significant challenge for both councils and the NHS, this is by no means the only issue facing health and social care, and it’s important it does not become the basis for which overall performance is judged.

“The LGA has worked hard to highlight the significant pressures facing adult social care and secure desperately-needed new government funding for the system. It also works to support member councils tackle these challenges, for example working with local care providers to ensure there are out of hospital beds to meet needs, and using telecare to better support people to recover in their own homes.

“The new funding for social care and the £2 billion announced over the next three years in the Budget is a significant step towards helping councils plug some of the social care funding gaps they face in the coming years.

“However, short-term pressures remain and they further emphasise the need to reform and fully fund the current social care system and find a long-term solution to the social care funding crisis.

“The Government’s Green Paper provides the opportunity to begin a much-needed meaningful national conversation about how, as a society, we should best support people of all ages with care and support needs in our communities.”

source

Who pays for social care?

Most people agree the UK needs to do better at providing social care. Some think it is just a case of increasing the money to pay for it by more than it has been increased in recent years. Others say there needs to be reform of the way public sector care is organised and provided. Underlying the debate are two major issues which need discussion.

The first is how much should the state pay and how much should the individual pay? The tripartisan approach for many years has been to say healthcare should be free, but living costs are down to the individual. If the individual has little capital or private pension income, then the state will pay the living costs as well.

Some say the state should take care of more of the living costs of more people. This would require substantial tax rises to meet the bills. It would mean that instead of selling the old person’s home when they move into residential care to pay the living cost bills, the money from the estate would be preserved and pass to the children. People ask why is it fair that someone who has saved and been careful all their active lives has to pay their own living costs, whereas someone who has lived beyond their means will be paid for?

Others say the current system is fine in this respect. If someone is well off, why shouldn’t they use their own assets and income to pay for their living costs? If someone cannot afford a reasonable standard of accommodation and food, don’t we have a duty to be good neighbours and to help pay? This is a cheaper solution for taxpayers.

The second issue is internal to government. At the moment central government pays for and runs the NHS, whilst local government pays for and runs much of the social service provision. It is true local government relies heavily on national government grants paid for out of national taxes, but local taxes have a part to play in financing social care.

Many people like the idea of devolution of power over policy and spending to Councils from Whitehall, yet when problems emerge in a local service the cry often goes up for government intervention. Quite often it is easier to blame the government for alleged underfunding, than to blame individual Councils for poor or unduly expensive provision.

The public is generally not much exercised over who runs the service. They want a good outcome. The main problem with Councils running care and the NHS running health treatments comes at the borders. An elderly person who has been treated in a hospital often needs improved care services in order to be able to return home.

Some Councils are reluctant to commit in a timely and sufficient way to the need to provide social care. The elderly person then remains in a very expensive hospital bed. This costs the state more overall. Someone no longer needing treatment occupies a bed needed for someone who does require treatment. It is often against the wishes and interests of the patient, who wants to get home.

Any thoughts on what reforms are needed?

Depression

Depression is a low mood that lasts for a long time, and affects your everyday life.

In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, depression can be life-threatening because it can make you feel suicidal or simply give up the will to live.

It feels like I’m stuck under a huge grey-black cloud. It’s dark and isolating, smothering me at every opportunity.

When does low mood become depression?

We all have times when our mood is low, and we’re feeling sad or miserable about life. Usually these feelings pass in due course.

But if the feelings are interfering with your life and don’t go away after a couple of weeks, or if they come back over and over again for a few days at a time, it could be a sign that you’re experiencing depression.

It starts as sadness then I feel myself shutting down, becoming less capable of coping. Eventually, I just feel numb and empty.

Are there different types of depression?

If you are given a diagnosis of depression, you might be told that you have mild, moderate or severe depression. This describes what sort of impact your symptoms are having on you currently, and what sort of treatment you’re likely to be offered. You might move between different mild, moderate and severe depression during one episode of depression or across different episodes.

There are also some specific types of depression:

  • Seasonal affective disorder (SAD) – depression that usually (but not always) occurs in the winter. SAD Association provides information and advice. See our page onSAD for more information.
  • Dysthymia – continuous mild depression that lasts for two years or more. Also called persistent depressive disorder or chronic depression.
  • Prenatal depression – sometimes also called antenatal depression, it occurs during pregnancy.
  • Postnatal depression (PND) – occurs in the weeks and months after becoming a parent. Postnatal depression is usually diagnosed in women but it can affect men, too.

See our page on postnatal depression for more information. PANDAS also has information and support for anyone experiencing pre- or postnatal depression.

Is premenstrual dysphoric disorder (PDD) a type of depression?

PDD is a severe form of premenstrual syndrome (PMS). Many women experience PMS, but for some women their symptoms are severe enough to seriously impact their daily life. This is when you might receive a diagnosis of PDD.

While PDD is not a type of depression, most women who experience PDD find that depression is a major symptom. See NHS Choices for more information about PMS and PDD.

Sometimes it feels like a black hole but sometimes it feels like I need to cry and scream and kick and shout. Sometimes I go quiet and lock myself in my room and sometimes I have to be doing something at all times of the day to distract myself.

What’s it like to have depression?

Watch Hannah, Helen, Rishi, Nathan and Georgina talking about what it feels like to have depression, how they’ve learnt to cope and how their friends and family help them.


USEFUL CONTACTS

Big White Wall

bigwhitewall.com
Online community for adults experiencing emotional or psychological distress. It is free to use in many areas if you live in the UK, if you’re a student or if you have a referral from your GP.

Cruse Bereavement Care

0844 477 9400
cruse.org.uk
Charity providing information and support after someone you know has died.

Depression UK

depressionuk.org
A self-help organisation made up of individuals and local groups.

Do-it

do-it.org
UK volunteering opportunities, including environment and conservation options.

Elefriends

elefriends.org.uk
Elefriends is a friendly, supportive online community for people experiencing a mental health problem.

The National Association for People Abused in Childhood (NAPAC)

0808 801 0331 (freephone from landline and mobiles)
napac.org.uk
A charity supporting adult survivors of any form of childhood abuse. Provides a support line and local support services.

National Institute for Health and Clinical Excellence (NICE)

nice.org.uk
Guidelines on treatments for depression.

NCT

0300 330 0700
nct.org.uk
National charity for parents, providing information and support for all parents.

NHS Choices

nhs.uk
Provides information on treatments for depression available through the NHS.

Samaritans

Chris, PO Box 9090, Sterling FK8 2SA
helpline: 116 123
jo@samaritans.org
samaritans.org
A 24-hour telephone helpline for people struggling to cope.

Volunteering England

volunteering.org.uk
Information about volunteering opportunities in England.

Volunteering Wales

volunteering-wales.net
Information about volunteering opportunities in Wales.

This information was published in June 2016. We will revise it in 2019.

New economic policy – A better NHS

John Redwood’s Diary

Posted: 29 Jul 2016 10:01 PM

An important feature of the Brexit campaign was to take back control of our money. Many want to see cash from our cancelled EU contributions spent on NHS matters. I set out a Brexit budget for the referendum as an illustration of what can be achieved.

That budget included money to train, recruit and retain 4000 extra doctors and 60,000 extra nurses. It included cancelling student loans for nurses, and returning to grants. It offered extra money for a wider range of new drugs on the NHS.

The NHS can also be improved by reducing the rate of gr0wth of demand. This can be brought about by moving to a system of controlled migration, cutting the extra numbers needing NHS cover. It can be assisted by a better designed way of invoicing anyone coming to the UK from a foreign country for non urgent health treatment, who currently often receive it free.

The NHS needs to be encouraged to be better at determining who needs hospital treatment. At present too many people go straight to hospital instead of going  through the process of GP evaluation. In hospital many elderly people are detained when there is little or nothing  that the doctors and  nurses can do. Sometimes they have to stay in because there is insufficient social care arranged to allow them back home or into the community. There needs to  be more care outside hospital and better access to it.