Funding and the Green Paper - Advantage Accreditation

Social Care Trends for 2019: Funding and the Green Paper

2019 is likely to see social care funding remain a top issue for British politics. The sector and the public are both awaiting a much delayed green paper on the issue. It’s likely, however, to disappoint more than it will solve.

The government has been talking of reform to social care in England – including its funding – for a number of years. The 2017 general election saw proposals emerge from all sides of the political spectrum. Arguably, the incumbent’s proposals, which would have seen those in homes valued at more than £100,000 liable for their full care costs, cost them a working majority. These plans, dubbed the ‘dementia tax’ by detractors, were quickly reworked, and then completely shelved.

New plans were touted to appear in the summer of 2018 but they have yet to be published. The indications from members of the team drafting the long-awaited green paper have already said that it is unlikely that free personal care would be on the agenda due to the expense. Indeed, most public pronouncements on the paper have focused on managing down expectations, with one already warning that it is likely to “disappoint” those who want more radical change.

One advantage that the government does have, though, should it choose to use it, is that the growing divergence between the different nations of the UK in health and social care. The current devolution settlement means that Wales, Scotland and Northern Ireland have independent health and social care policies. This means there is plenty of scope for experimentation and the devolved nations could be a ready source of knowledge in what works and what doesn’t. Scotland, for instance, is often held up as a model for deeper integration between health services and social care.

Based on the growing pain in the sector, however, and how these proposals tend to take shape, we can predict that the green paper may include the following:

  • A commitment to a step-by-step increase in social care funding, although likely to fall well short of the £20 billion promised to the NHS.
  • Those who can afford it being liable for certain aspects of their social care, similar to how people pay for prescriptions and eyeware on the NHS.
  • More integration between social care and the NHS, possibly using ideas from Scotland such as ‘integration authorities’, joint planning and monitoring committees.
  • A focus on preventative measures to keep people out of social care and hospitals, including reablement and home adaptation.
  • Whatever the result, it is likely to generate controversy from all corners. Social care funding and reform has been a political hot potato for a number of years, but with care providers failing and budgets falling, the government’s hand is being forced.

Whatever the result, it is likely to generate controversy from all corners. Social care funding and reform has been a political hot potato for a number of years, but with care providers failing and budgets falling, the government’s hand is being forced.

The NHS Long-Term Plan: What it means for training

NHS Long Term Plan - Advantage AccreditationThe Government published its long-term plan for the NHS this week. We’ve looked at what it means for mandatory, clinical and specialist training for the next decade:


Focus on mental health

There has been a huge emphasis on mental health in the media and in politics in recent times, and this has carried over into the NHS. Mental health training features on a number of occasions. There is a recognition in the plan that certain groups of young people are particularly vulnerable to mental health issues, and it says that teams will receive “information and training to help
them support young people more likely to face mental health issues – such as Lesbian, Gay, Bisexual, Transgender (LGBT+) individuals or children in care”. The plan recognises that “preventative support” is important to help address problems before they have serious repercussions.

The plan also says that ambulance staff will receive training to help deal with people with mental health issues who are “in a crisis”. Some trusts are already doing this, but growing awareness of the scale of mental health problems in the UK and the impact it has on 999 calls means that all ambulance staff will soon be able to help with issues.

Training to improve end of life care

One of the aims of the plan is to “personalise” and “improve” end of life care. This, it says, will mainly be accomplished by training to help staff identify patients’ needs as they head into the final stages of their life. The plan hopes that this will reduce emergency admissions, but the majority of people will see this as a necessary part of a caring modern society.

There is little new about a wish to improve end of life training. Former guidance has included breaking down training into “bite-sized” sessions to build knowledge quickly, as well as role modelling good practice at every opportunity. It will be interesting to see how this new commitment bears out in practice, and whether it will mean mandatory, classroom-based courses for practitioners.

Learning disabilities and autism awareness

The plan states an intent to roll out training in awareness of learning disabilities and/or autism to NHS teams. The plan alludes to a consultation published in 2018, which says that the aim of the training is ultimately to help staff “support people with a learning disability, their families and carers; to ensure that perceptions of learning disability do not prevent a robust assessment of physical health, and that staff can make personalised, reasonable adjustments to care”. The skills and competencies required for this awareness have already been outlined in the Learning Disabilities Core Skills Education and Training Framework.

If this roll-out follow the recommendations included in the consultation, it means that a further consultation on proposals will begin in March this year, as well as an audit on skills in the NHS workforce. The CQC will monitor the uptake of the training from its full introduction.

Dealing with violence

The long-term plan mentions that a programme has already been launched to train staff in how to handle violence. This may include positive behaviour support, de-escalation training, and breakaway techniques. Its inclusion in the plan emphasises that this is a growing problem and such training is here to stay.

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