‘Medical opinions ignored’ by NHS payment assessor, workers say

Medical opinions have been ignored in the assessment of NHS payments to patients receiving care, it is claimed.

Three health workers said an assessor organisation discounted medical views so some patients were denied NHS care.

Norman Lamb MP said England-wide data obtained by the BBC showed a “regional disparity” and was “an injustice”.

However the assessor organisation, Arden and Greater East Midlands CSU, says it follows national guidelines to decide on payments.

Under national criteria, the NHS pays for long-term support and care if a patient’s condition is severe enough.

However, BBC Inside Out East has found a wide difference among clinical commissioning groups (CCGs) in England in the percentage of patients rejected following assessment for continuing health care (CHC).

Between July 2016 and July 2017, Birmingham South and Central CCG rejected 75% of its new CHC assessments, Manchester CCG turned down only 17% of assessments, while Tameside and Glossop CCG only rejected 5% of those assessed.

All assessors – of which there about half a dozen covering England – should use the same criteria.

Three health workers told the BBC that one of the main assessor organisations, Arden and Greater East Midlands CSU (Commissioning Support Unit), sometimes ignored medical opinions in assessments so patients could not obtain NHS care.

One worker told the BBC: “There has been bullying at the meetings – attempts to ridicule people who are there who have a professional opinion.

“They ignored what professionals have said and changed what professionals have said. The concern is that this puts patients at risk.”

read more here: http://www.bbc.co.uk/news/uk-england-41187615

Huge number of parents with disabled children are suffering mental health problems

Parents of disabled children in Yorkshire and the Humber believe health and social care services are at breaking point, with confidence at an all-time low.

That is the shocking conclusion of a survey commissioned by the Disabled Children’s Partnership (DCP), a coalition of more than 50 charities, which also found that nearly three-quarters of parents of disabled children have experienced mental health issues as a result of continued strain, far higher than the 1 in 6 who report an issue in the general population.

At the root of the issue is the overwhelming lack of health and social care support families receive, with two-thirds worrying daily about being able to meet their disabled child’s needs and 4 in 5 parents having issues accessing vital care services.

read more here: http://www.examiner.co.uk/news/huge-number-parents-disabled-children-13370026

Dozens of leading charities face insolvency after Government demands back pay for night-time carers

Vulnerable people could lose ‘vital care’ after HMRC demands £400m bill, warn charity chiefs

Dozens of leading charities could face insolvency within weeks after the Government ruled they must pay millions of pounds in back payments to overnight carers. Around 200 disability charities, including Mencap, are said to face a bill of around £400m in back payments after new guidance was issued stating overnight carers must be paid the national minimum wage (NMW) for all hours.

Vulnerable people with learning difficulties face losing “vital” care as a result of the bills, charities have warned, with around 5,500 supported by Mencap alone set to be “majorly impacted”, while some may end up losing that support all together.

Under guidance issued by the Government in 1999, when the minimum wage was introduced, disability charities, which sent a carer overnight to look after someone with learning difficulties, were required to pay a flat rate “on call” allowance of £25 or £35 to cover the period when they were asleep.

But, following two tribunal cases in 2015 and last year, the Department for Business, Energy and Industrial Strategy (BEIS) changed the guidance in October to state that these organisations must now pay the minimum wage throughout the shift, meaning overnight carers would earn £60 for eight hours of sleep.

Mencap and other charities and companies are now warning that they cannot afford the huge and unexpected additional sums being demanded by HM Revenue & Customs (HMRC), even though they believe their staff should get the higher pay levels demanded by the business department.

Derek Lewis, chairman of the Royal Mencap Society, said “sleep-ins”, which are widely used in the sector, rarely see the carer disturbed during the night, citing research showing that 99.7 per cent of them slept peacefully.

“Sleep-ins are widely used in the learning disability sector to provide care for some of our most vulnerable adults, in their own homes in the communities they live in,” he said.

“The carer is only there ‘just in case’ to provide safety and reassurance and is rarely disturbed. Recent research which looked at the last three years showed that 99.7 per cent of carers slept peacefully.

“The unintended consequences have been disastrous as HMRC have begun enforcement action demanding six years’ back pay. Estimates of the costs to the Learning Disability sector are in the region of £400m and Royal Mencap Society will be severely affected.”

McDonnell calls for disabled-led solution to care crisis, as DPAC occupies parliament

Labour’s shadow chancellor has called for disabled people themselves to be given the job of designing the solution to the social care funding crisis.

John McDonnell was speaking to Disability News Service (DNS) as activists from Disabled People Against Cuts (DPAC) were protesting about cuts to social care, in parliament’s central lobby yesterday (Wednesday).

read more here: http://www.independent.co.uk/news/uk/home-news/charities-insolvency-threat-warning-night-carers-back-pay-mencap-hmrc-a7848911.html

Disabled people are to be ‘warehoused’. We should be livid

New rules could see 13,000 people with disabilities and long-term health needs forced into care homes. This is treating people as objects to be stored

The inescapable logic of austerity is looking likely, once again, to reduce people with disabilities to objects – and in doing so to reduce their independence, options and enjoyment of life. According to the Health Service Journal, Freedom of Information (FOI) requests from campaign group Disability United found that 37 NHS clinical commissioning groups (CCGs) in England were introducing rules about ongoing care that could force up to 13,000 people with health conditions into care homes. The CCGs will essentially begin saying to people with disabilities and long-term health needs: if you haven’t got the cash for homecare, then it’s off to a care home for you.

As a country we have been brutalised into accepting that each year the porridge pot gets smaller and our belts tighter

Imagine you have been living in your home for years. It might be where your kids were born. Being at home, having your stuff around you, having the greatest possible measure of independence, obviously means a lot to everyone, whether you’re well, ill or disabled. Then one day someone comes and tells you, “Nope, you’re too expensive here. We’re moving you to a care home unless you cough up the money to pay for what you need.”

read more: https://www.theguardian.com/commentisfree/2017/jan/25/disabled-people-disabilities-health-care-homes

Since Theresa May thinks giving people a ‘year off work’ to become carers is a good idea, I’d like to offer a reality check

The Tories’ introduction of employment tribunal fees means that if, at the end of your year, your employer decides to replace you with somebody else, there’s nothing you can do unless you’re prepared to spend around £1,200 and a great deal of time in a legal contest with your former employer. Enjoy the urine, faeces, blood and heightened risk of mental health problems

read more here: http://www.independent.co.uk/voices/theresa-may-workers-rights-employment-tribunal-carer-caring-year-off-work-reality-check-a7736926.html

Disabled people are to be ‘warehoused’. We should be livid

New rules could see 13,000 people with disabilities and long-term health needs forced into care homes. This is treating people as objects to be stored

The inescapable logic of austerity is looking likely, once again, to reduce people with disabilities to objects – and in doing so to reduce their independence, options and enjoyment of life. According to the Health Service Journal, Freedom of Information (FOI) requests from campaign group Disability United found that 37 NHS clinical commissioning groups (CCGs) in England were introducing rules about ongoing care that could force up to 13,000 people with health conditions into care homes. The CCGs will essentially begin saying to people with disabilities and long-term health needs: if you haven’t got the cash for homecare, then it’s off to a care home for you.

As a country we have been brutalised into accepting that each year the porridge pot gets smaller and our belts tighter

Imagine you have been living in your home for years. It might be where your kids were born. Being at home, having your stuff around you, having the greatest possible measure of independence, obviously means a lot to everyone, whether you’re well, ill or disabled. Then one day someone comes and tells you, “Nope, you’re too expensive here. We’re moving you to a care home unless you cough up the money to pay for what you need.”

This sounds innocuous to many people. Disabled people and care homes go together in the public mind as easily as “peak-time train service” and “cancellation”. The FOI requests found CCGs were setting limits on how much they were prepared to pay for supporting people in their homes compared to an “alternative option”, which is usually a care home. They were willing to pay between 10% and 40% above the care home option, which will often not be enough to keep someone in their own home.

Anita Bellows, a member of campaigning group Disabled People Against the Cuts is emphatic about what this means: “Institutionalisation is the logical conclusion of cutting the funds for maintaining people at home.”

read more here: https://www.theguardian.com/commentisfree/2017/jan/25/disabled-people-disabilities-health-care-homes

Social care system ‘beginning to collapse’ as 900 carers quit every day

More than 900 adult social care workers a day quit their job in England last year, new figures reveal. Care providers warn that growing staff shortages mean vulnerable people are receiving poorer levels of care.

In a letter to the prime minister, the chair of the UK Homecare Association says the adult social care system has begun to collapse. The government says an extra £2bn is being invested in social care. An ageing population means demand is increasing for adult social care services.

“You just can’t provide a consistent level of care if you have to keep recruiting new people”, said Sue Gregory, who has been a care home nurse in North Yorkshire for 13 years.

“Its very simple, not many people want to do this kind of work, and this is a profession that relies on you getting to know the people you are looking after.”

Data gathered by the charity Skills for Care, shows that in 2015-16 there were more than 1.3 million people employed in the adult social care sector in England.

Analysing the data, BBC News has found that:

• An estimated 338,520 adult social care workers left their roles in 2015-16. That is equivalent to 928 people leaving their job every day.
• 60% of those leaving a job left working in the adult social care sector altogether
• The average full-time frontline care worker earned £7.69 an hour, or £14,800 a year.
• One in every four social care workers was employed on a zero hours contract.
• There was an estimated shortage of 84,320 care workers, meaning around one in every 20 care roles remained vacant.

Those who provide care to people directly in their own homes, or in nursing homes, say a growing shortage of staff means people face receiving deteriorating levels of care.

 

read more here: http://www.bbc.co.uk/news/uk-england-39507859

Conservative Government’s Health Cuts See Dramatic Rise in Deaths

As angry demonstrators take to the streets to highlight the effects of cuts to vital services across the county research has highlighted how the Conservative government’s health policy is now lead to a significant increase in in mortality rates. (17th Feb 2017)

An unprecedented rise in mortality in England and Wales, where 30,000 excess deaths occurred in 2015, is likely to be linked to cuts to the NHS and social care, according to research which has drawn an angry response from the government.

The highly charged claim is made by researchers from the London School of Hygiene & Tropical Medicine, Oxford University and Blackburn with Darwen council, who say the increase in mortality took place against a backdrop of “severe cuts” to the NHS and social care, compromising their performance.

(The report can be accessed here: Why has mortality in England and Wales been increasing? An iterative demographic analysis.)

The Department of Health (DH) responded by accusing the authors of the paper and accompanying commentary, published in the Journal of the Royal Society of Medicine on Thursday, of “bias”.

 

Read more here: http://www.dorseteye.com/north/articles/conservative-government-s-health-cuts-see-dramatic-rise-in-deaths

New analysis links 30,000 excess deaths in 2015 to cuts in health and social care

From the Royal Society of Medicine

Researchers exploring why there has been a substantial increase in mortality in England and Wales in 2015 conclude that failures in the health and social care system linked to disinvestment are likely to be the main cause.

There were 30,000 excess deaths in 2015, representing the largest increase in deaths in the post-war period. The excess deaths, which included a large spike in January that year, were largely in the older population who are most dependent on health and social care.

Reporting their analysis in the Journal of the Royal Society of Medicine, the researchers from the London School of Hygiene & Tropical Medicine, University of Oxford and Blackburn with Darwen Borough Council, tested four possible explanations for the January 2015 spike in mortality.

After ruling out data errors, cold weather and flu as main causes for the spike, the researchers found that NHS performance data revealed clear evidence of health system failures. Almost all targets were missed including ambulance call-out times and A&E waiting times, despite unexceptional A&E attendances compared to the same month in previous years. Staff absence rates rose and more posts remained empty as staff had not been appointed.

Professor Martin McKee, from the London School of Hygiene & Tropical Medicine, said: “The impact of cuts resulting from the imposition of austerity on the NHS has been profound. Expenditure has failed to keep pace with demand and the situation has been exacerbated by dramatic reductions in the welfare budget of £16.7 billion and in social care spending.”

He added: “With an aging population, the NHS is ever more dependent on a well-functioning social care system. Yet social care has also faced severe cuts, with a 17% decrease in spending for older people since 2009, while the number of people aged 85 years and over has increased by 9%.”

“To maintain current levels of social care would require an extra £1.1 billion, which the government has refused.”

Professor McKee continued: “The possibility that the cuts to health and social care are implicated in almost 30,000 excess deaths is one that needs further exploration. Given the relentless nature of the cuts, and potential link to rising mortality, we ask why is the search for a cause not being pursued with more urgency?”

“Simply reorganising and consolidating existing urgent care systems or raising the ‘agility’ of the current A&E workforce capacity is unlikely to be sufficient to meet the challenges that high levels of admissions of frail elderly people and others who are vulnerable are likely to present this winter and in future winters.”

The researchers say that there are already worrying signs of an increase in mortality in 2016. Without urgent intervention, they say, there must be concern that this trend will continue.

Commenting on the analysis, Professor Danny Dorling, University of Oxford, added: “It may sound obvious that more elderly people will have died earlier as a result of government cut backs, but to date the number of deaths has not been estimated and the government have not admitted responsibility.”

read more here: https://www.rsm.ac.uk/about-us/media-information/2017-media-releases/new-analysis-links-30000-excess-deaths-in-2015-to-cuts-in-health-and-social-care.aspx