BGS Policy Update: Summer 2018
Recent policy developments
Announcement of NHS Funding Plan, and delay of Green Paper on Social Care
On 18 June the Prime Minister announced a Five Year NHS Funding Plan which will deliver an average increase of 3.4 per cent per year overall. Since then there has been a wealth of commentaries from senior opinion-formers and commentators, all saying that the increased funding will not be enough to keep pace with demand on services. At the same time it was announced that the publication of the Green Paper on the reform of social care has been delayed until the Autumn, to tie in with the development of Government’s Ten Year Plan for the NHS.
New Minister for Health and Social Care
The reshuffle arising from the resignation of Boris Johnson as Foreign Secretary means that we have a new Minister, Matt Hancock MP. The key question for BGS is, what difference will this make to our members, and to the quality of health and social care for older people? In his first major speech, Mr Hancock stated that increased funding for health and a Green Paper for social care are only the first steps for a long term plan, which must be “nationally agreed, clinically led and locally supported”. The full text of the speech is available here: https://www.gov.uk/government/speeches/matt-hancock-my-priorities-for-the-health-and-social-care-system
Dementia 2020
A review of progress against the Prime Minister’s Challenge on Dementia 2020 is being carried out by the Department of Health and Social Care. BGS submitted written evidence in which we made clear that we believe the 2020 objectives are only achievable if some of the other obstacles to achieving them are addressed urgently. We highlighted the need for: adequate staffing levels; earlier action and investment to address the cardiovascular risks of dementia, for example through expansion of management programmes for diabetes, hypertension, and smoking cessation; and increased education and training for all staff who work with people with dementia on a regular basis as well as increased training in frailty as a specific medical condition. The full submission can be viewed here: http://www.bgs.org.uk/cga-managing/resources/policy-digest/bgs-response-to-the-review-of-the-prime-minister-s-challenge-on-dementia-2020-by-department-of-health-and-social-care
The Mental Capacity Amendment Bill
This Bill was introduced into the House of Lords on 3 July. Its purpose is to reform the current system known as Deprivation of Liberty Safeguards (DOLS). BGS responded to the Law Commission’s consultation on the reform of the current system in 2015, and to the Inquiry on reform of DOLS by the House of Commons Select Committee on Human Rights earlier this year. Government accepted the majority of the recommendations made by the Law Commission, and the introduction of draft legislation is a positive step towards change that will make the system less bureaucratic and more streamlined if the Bill is passed.
Government funding and strategy for tackling loneliness and social isolation
Also on 18 June, Government announced an investment of £20 million to help tackle loneliness and isolation. In response, BGS published a media statement in which we welcomed the investment, while at the same time making clear that tackling loneliness is only one way of helping to improve quality of life for older people, and that ensuring older people can access the right care at the right time is an important means of tackling loneliness. The timing was helpful as it enabled us to promote the work on the health impacts of loneliness among older people which had been the focus of a BGS conference held on 13 June, chaired by our President-Elect, Professor Tash Masud.
Government is currently developing a cross-cutting strategy for tackling loneliness and social isolation which is due to be published later this summer. We submitted a response to Government’s short consultation on the development of its strategy for tackling loneliness and isolation. In our submission we made clear the importance of addressing the causes of loneliness, and highlighted evidence of what works in practice in terms of health interventions: for example, access to timely and appropriate treatment for health conditions that can sometimes be quite easily addressed but limit independence, and increase the risks of loneliness and social isolation. We promoted the benefits of CGA and a regular medical review by GPs. We also highlighted our own conference on the mental and physical health impacts of loneliness on older people and the evidence and expertise that exists.
Parliamentary engagement
As part of the Inquiry by the All-Party Parliamentary Group on Hospice and Palliative Care into widening access, the APPG is holding a series of evidence sessions. BGS submitted written evidence to the Inquiry in May, and in June, BGS member Dr Anna Steel attended the first oral evidence session. We will be keeping a watching brief on this, and supporting the development, over time, of stronger links between BGS members, and palliative care specialists.
On 11 July I attended the parliamentary launch of a research report by Arthritis Research which highlighted the challenges many people experience in trying to access aids and adaptations which local authorities have a statutory duty to provide. It was encouraging to see that the Minister for Social Care, Caroline Dineage MP, attended and spent a significant amount of time engaging with attendees, and to find that she remembered her meeting with Dr Eileen Burns earlier this year.
On 6 June I attended the parliamentary launch of a report by the NHS Confederation, Securing the future: funding health and social care to the 2030s. This was well attended by parliamentarians, and there was a real sense of consensus among those present about the need for greater investment to support the future development, backed up by strong economic analysis in the report which is available here: https://www.nhsconfed.org/resources/2018/05/securing-the-future
Further Reading
While the publication of the Green Paper on Social Care has been postponed until the autumn, the range of evidence showing the need for reform continues to expand. This includes a report by the Housing, Communities and Local Government and Health and Social Care Select Committees, calling for sustainable funding for adult social care. The report includes input from engagement with the public via a ‘Citizens’ Assembly’ which, when they were brought up to speed with the current system, concluded that it is “complex, dysfunctional and underfunded”. A summary report is available here:
https://www.parliament.uk/business/committees/committees-a-z/commons-select/communities-and-local-government-committee/inquiries/parliament-2017/long-term-funding-of-adult-social-care-17-19/
On 4 July the National Audit Office published a report on the health and social care interface which assesses the challenges preventing health and social care working together more effectively. The Head of the NAO, Amyas Morse, is calling for further and faster progress towards integration: https://www.nao.org.uk/report/the-health-and-social-care-interface
The public’s views of the NHS. The King’s Fund in partnership with Ipsos MORI has published the results of engagement with the public on their views on the NHS. They show that most people see the NHS as a key part of society that they are proud of, and they support the founding principles of the NHS as a comprehensive service, free at the point of delivery and primarily funded through taxation. They recognise the current challenges faced and would be willing to pay more tax if it was a dedicated NHS tax. An overview of the findings is available here: https://www.kingsfund.org.uk/sites/default/files/2018-06/The_public_and_the_NHS_summary_0.pdf
Your involvement
If you would like to get more involved in BGS’s policy work or have any questions about this update please don’t hesitate to get in touch as there are a range of ways in which you can engage in the delivery of our policy and influencing strategy.
Caroline Cooke
BGS Policy Manager