Policy Update March 08
England
National government
National carers strategy review
The Trust and our partners at Crossroads Caring for Carers are continuing to liaise with Ministers and officials on the need to increase the focus on specialist carers support services and joint commissioning between health and social care. We feel that the support for local implementation of the strategy will be crucial, particularly given the tight financial situation public services find themselves in as the strategy is finalised. The launch date has not been confirmed but is still expected to be “late spring”, which may mean Carers Week in June.
Vital Signs and National Stroke Strategy
Vital Signs (the national NHS targets and indicators for 2008) outlines how NHS Trusts will be inspected from 2008 onwards. It contains the most substantial NHS inspection levers related to carers to date.
The government has a new National Stroke Strategy for the NHS in England. Delivering the strategy is a key national indicator for all NHS trusts, and support for carers runs throughout the strategy document, so it will important for carers’ services to demonstrate to health commissioners how their work can help to deliver the strategy. Much of the family/ carer support that is suggested by the strategy is needed at the interfaces between health and social care (hospital discharge etc), suggesting that joint health and social care commissioning will be required.The Trust has produced guidance on the current NHS policy / commissioning levers relevant to carers, including using Vital Signs and the Stroke Strategy available on request.
Review of Fair Access to Care Services (FACS) eligibility criteria for community care
CSCI has been charged by the government with leading on the review of FACS eligibility criteria, following CSCI’s damning verdict in this year’s State of Social Care report (see Trust briefing paper on Trustnet ). We sit on the CSCI Carers Improvement Board and we are meeting the DH lead on this review with Crossroads. Please let me know your thoughts on FACS, and what should replace it. In particular, we would value any examples of where FACS has had a negative (or positive!) impact on carers and any thoughts you have on a carer-friendly alternative.
You and your carers can respond using the easy online questionnaire at www.csci.gov.uk/about_us/news/review_of_eligibility_criteria.aspx or emailing / posting a submission () by May 9th.
Legal ruling on direct payments from the NHS
Sunderland Primary Care Trust has agreed, following a Judicial Review, to make payments directly to the parents of a severely disabled adult for the care they provide to her, and which she refuses to receive from paid care workers. As a NHS Continuing Healthcare patient, the responsibility for funding and arranging the daughter’s care falls on the NHS, rather than the local social services department who would have been able to make direct payments to the parents as her refusal to receive care from anyone but her parents would constitute the “exceptional circumstances” required in order to allow direct payments to be made to close, co-resident family members. Direct Payments do not apply to PCTs. Although NHS law is theoretically wide enough to allow for equivalent payments, the PCT argued that it would be 'unlawful' to make them and to do so would open the floodgates. The judge accepted the family’s argument that there was no legal bar to the PCT making such payments and no reason to justify different treatment of those who are the responsibility of social services, and the health service. Payments of over £35,000 per annunm, and the family’s legal costs will now be paid.
Health Secretary policy announcements
Alan Johnson, the Health Secretary has made a number of announcements on future care policy. By the summer, the Care Commission will announce plans to extend flexible working and rights similar to those under maternity law to the estimated six million people who currently look after a disabled or elderly relative. And more elderly married couples will be able to access shared residential care rather than being placed into separate homes or having to stay in difficult caring situations to avoid being separated.
New Drugs Strategy and Clinical Guidelines on Drug Misuse
The 2008 Drugs Strategy sets out the Government’s aims for the next 10 years in drug treatment and prevention. This Strategy represents a positive step towards better support and outcomes for substance misuse carers. This is due to its aims to improve the care and support service users receive, but also by placing greater emphasis on families’ and carers’ needs. A more preventative and holistic approach is being taken, including clear aims to increase the involvement of young people, parents and other carers in the planning and process of treatment, and the design and planning of treatment services.
The 2007 Clinical Guidelines on Drug Misuse and Dependence (or ‘Orange Book’) provide guidance on treatment for drug misusers for all clinicians in the UK. A key principle of the Orange Book states that while clinicians’ focus must be on the patient, the impact of the patient’s drug misuse on other individuals (i.e. carers and dependent children) should be taken into consideration. In particular, the Orange Book states that carers should be given information and support, and includes a list of specific information, advice and support that should be given to the carer by clinicians. It also states that “children [of drug misusers] have a right to express their views and to have them taken into account when decisions are made about what should happen to them” (point 2.5.3, p.22).
For more information on both documents, please contact Drew Lindon at The Trust on .
Local government
Putting People First and 10 High Impact Changes for Social Care
The Trust is working with the Local Gov Association (LGA) and their health equivalent, the NHS Confederation to promote good practice examples of how the new government “concordat” on personalised services, Putting People First, can be made a reality for carers. Putting People First has a very strong carers theme, so we aim to produce a report with examples of personalised approaches which work for carers for an audience of local authority and health trust policy makers (see full document at www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081118 or Trust Guidance on NHS Operating Framework and Concordat on Trustnet ).
Centres have already provided some great good practice examples – but we still need more! Please send us brief accounts of services which have been designed in innovative ways to be tailored to individuals’ needs. They might involve new or unusual partnerships, commissioning arrangements or support packages that use Direct Payments. They might put carers in control and treat them as experts. The report we aim to produce will have a similar feel to 10 High Impact Changes for Social Care which has just been produced by the Care Services Improvement Partnership (CSIP). This report also illustrates how the principles of Putting People First can be made a reality, with practical examples of how to make the changes outlined in the Concordat. Congratulations to The Carers Resource in Harrogate and Craven, which is highlighted as an example of good practice under the provision of information theme. The 10 changes and their illustrations in practice are at the end of this document.
Complaints
A new unified complaints system for health & social care is being piloted in each SHA region from April 08, with national roll out from April 09. The new system is designed to be simpler, with a first stage focused on local resolution followed by - if needed - an investigation by the Health or Local Government Ombudsman. This should be easier for people who use a combination of health and social care services. The system is designed to encourage services to learn from complaints, feeding into service improvement.
Inspection of local authority and health services
There is a consultation on the future regulation of health and adult social care, including the new Care Quality Commission, which will be a merger of the existing Healthcare Commission (HCC), the Commission for Social Care Inspection (CSCI) and the Mental Health Act Commission (MHAC). The key concern for us is that the new inspectorate could be NHS dominated, with less prominence given to social care and that CSCI’s excellent work raising the profile of carers will be lost.
The consultation can be accessed at www.dh.gov.uk/en/Consultations/Liveconsultations/DH_083625 and of course, we would value your thoughts for The Trust’s response.
Service development
Futurebuilders funding
Liverpool Crossroads Caring for Carers was offered a Futurebuilders investment (mostly a loan with some grant) of £181,000, enabling it to develop its existing services by steadily increasing Carer Support hours over the next 5 years. This case study is a good illustration of how Futurebuilders funding can be used to help transform a carers’ organisation. See: www.futurebuilders-england.org.uk/content/Search/CaseStudies/article_36_71.aspx?iid=76
Grassroots grants for the third sector
The Cabinet Office has announced a new, £130 million grant scheme which will give small grants and money to generate endowments for small local organisations from July 2008. It will be delivered by local funders, currently applying for that status to the Community Development Foundation who are at: www.cdf.org.uk
Carers and employment
The Carers Resource at Harrogate and Craven (a Princess Royal Trust member) runs the Changing Lives project. Staff of Changing Lives support carers at their own pace to build confidence and find new training and employment opportunities. Courses are fun and motivating, running at times and places that suit carers, from computer skills and interview techniques to confidence building and individual interests. The project has over 100 learners currently on courses including IT, maths, English, personal development etc. The project has helped 25 carers into full, part time and voluntary work and self employment. The project has also provided Skills coaching and Next step services to 250 carers. Delivery partners have achieved Matrix - enabling them to access LSC/JCP funding/projects/partnerships. Contact: 01423 500555;
Princess Royal Trust Sunderland Carers Centre has worked with employers to try to improve awareness and therefore policy and practice, to enable carers to remain in paid employment since the 1990s. The Centre’s Carers in Employment Charter (see appendix) and the local Carers in Employment Forum (convened by the Carers Centre with representation from the council). PIE (People into Employment) is a partnership funded from a number of local authority and health budgets, bringing the Carers Centre together with the PCT, hospital Trust, adult services, a local physical disability alliance and a local not for profit training organisation. It has two elements: getting people into work and supporting those already in employment. The employer’s Charter is a brief statement of intent for employers to sign up to. Please contact Ailsa Martin, CEO Sunderland Carers Centre or for PIE: Gill Charman at ETEC
Self assessment processes for carers
Princess Royal Trust Kent Carers Centre (contact: Ron Alexander ) are piloting an online self assessment process for access to the Carers Centres and other services which will feed into the council’s strategy to deliver more initial needs assessments for users and carers online. See: www.kent.gov.uk/SocialCare/adults-and-older-people/self-assessment/declaration-carers.htm
Older carers
Voices for Older People’s Advocacy aims to promote Independent Advocacy for older people through sharing experiences. See www.acting-up.org.uk/opaal.htm
The All Party Parliamentary Group for local government is holding an inquiry into older people’s services, to which we will be contributing. It would be very useful to hear your thoughts on the issues, challenges and good practice for our contribution, which will be submitted by 29th April.
Hospital based resources for carers in East Sussex
Care for the Carers (a Princess Royal Trust member) and East Sussex hospitals NHS Trust have produced a range of resources for supporting carers, including a Good Practice Guide for hospital staff covering information sharing etc, a Carers Information Leaflet and a Care Passport, which allows carers to help the cared-for person express their care needs and let staff know they can share information with the carer. See www.carers.org/local/south-east/eastbourne/ for more and relevant contact details.
GP based carers support in West Sussex
The Carers Development Worker (Primary and Community Care) project at the Princess Royal Trust Worthing & District Carers Liaison Service has had dramatic effects on the numbers of carers identified by GP practices, with some increasing their numbers by many times since 2004. Contact via: www.carerswsx.org.uk. One full time equivalent Carers Development Worker based at the service works with 37 GP practices. The project:
• Identifies a link person in each GP practice
• Completes an annual Monitoring Tool
• Uses an Action Plan for task completion
• Provides Carer Awareness training and information/support for all GP staff
• Promotes healthy living practices at carers events
• Ensures that GPs work to the GMS contract (Management Indicator 9)
Parliamentary and lobbying
Census 2011
The lobbying on the carers question in the 2011 census has paid off! Angela Eagle MP, Exchequer Secretary to the Treasury has written to Hywel Francis MP, Chair of the All Party Parliamentary Group for Carers, to say that funding will be provided for a fourth page in the 2011 census. This will mean that the Office of National Statistics (ONS) can now accommodate more of the user demands for information and continue with the plans to include a question on carers in the 2011 Census.
DWP Select Committee inquiry into the New Deal for Carers
We submitted a response to this inquiry and hope to be called upon to give further evidence later in the year. See our response on Trustnet .
Pension credits for carers
The Pensions minister said that that the new more generous crediting arrangements for parents and carers will mean up to one million more people (around 90% female) will accrue state second pension: www.theyworkforyou.com/wrans/?id=2008-01-17a.175073.h&s=carers+-parent
Carers receiving parking fines
Islington Carers' Centre conducted a survey and found that there are a high number of carers receiving parking fines. Is this also a concern in your area?
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