Will the Care Act blur the distinction between health and social care?

[jimbo 111]

Will the Care Act blur the distinction between health and social care?
Call for greater clarity ahead of new legislation

• What are the most important changes to the Care Act?
Chief executive of the NHS, Simon Stevens, who has suggested he would like to see care homes close. Photograph: Owen Humphreys/PA
There's still a good deal of muttering about a comment a few weeks ago by new NHS chief executive Simon Stevens that he was looking forward to the demise of care homes. "It would be a disappointment," he told charity Age UK's annual Later Life conference, "if in 30, 40, 50 years' time, nursing homes still existed."
Stevens enjoys casually lobbing such grenades and standing back to observe the fallout. He made a similarly provocative comment in his first weeks in the job about community hospitals, interpreted in some quarters as opposing any further closures. But his use of the term "nursing homes" has caused some confusion.
There is a clear and important difference in the UK between nursing and residential homes, though some are both. Stevens confirmed as he left the conference that he had meant all care homes, making the point that models of care change over time and could be expected to do so. We should be disappointed if they did not.

Read more
http://www.theguardian.com/social-c.../care-act-blur-distinction-health-social-care

 

[Lindy50]

Interesting article Jimbo, thanks for posting

Not sure what I think about the possible boundaries between health and social care....but I am certain we need to keep monitoring the proposed changes!

Lindy x

 

[WILLIAMR]

I think they will have to have some sort of care place for people like my step mother.
As the social worker said she could have murdered a child.


William

 

[Wirralson]

Essentially the problem remains the one inherent in the postwar social settlement: s21(8) of the National Assistance Act which prohibits a local authority from providing a service which is the responsibility of the NHS. That battleground has been a problem since the start, but Government is never going to concede that it is the duty of the Health budget to provide unlimited funding for the accommodation of the elderly infirm. The 2012 Act's main aim is to push "integrated care" - a polite way of saying that it will try and push the boundary of s21(8) away from the NHS and towards Local Authorities taking more responsibility and so applying means-tested charging. This is what is behind the remark about seeing the end of care-homes - residential care is expensive and what is really meant is reducing the liability of the NHS and LAs for funding such care - there would be nothing to stop private funding.

W

 

[WILLIAMR]

It would not surprise me if the laws re Tenants in Common ownership could change where there is a parent and offspring involved if the offspring is not living in the property.
I know of at 11 houses which are owned in this way by me.
I don't think anything could be done about present ownership situations but something could be done for the future.


William

 

[Wirralson]

It would not surprise me if the laws re Tenants in Common ownership could change where there is a parent and offspring involved if the offspring is not living in the property.
I know of at 11 houses which are owned in this way by me.
I don't think anything could be done about present ownership situations but something could be done for the future.


William

I can't see that happening. Too much in the law of property hinges on what happens with Tenants in Common.

Edited to add: I posted the post at the link below in the wrong thread - it belonged here

http://forum.alzheimers.org.uk/show...-for-relatives&p=981281&viewfull=1#post981281

 

[WILLIAMR]

Whatever laws they make I am just wondering if Social Workers will try to get the patient /relatives to pay even if the funding is the responsibility of the NHS or the council.

Clearly the social worker was wrong saying the bungalow my step mother was living in would have to be sold when I was the 100% owner.

I accept I had a letter later from the council saying the sale would have been stopped when it got to the care home contributions teem but if I had agreed to pay would it have got to that teem?.

William

 

[handyjack]

"It would be a disappointment," he told charity Age UK's annual Later Life conference, "if in 30, 40, 50 years' time, nursing homes still existed."

All good stuff,, but does he realise the effect of not having nursing homes would have on NHS hospitals? Bed blocking, overcrowding, lack of resources? I just don't think he's thought this through. (or perhaps he's opened his mouth, before putting his brain in gear)

 

[Wirralson]

All good stuff,, but does he realise the effect of not having nursing homes would have on NHS hospitals? Bed blocking, overcrowding, lack of resources? I just don't think he's thought this through. (or perhaps he's opened his mouth, before putting his brain in gear)

I'm sure he has thought it through. The objective of the remark is partly provocative - that's his style - but partly to try and force what the NHS calls commissioners (commissioning is NHS-speak for purchasing or procurement of healthcare services) and also Local Authorities to look at other, cheaper solutions than residential care. Behind all this lurks the specgtre of co-payment and potentially insurance for healthcare, which is where part of Stevens' background is in both Europe and the US.

W

 

[handyjack]

The objective of the remark is partly provocative - that's his style - but partly to try and force what the NHS calls commissioners (commissioning is NHS-speak for purchasing or procurement of healthcare services) and also Local Authorities to look at other, cheaper solutions than residential care.

And that would be?? In the Guardian article quoted earlier, he didn't mention "residential care" he directly mentioned "Nursing homes" (I think the operative word here is "nursing") Even if he did mean residential care, what's the alternative? Home visits from inexperienced care workers, who will undoubtedly have a schedule to keep to (so visits will be short)? Or perhaps the occasional visit from a district nurse (overworked as usual, and again a schedule to keep to)? Does he want sons and daughters to give up work to look after loved ones at home?
Perhaps I'm looking at a worst case scenario, but if this comes about, I bet I'm not a million miles off the mark.

 

[Wirralson]

And that would be?? In the Guardian article quoted earlier, he didn't mention "residential care" he directly mentioned "Nursing homes" (I think the operative word here is "nursing") Even if he did mean residential care, what's the alternative? Home visits from inexperienced care workers, who will undoubtedly have a schedule to keep to (so visits will be short)? Or perhaps the occasional visit from a district nurse (overworked as usual, and again a schedule to keep to)? Does he want sons and daughters to give up work to look after loved ones at home?
Perhaps I'm looking at a worst case scenario, but if this comes about, I bet I'm not a million miles off the mark.

Or "adult fostering" as used in the US in Maine. What he may be partly trying to foreshadow is the NHS getting out of the "hotel" costs element of nursing home care in CHC payments. He's probably pretty indifferent to whether Local Authorities or private individuals continue to use care homes (as opposed to nursing homes). It's also a threat to the major care home providers - cut your costs or else we look at other options.

W