The Common core principles to support self care have been developed by Skills for Health and Skills for Care with key stakeholders, including service users and carers, to develop a set of common core principles to support self care. The principles capture best practice in order to enable service reform and encourage choice, control, independence and participation of those using health and social services.

The Cabinet Office have produced Volunteering in the Public Services: Health and Social Care which is the first in a series examining the role of volunteers and volunteering in public services. Through consultation with over 1000 volunteers and organisations it found much potential to expand volunteering in health and social care to build more people centred services. It identifies a largely untapped source of volunteers in service-users. It argues that they could make an enormous contribution as volunteers in health and social care because no one understands what it is like to have a condition like a person who has it themselves.

The main recommendations are:

• In-house ‘volunteering hubs’ should be established within government agencies to help mainstream volunteering in health and social care services.

• When commissioning services, Government agencies should consider the social benefits and true costs of volunteering.

• Employee volunteering schemes should become commonplace throughout health and social care services.

• A programme board should be set up, with a remit to increase volunteering in health and social care and ensure that volunteers are properly managed.

• Both the Government and charities need to make more of the huge, largely untapped, resource of service-users as volunteers.

• NHS websites should signpost their users to peer group support websites, and to more general volunteering opportunities.

More responsive public services? A guide to commissioning migrant and refugee community organisations is a practical guide from the Joseph Rowntree Foundation to commissioning migrant and refugee community organisations (MRCOs) to deliver public services.

The government is promoting the role of the ‘third sector’ in delivering public services, and wants to ensure that services meet the needs of all potential users. Many migrant or refugee-led community organisations are already delivering services in culturally-sensitive ways, and it is possible that more of these organisations could become formal public service providers.

This guide reviews the commissioning process, why it should include bodies like MRCOs, what MRCOs are and what they can offer to commissioners of public services. It demonstrates how MRCOs can engage with the commissioning process, asks whether it is the right step for them to take, and suggests what changes in their organisations and capacities might be required. It explores potential commissioning opportunities for MRCOs in eight service areas, including accommodation, Supporting People services, health care and legal advice, and includes over 30 practical examples of service provision.

The Health and Social Care Bill 2007-08 has it’s third reading today.  The Bill aims to enhance professional regulation and create a new integrated regulator, the Care Quality Commission, for health and adult social care.  This body will provide assurance about the safety and quality of care for patients and service users.

• Assures the safety and quality of care and creates a new regulator, the Care Quality Commission
• Equips the new regulator with tougher powers, backed by fines, to inspect, investigate and intervene where hospitals are failing to meet hygiene standards
• Strengthens clinical governance and reforms the system of professional regulation to ensure it earns and sustains the confidence of patients, professionals and Parliament
• Extends financial support to mothers-to-be from the 29th week of pregnancy
• Ensures all healthcare professional regulatory bodies use the civil, rather than criminal, standard of proof
• Creates an independent adjudicator to undertake independent and objective formal adjudication for the professional regulatory bodies
• Ensures that all healthcare organisations employing or contracting with doctors appoint a ‘responsible officer’ to work with the GMC to identify and handle cases of poor professional performance by doctors
• Updates the Public Health (Control of Disease) Act 1984 with the aim of providing a more effective and proportionate response to infectious disease.

Children on bullying report summarises research on children’s views on bullying, defining what bullying is and what to do about it. There are both worrying messages and hopeful signs among the varied responses.

It covers children living away from home in England (in children’s homes, boarding schools, residential special schools, residential further education colleges, foster care, adoption placements or residential family centres), those who are getting help of any sort from the children’s social care services of their local council and care leavers.

Between June and October 2007, proposals for reform of NHS and social care complaints arrangements were consulted on. Making experiences count: the proposed new arrangements for handling health and social care complaints - response to consultation summarises the responses and how the Department of Health has taken them into account in its response. Itsets out the detail on its intentions to implement reform of the health and social care complaints processes.

Making experiences count: a new approach to responding to complaints - a document for information and comment can be read here.

I Exist: the message from adults with autism in England from the National Autistic Society considers the experiences of adults with autism and the changes that required to make their lives better. It is based on the largest-ever survey of adults with autism and their parents and carers.It considers existing provision by local authorities and health services.

Mental Health Act Commission Eleventh Biennial Report (In Place Of Fear) questions whether all inpatient mental health services provide their patients with acceptable levels of security, care, or a sense of being treated as  someone who matters. It welcome the Government’s announced refocus on inpatient services and call for it to concentrate on building up these aspects, in place of the fear that many patients have of services and that many people have of mentally disordered people.  The importance of breaking such ‘circles of fear’ for Black and minority ethnic patients are particularly welcomed.

There is evidence that inpatient services are losing staff and resources to community
services, but that pressures on inpatient beds remain high. Over half of all wards are full or have more patients than beds, with staffing shortages and unpleasant ward environments undermining the therapeutic purpose of inpatient admission.

The report highlights the dangers inherent in devolved service commissioning for ensuring adequate levels of specialist provision, and note the vulnerability of mental health services as Trusts face financial crises.

The extension of patient ‘choice’ across health service provision should not be allowed further to disadvantage or ostracise patients who are unable to exercise choice because of their mental incapacity or because of legal powers of compulsion held over
their treatment.

Boundaries of current mental health law under stress, with discussion of about forty cases
in court, and a more general observation of legal powers being used in ways that may not have been intended by Parliament, often for pragmatic reasons where professionals are keen to intervene in what they perceive to be a person’s best interest or as measures of social order.

It also discusses aspects of the use of present mental health powers in relation to civil detention and police powers, including an extended discussion on the detention of mentally disordered offenders.We provide analysis of deaths of detained patients; seclusion incidents notified to the Commission; and Second Opinion activity during this period.

The report has a strong focus on measures to encourage and support the empowerment of all patients, including those without mental capacity to make certain decisions about their care.

It finally reviews the proposed future arrangements for monitoring detention of mentally disordered persons and suggest ways in which the forthcoming Mental Health Bill might be improved to ensure acceptability to mentally disordered persons and the effective protection of their rights.

Mental Health Act Commission Eleventh Biennial Report - Errata and Addendum

Giving a comprehensive overview of the social care sector in England ‘The state of social care in England 2006-07 (Executive Summary)’ the Annual Report of the Commission for Social Care Inspection follows concerns raised by the Commission last year, and explores the experiences of people not deemed eligible for state-supported social care. It shows that many younger disabled people and frail older people are being ‘signposted’ to voluntary services. Many are forced to rely on help from family and informal arrangements which can break down at short notice. People unable to rely on families or friends and unable to pay for care services themselves are simply left to cope with everyday life, while some become virtually trapped in their own home.Local authorities are increasingly only helping those with ‘substantial’ or ‘critical’ needs. This despite the use of a national set of rules (called Fair Access to Care Services - FACS ) to decide who is eligible for support. However who does or doesn’t get help varies not only between but also within the same council. In practice the criteria can be interpreted in different ways by local staff.

The full report can be downloaded using the links below along with the evidence that informed it.

State of social care - foreword & overview

State of social care - context and focus

State of social care - part 1

State of social care - part 2

State of social care - appendices

Lost to the System? The Impact of Fair Access to Care

Self-funded social care for older people: an analysis of eligibility, variations and future projections

You can also download the mp3 audio summary Audio summary.

Established to contribute to the national debate about the future shape of social care to meet  the major demographic changes, higher expectations of quality support amongst carers and the strong focus on self-directed care and independent living.  The Standing Commission on Carers will seek new solutions to old problems. It aims to put carers at the heart of policy-making as equal partners in exploring new ways of maximising independence and developing high quality (and cost-effective) services fit for the 2lst century.

Currently their site details membership and terms of reference.

Lesbian, gay, bisexual and trans (LGBT) people experience a number of health inequalities which are often unrecognised in health and social care settings. These briefings are intended to show that LGBT people can be younger, older, bisexual, lesbians, gay men, trans, from black and minority ethnic (BME) communities and disabled, and to dispel assumptions that they form a homogeneous group.

The briefings provide easy-to-read guidance for health and social care commissioners, service planners and frontline staff. They aim to inform the delivery of appropriate services and to support health and social care professionals in their everyday work with LGBT people by providing fundamental awareness and evidence of LGBT needs in relation to health.

• Introduction
• Briefing 1: Working with lesbian, gay, bisexual and trans (LGBT) people
• Briefing 2: Improving access to health and social care for lesbian, gay, bisexual and trans (LGBT) people
• Briefing 3: Young lesbian, gay and bisexual (LGB) people
• Briefing 4: Older lesbian, gay and bisexual (LGB) people
• Briefing 5: Lesbian health
• Briefing 6: Gay men’s health
• Briefing 7: Bisexual people’s health
• Briefing 8: Healthy lifestyles for lesbian, gay, bisexual and trans (LGBT) people
• Briefing 9: Mental health issues within lesbian, gay and bisexual (LGB) communities
• Briefing 10: Sexual health
• Briefing 11: Trans people’s health
• Briefing 12: Lesbian, gay and bisexual (LGB) people from Black and minority ethnic communities
• Briefing 13: Disabled lesbian, gay and bisexual (LGB) people

A brief shout out to Sue over at Lancashire Care who noticed this.

The Commissioning framework for health and well-being sets out the eight steps that health and social care should take in partnership to commission more effectively. It is squarely aimed at commissioners and providers of services in health, social care and local authorities.  Recently issued are the ministerial statement and summary of responses to consultation on the framework.

Informal and private care is plugging a funding gap of £25k for every disabled person over the age of 65 in Britain today says A Charter for Change, a new report from the charity Counsel and Care. Coming ahead of a Green Paper on Social Care, it calls for 2008 to be ‘the year of the care debate’ and urges Government to adopt a radical new framework for the future of social care.

Putting people first is a ministerial concordat expressing the Government’s shared ambition is to put people first through a radical reform of public services, enabling people to live their own lives as they wish, confident that services are of high quality, are safe and promote their own individual needs for independence, well-being and dignity. It promises to invest £500 million in social care services, and give people more control over the care they receive.  The concordat establishes the collaboration between central and local government, the sector’s professional leadership, providers and the regulator, setting shared aims and values which will guide the transformation of adult social care, and recognises that the sector will work across shared agendas with users and carers to transform people’s experience of local support and services.

Crisis Resolution Home Treatment teams are having a positive impact on local acute mental health services, providing an alternative to hospital admission for people experiencing a short-term mental health crisis.

But Helping people through mental health crisis: The role of Crisis Resolution and Home Treatment services (Executive Summary, Crisis Resolution Home Treatment Services: Report from a Survey of Referring Clinicians) from the National Audit Office found that services are being limited by a lack of input from specialist health and social care professionals, variations in staffing levels across the country and too few admissions to hospital being assessed by CRHT teams. These teams have been implemented across most areas of the country, there are wide variations between areas in the extent to which teams are staffed and resourced but where they are working they are making a significant impact. CRHT teams have reduced pressure on beds and the teams have been successful in reaching many service users who would otherwise have needed admission to hospital. CRHT teams are also supporting people in early discharge from hospital.

Only three regions achieved the Department’s estimate for a full functioning service of 14 or more whole-time-equivalent CRHT staff per 150,000 population. Staffing in the least well resourced region (North West) is 25 per cent lower than that in the best (South Central) and the national headcount for staff is only 90 per cent of the number estimated by the Department as required.

The report concludes that there is still more to do. To maximize the impact of CRHT and improve value for money the Department and the NHS need to ensure that CRHT teams are properly resourced, fully functional and integrated within local mental health services. National data on services must improve, and better use of feedback and data made at the local level. Local NHS organizations need to improve links between CRHT teams and other mental health services, and Mental Health Trusts should enforce written policies and procedures requiring every inpatient admission to be preceded by a CRHT assessment.

POPP is an initiative being led by the Department of Health, providing £60m funding to council-based partneships to set up innovative pilot projects to:

• Provide person-centred and integrated care for older people.
• Encourage investment in preventative approaches which promote health, well being and independence for older people.

The strategic aim of ‘Partnerships for Older People Projects’ is to test and evaluate innovative approaches that enable a sustained focus on prevention. It is expected that partnerships will demonstrate improved outcomes in:-

• Providing more low level care and support in the community with a view to preventing or delaying the need for higher intensity and more costly care
• Reducing avoidable emergency admissions to hospital
• Supporting more older people to live at home or in supported housing such as sheltered or Extra-care housing rather than in long-term residential care

Just published are interim reports on the projects progress.

• National Evaluation of Partnerships for Older People Projects: Interim report of progress
• National Evaluation of Partnerships for Older People Projects: Interim report of progress, Briefing paper: Cost-effectiveness, Measuring Effects: Emergency Bed-Day use

You can also check out the Mass Media Coverage 21/11/07 over on Fade the Blog.

This paper reports the findings of the evaluation of the Supporting People Health Pilots programme, which was established to demonstrate the policy links between housing support services and health and social care services by encouraging the development of integrated services. The paper highlights the challenges of working across housing, health and social care boundaries.

The challenges of joint working: lessons from the Supporting People Health Pilot evaluation
Ailsa Cameron, Geraldine Macdonald, William Turner, Liz Lloyd

The General Social Care Council’s statement of roles and tasks is the first official report on social work in England for nearly a generation.  A final draft of ‘Social Work at its Best - The Role of Social Work in 21st Century Care Services’ will give you details on the roles and responsibilities of social workers.

NHS Estates projects are flavour of the month in Liverpool so it’s timely that the Department of Health issue two pieces of grey literature to support the planning process.

The Guide for the NHS aims to

• outline the town and country planning system in England at regional and local level with reference to issues specific to the NHS
• explain the correlation between planning and health, and
• encourage NHS organisations to get involved in the planning process.

A guide to town planning for NHS staff

Meanwhile for Local Authorities their guide gives local planning authorities an overview of the NHS in England. It outlines the key principles of public health; identifies the wider determinants of health and how planners impact on them; and points to how local planning authorities can interact with NHS organisations to deliver sustainable health and social care services.

A guide to the NHS for local planning authorities