The healthmatters blog; commentary, observation and review
- Just one in five (21%) people don’t expect to need residential social care in their old age.
- Of those who believe they may, two-thirds (67%) thought it most likely they would need it from age 80 or older.
- 80% of people think average time needing care is over three years and 30% believe the average is more than five years.
With a growing elderly population in the UK, social care is a key subject on the political agenda. As highlighted in the recent report from Independent Age* only one in ten MPs in England (10%) believe that the current social care system is suitable for the UK’s ageing population. And after controversial plans in its Manifesto, the Government is due to consult shortly on how its funding can be shared between the state and individuals.
New research** from Aegon has found that only 21% of people anticipate that they won’t need residential social care in their old age, indicating that four out of five people are facing up to the prospect and not burying their heads in the sand.
The research also found that of those who believe they may need residential care, two-thirds (67%) thought it most likely they would need it from age 80 or older.
Length of time people expect to spend in care
The research also revealed that most people had realistic expectations in terms of how long people typically spend in residential care in their old age. 80% of respondents thought the average time would be more than three years, while 30% believed the average is more than five years. A study by Newcastle University*** found men spent 2.4 years on average needing regular care albeit not necessarily in a residential facility and women three years.
How much people expect care will cost
The findings also indicated that 78% of people thought the average cost of residential care is £30,000 or more a year with most (59%) expecting it to be between £30,000 and £50,000 a year.
This is in keeping with the latest figures from Laing & Buisson’s Care of Older People UK Market Report 2016/17****, that estimate that it costs on average around £31,200 a year for residential care, rising to over £43,700 a year if nursing care is necessary.
Steven Cameron, Pensions Director at Aegon UK, said:
“Our research captured a wide range of views on the likely need for social care in old age and the associated costs. It’s reassuring to see that the reality of these costs is resonating with people with the majority expecting residential care to cost between £30,000 and £50,000 a year. This understanding of cost is a good first step when it comes to planning for retirement and factoring in the years of care that might be required in late life. The second step is for this understanding and awareness to be converted into action.
“It’s particularly noteworthy that only one in five people (21%) said they don’t think they will need residential social care in their old age. This means most people need to be asking themselves how they’ll pay for it. The state won’t pick up the full tab and failing to plan ahead could have serious implications for inheritance aspirations.
“This is a very complex area and the Government is likely to put in place new rules around what individuals will be expected to pay. This is an area we will be following closely as the sums of money involved are significant and individuals will want to understand their savings options. As the debate about care costs evolves, getting professional financial advice may help to ensure people are well placed to meet any future costs.”
*Independent Age MPs Parliamentary Audit, https://www.independentage.org/sites/default/files/2017-08/Independent%20Age_MPs_Parliamentary_Audit_Social_Care.pdf
** Research was conducted by Aegon with the Aegon UK consumer and customer panel. Total sample size was 651 adults. Fieldwork was undertaken in August 2017.
*** Newcastle University study as published in the Lancet, August 2017,http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31575-1/fulltext
**** Laing & Buisson’s Care of Older People UK Market Report 2016/17,http://www.payingforcare.org/care-home-fees
ONE in five people will live with sight loss in their lifetime despite at least half of all cases being avoidable[i], warns a new report published by charity Royal National Institute of Blind People (RNIB) and high street opticians Specsavers.
The alarming new statistics show that every day 250 people start to lose their sight in the UK. Women, who tend to live longer, are at greater risk than men, with one in four women set to develop sight loss in their lifetime compared with one in eight men[ii].
Almost six million people in the UK currently live with sight-threatening conditions yet 25 per cent of people are not having an eye test every two years[iii] as recommended by the College of Optometrists[iv]. The extent of the problem means that nearly every family in Britain is touched by sight problems in some way.
RNIB acting CEO Sally Harvey says: ‘Our report reveals new evidence that one in five people will live with sight loss in their lifetime, so our work is now more important than ever. The eye health crisis looks set to deepen and the cost burden is destined to soar unless urgent action is taken.
‘Almost 80 per cent of people living with sight loss are over the age of 64[v], so with an ageing population that is expected to retire later, more of our national workforce will be impacted by sight loss. Alongside rapidly growing demand for eye care services, and capacity problems in some clinics at a time of growing budget deficits, we are facing an extremely challenging time for eye health in the UK, and we must take action now.
‘We will continue to press for integrated services and effective referral and treatment for local communities as a key way of tackling the capacity problems in hospital eye departments. We will champion active planning that is based on the eye health needs of local communities and we will present conclusions from our policy roundtables to a parliamentary Inquiry on eye health services.’
The State Of The Nation Eye Health 2017: A Year in Review report, launched ahead of National Eye Health Week (18 – 24 September), is an annual benchmark of Britain’s eye health by RNIB and Specsavers, who joined forces in 2016 to raise awareness of the importance of eye health at every level to help prevent avoidable sight loss.
While a YouGov survey commissioned for the report suggests 1.1 million[vi] more people took action to improve their eye health by visiting an optician since the campaign launched last September, there is much still to be done, according to Specsavers founder Doug Perkins.
An optometrist for more than 50 years, he says: ‘We are calling on political leaders, senior decision makers in health and social care, and local champions to work together to ensure that people receive timely treatment to prevent avoidable sight loss.
‘Without this leadership the eye health crisis will continue to worsen and patients’ sight will be put increasingly at risk, deepening the economic burden that we already estimate will rise from £28 billion today if nothing is done now.’
TV presenter and journalist Anne Robinson is supporting this year’s campaign as eye health ambassador. Her own family experience of eye health problems saw her Irish godfather, who had a love of horse racing, lose an eye through cancer.
Anne says: ‘It was really sad – not only could he no longer watch television, but he couldn’t look up the form or do all the things he usually loved to do. This needn’t have happened as science has progressed so far that if he’d have been having regular eye tests he could have enjoyed those racing programmes until he died.’
Anne’s father also struggled with sight loss. After years of ignoring his vision problems he decided to have his eyes tested on a family trip to London. The optician discovered that he had cataracts and referred him for surgery to remove them.
Anne adds: ‘Neither of my parents went for regular eye tests. My father had been a teacher all his life until he retired so reading, as it is to all of us in our family, was terribly important. He’d missed out on reading newspapers and books. Sometimes, as you get older, you don’t admit that you’re struggling. Looking back, he clearly knew something was wrong. With the cataracts gone he could read comfortably again.
‘I now know that all of us, from the age of three, should be having our eyes tested regularly because of what an optician can detect.’
The report also reveals that:
- Sight is the nation’s most precious sense by far; 10 times more people (78 per cent of people) said sight was the sense they fear losing most compared to the next most popular sense, smell (8 per cent), followed by hearing (7 per cent)
- Almost a quarter of people are ignoring the first signs of sight loss; despite not being able to see as well in the distance or close up as they used to, 23 per cent have not sought advice from an optician or medical professional
- More than 80 per cent of people are not aware that an optician can spot the early signs of cardiovascular disease, the leading cause of death in the UK
- People put their boiler before their eye health; half of UK adults have their boiler serviced once a year, over a third renew their mobile phone contract every two years, while 50 per cent of UK adults last had their eyes tested more than a year ago or never
- Research suggests Brits check their teeth more often than their eyes; 42 per cent visit the dentist once every six months (equating to four times over two years) while 25 per cent of UK adults haven’t had an eye test in the past two years or at all
A quarter of people who spend £50 a year on shoes would not be prepared to pay anything at all for an eye test
The report, written by RNIB and Specsavers and supplemented by an independent YouGov poll of 6,430 UK adults, was unveiled at an event hosted by the partnership in London today.
The event marks a stepping up of RNIB and Specsavers transforming eye health campaign, which will include a multi-million pound investment in marketing, nationwide fundraising and a tour of the UK with their Eye Pod simulated sight loss experience to educate the nation about the importance of eye health.
[i] The State of the Nation Eye Health 2017: A Year in Review, Specsavers/RNIB
[ii] This is primarily due to the fact that women have a greater life expectancy.
[iii] YouGov Survey commissioned by Specsavers and RNIB 23rd June -7th July 2017 of 6,430 UK adults aged 18+
[iv] The State of the Nation Eye Health 2016, Specsavers/RNIB
[v] The State of the Nation Eye Health 2016, Specsavers/RNIB
[vi] YouGov Survey commissioned by Specsavers and RNIB 23rd June -7th July 2017 of 6,430 UK adults aged 18+. Specsavers calculation based on the Office of National Statistics’ 2015 and 2016 UK 18+ population estimates. 2015 population estimate for those who have been for an eye test in past year = 51339161 x 0.4567 = 23,446,594.83. 2016 population estimate for those who have been for an eye test in past year = 51767543 x 0.4750 = 24,589,582.93. 24,589,582.93 – 23,446,594.83 = 1,142,988.10
Trials and tribulations on the left
Health Service Journal columnist Andy Cowper says in his latest blog that Labour’s policy of saving the NHS from privatisation does not have much traction beyond the party’s political base. Can we be so sure? Is Prof Steven Hawking part of Labour’s political base? An astonishingly clever man, Hawking repeats the Tolkienesque story that all changes in the NHS are designed to replace it with a US-style health insurance system. This endorsement of a myth could have public impact, given the authority of its source.
Conspiracy theories run deep, especially amongst those with paranoid tendencies, and because they are crude simplifications they have the advantage of not being intellectually taxing. They create an anti-politics that finds demonic enemies to mobilise people against. When you next join a rally to save an A&E department or a maternity unit or a much-loved if shabby local hospital, check out the protestors’ rationality, tone and depth of knowledge.
The NHS may have brought this upon itself, doing most of its work in secret and fostering a shroud-waving political culture, but that will not be easy to turn round. Labour does indeed have a problem, being vulnerable to theological thinking in an area where logical thinking would be more use. In the past shadow health leaders like Robin Cook and Frank Dobson canvassed opinion about policies widely, sometimes to the annoyance of in-house lobby groups like the Socialist Health Association. Now the sources of expertise are different – the BMA has less credibility – and have been outsourced, to the Kings Fund and Nuffield, or to Deloitte and PwC.
What is to be done about the NHS?
Whilst we are on the topic of Labour policy, let’s face some facts. For the first time the NHS will shrink, this winter. Up to now its budget growth has been limited, from 3-4% extra per year to 1-2%. This shrinkage (in budget per capita) will lead to service reductions and staff losses. Both NHS Hospital and Community Trusts are financially vulnerable, and last year became dependent on other income streams like car parking fees, local government transfers, research grants, private patients and retailing. In response to the shrinkage Trusts will sell land, delay (or dispense with) some treatments, merge to combine and reduce back-office functions, increase efficiency and reduce waste, and reconfigure services to increase productivity. There will be another A&E crisis, because A&E departments are unable to recruit enough staff, and are dependent on very expensive agency workers. There will also be a problem in hospital discharge, depicted as “bed blocking” (DTOCs- delayed transfer of care), despite investment in social care this year.
The context in which these challenges occur may determine the outcome. Privatisation has largely failed. Most entry of commercial organisation into NHS provision has been in community- services, not the hospital network (which takes 75% of the NHS budget). Private management of hospitals has been a disappointment for the marketeers, which are looking at different strategies, like sharing new facilities with the NHS. The Health & Social Care Act 2013 was meant to trigger a wave of privatisation, comparable to the 1983 ‘big bang’ privatisation of local authority and NHS care homes, but this has not happened. The privatisation of care homes haunts the Tories, because of the market’s failure to run care homes well; the ‘dementia tax’ hastily withdrawn from the 2017 Conservative election proposals shows how vulnerable they are. For all that, marketization of the NHS continues, with purchaser-provider split, targets, incentives,’ bullying’, and endless consumer satisfaction surveys impacting on everyday clinical work; a new round of PFI is even being proposed. Staffing shortages are a problem across the NHS, but are worse in the North, and in services outside the metropolitan areas. A prolonged pay freeze in a period of austerity compounds the problems of the NHS.
What could a Labour government do to restore stability in the NHS? Increased public spending may move towards sectors that have been harder hit than the NHS – social care, prisons, possibly education. Combatting waste and increasing efficiency seem desirable actions, and reconfiguring services to increase productivity is arguably in the public interest. How can the staff shortages be reduced? Could it be that Labour’s future health policy will look quite similar to its predecessor’s, but with a bit more cash?
Down the hatch?
Public health initiatives are often contested. The UK’s alcohol guidelines were reviewed last year, reducing men’s recommended intake to 14 units per week, in line with women’s intake, and moving from daily recommendations to weekly. The Chief Medical Officer, who is responsible for the guidelines, was quoted to have said there was ‘no safe level’ of drinking.
A new initiative, Drinkers’ Voice Ltd, has emerged to promote the health and wellbeing benefits of drinking alcohol. Its’ National Coordinator, Amy O’Callaghan says: “There is clearly a lack of trust in the government’s tone on alcohol advice. So much so that most people have just stopped listening to them altogether. For too long, the anti-alcohol lobby has been able to spread myths about drinking and, at the same time, choosing to ignore the health benefits moderate drinking can bring us. We think this has led to nervousness from the government who issued new guidelines last year which are among the lowest in Europe. Now, we want drinkers to have their say. Drinkers’ Voice want people across the country to join them in exposing these myths, talk openly about the benefits and risks of drinking, and bring some rationality to the debate”.
Current spokesperson for Drinkers’ Voice, Charlie Hooson-Sykes, says: “There is a culture of shame that is being promoted around alcohol which doesn’t take into consideration the positives: The celebratory elements, the community, the culture. We want to be the voice of those who like a glass of rosé on a Friday night, a glass of champagne on their birthday or a beer in front of the telly”.
Drinker’s Voice aims to become a movement of normal people talking about how drinking in moderation plays a positive role in their lives, and is seeking supporters and donations. It has interesting people in leading positions, like Henry Byron Davies, a Conservative politician and ex-police officer, who was ousted as MP for Gower in 2017. Another officer of the company, Dr William McCrea, is a consultant cardiologist in Swindon who recommends two small (125ml) glasses of red wine a day (ideally the cheaper young wine made from grapes grown on higher slopes, because of their anti-oxidant content) to his patients. Dr Richard Harding contributed to the 1995 Sensible Drinking guidelines and gave evidence to the 2012 update emphasising the health benefits of limited alcohol consumption. Colin Valentine is chairman of the Campaign for Real Ale. One of Drinkers’ Voice’s spokespersons is libertarian Josie Appleton, author of ‘Officious: rise of the busybody state’ published by Zero Books. This is a company that is well worth watching, in NfN’s view. You can find out more about Drinkers’ Voice by going to www.drinkersvoice.org.uk
New data has revealed that cases of suspected carbon monoxide (CO) poisoning in children are on the rise across the UK, with cases in the West Midlands up by 58%.
Campaign group Project SHOUT tracks the numbers of those attending A&E with suspected carbon monoxide poisoning, which has exposed an increase in the total number of cases of under 18s since 2015 throughout the UK, with more than 500 cases reported in the last year alone.
Worryingly, the number of suspected CO cases across all age groups in the West Midlands also increased by 90%.
Children are particularly susceptible to the deadly gas, also known as the silent killer, as you can’t see it, smell it or taste it. Due to their less developed nervous system, and higher frequency of breaths leading to an increased consumption of oxygen, children process carbon monoxide differently than adults and may be more severely affected by it.
To compound the issue even further, recent research from npower discovered that only 4% of parents can identify symptoms of carbon monoxide poisoning, clearly highlighting the lack of awareness of the deadly gas amongst the UK population.
Rob Lyon, campaign director for Project SHOUT, said: “These numbers are very concerning and highlight the fact that we need to do more to tackle the dangers of carbon monoxide and raise awareness of the symptoms.”
Approximately 50 people needlessly die each year from carbon monoxide poisoning and thousands more are treated in hospital.
Carbon monoxide is produced when fuel doesn’t burn properly, usually from badly fitted or poorly maintained appliances. Common sources of CO are gas and oil boilers, gas hobs and fires, log burners, open fires and BBQ’s.
Symptoms of CO poisoning are often mistaken for something else, particularly colds and flu.
Common symptoms include dizziness, headaches, nausea and generally feeling unwell.
Alarms are the only way to detect CO poisoning as you can’t see it, smell it or taste it. With two-thirds of homes unprotected by an alarm, an estimated 40 million people are at risk.
80% of residents in properties that DO have an alarm admit that they have no idea whether it works or not as they never test it.
Make sure your gas appliances are initially installed and serviced regularly by a qualified GAS SAFE registered engineer.
Know the symptoms, they are often mistaken for something else.
Get an alarm; it’s the only way to detect the deadly gas.
Know what to do if your alarm goes off.
Rural residents are more concerned about declining healthcare services than any other issue, according to the preliminary results of a wide-ranging survey.
Health topped the list of the topics of most concern to rural residents – ahead of public transport, rural housing and rural crime.
The survey of 1901 people was conducted on behalf of Rural England Community Interest Company  by researchers from the Countryside and Community Research Institute, based at the University of Gloucestershire , and in partnership with the Rural Services Network .
The survey – believed to be the largest of its kind for many years – highlighted a range of issues with health services of most concern to respondents.
Full findings are due to be published later this autumn.
However, the preliminary ‘headline’ – summary results are being published at this year’s annual Rural Services Network Rural Conference – held at the University of Gloucestershire’s Cheltenham campus on Wednesday, 6 September .
RSN chair Cecilia Motley said: “The theme of this year’s Conference is ‘The Infrastructure of Success – New Routes to Economic Growth’.
“What we mean by ‘Infrastructure’ is all those things essential to economic and community well-being.
“So we include health services and care, reliable, affordable fast speed broadband and mobile connectivity; affordable homes to meet the needs of local people; reasonable public transport; accessible training and development opportunities; good quality schools and the accessibility and affordability of all of the essential services provided by local government.
“These preliminary results are very timely to aid discussions at the Conference.
“Confirmation that health – together I suspect with Social Care – is the main preoccupation for rural communities will surprise many people who might think other issues are more pressing, as past surveys (by others) have shown.”
“This early evidence of concern about healthcare provision comes at a time when many countryside communities face the withdrawal of vital GP services, NHS Service re-configurations and general recruitment difficulties. NHS Providers are already expressing grave concerns about what they are describing as the worse winter in recent history .
“Although rural residents have other concerns – such as lack of affordable housing, poor public transport, often non-existent mobile and broadband connectivity and fears over the future of rural schools – health provision, social care and accessibility has risen sharply up the rural agenda.”
The aim of the survey was to canvass rural opinion with a view to creating, for the first time it is believed, a statistically valid representative panel of people to highlight the need for the adequate provision of rural public services and other policy issues affecting rural areas.
Largely rural shire areas score badly on some Public Health Outcomes Framework (PHOF) indicators, according to a recent report by the Rural England Community Interest Company .
This includes the provision of health checks, mental health services, access to health screening and late HIV diagnosis.
In terms of rural public transport, the survey findings come as little surprise with significant reductions in public transport services across rural areas as a result of government cuts in financial support for local government services .
And when it comes to rural housing, campaigners have long warned that high prices mean people are often unable to afford to buy their own home in the communities where they were born .
Meanwhile, a National Rural Crime Network report in 2015 warned that crime in the countryside was costing as much as £800m annually – putting further pressure on already stretched police forces .
Councillor Motley said: “There is a lot of concern among rural communities about the impact of public service cuts on services generally.
“Rural areas have always had thinner services than in other areas and funding cuts are hitting those services very hard – rural people, businesses and communities are still having a very difficult time.”
 Rural England is a Community Interest Company which brings together rural networks and stakeholders to improve the rural evidence base. It commissions, undertakes and disseminates rural research and encourages debate about its findings. For further details, visit http://ruralengland.org.
 The survey was undertaken by researchers at the Countryside and Community Research Institute (CCRI), a partnership between the University of Gloucestershire, the Royal Agricultural University and Hartpury College. It is the largest specialist rural research centre in the UK. For details, visit http://www.ccri.ac.uk.
 The Rural Services Network seeks to provide a voice for rural communities by representing rural services, networking between rural service organisations and establishing and broadcasting best practice in rural service provision. It comprises SPARSE Rural, the Rural Assembly, the wider Rural Services Partnership and the RSN Community Group. The organisation works with Rural England, a stand-alone CIC research group. For details, visitwww.rsnonline.org.uk.
 For more details about the Rural Conference, visit http://www.rsnonline.
 See “The worst is yet to come for the NHS – hospital chiefs” (BBC Online, 3 September 2017) http://www.bbc.co.uk/
 See “The State of Rural Services 2016” (Rural England, January 2017) https://ruralengland.
 See “Council cuts ‘threat’ to rural bus services” (BBC Online, 4 February 2016) http://www.bbc.co.uk/
 See “New research lifts the lid on the ‘hidden crisis’ of rural homelessness” (Hastoe Group, 10 July 2017) http://www.hastoe.com/
 See “Largest ever survey of crime in rural areas reveals an unprecedented £800m crime bill” (National Rural Crime Network, 15 September 2015) http://www.
NHS Confederation chief exec and Brexit Health Alliance co-chair Niall Dickson comments on life sciences strategy
Life sciences, the development of cutting-edge medical innovations in exciting areas like biotech and genomics, is one of the most successful sectors of the UK economy. The industry generates around £66 billion each year, is twice as productive as America’s equivalent and three times more productive than Germany’s. But we can do better still, and the NHS can play a vital role in driving Britain’s future prosperity in this area.
With the aim of making “the UK the best place in the world to invest in life sciences”, the launch of Government’s Industrial Strategy Green Paper in January was welcomed by many but the links between it and the health sector were, at best, implicit. Today, geneticist Sir John Bell publishes the Government’s specific strategy for life sciences. If this is to fulfil its potential, the NHS must be supported, encouraged and resourced to play its part.
There are four areas where action is required to make this happen.
First, it is essential that the right conditions are created to encourage NHS institutions to take part in research and innovation. A recent report by Sir Robert Naylor on NHS estates set out how NHS Trusts could be incentivised to realise additional value from their land, including by allowing the receipts of any sales to be retained locally. A similar approach could be pursued in research, with profits from discoveries shared by the NHS Trusts most heavily involved in collaborating on the development of breakthroughs. The health service can help industry evaluate and test products and adopt them at scale. Risks may be taken by Trusts but rewards shared with NHS institutions that contribute significantly to new treatments’ development and delivery.
At the same time industry and the NHS must embrace the digital future – and that means linking data between the different parts of the healthcare system. The UK’s comprehensive healthcare system could capture data, measure outcomes, and provide evidence that, in turn, could help industry market innovations across the world.
Secondly, we need a much less risk averse culture in which regulators and others at the centre are willing to support innovation. Many NHS leaders talk about a top-down “fear of failure” that prevents them from taking risks in terms of research-led, personalised care. We need a new message from the centre, signalling a greater willingness to support research.
Thirdly, if we are to retain and enhance the UK’s status as a world leader in life sciences, we will need to reflect seriously on wider investment in the health service. Too often research can be squeezed out when organisations are struggling with the day to day – the case for a fundamental review of funding is unanswerable and, without it, there are dangers to effective support for life sciences.
Finally we need to support and develop the vital relationship between our university teaching hospitals and their academic partners. Almost 20 per cent of England’s NHS Trusts are university hospital trusts, where academic, research, education and clinical work is inextricably linked. It is within university hospitals that much of the ground work takes place, and the success of the life sciences strategy will depend to a significant degree on the support of these Trusts and their partners. It is important that their voices are heard as the strategy is taken forward.
In many of our political debates about structures and processes, we tend to fight the last war, not anticipate the next one. Critically we underestimate the impact of science and technology. We must not do so now. The benefits of a greater focus on life sciences are unarguable. We need to take forward progress in key areas such as genomics and our understanding of the biology of ageing, and to use biomedical engineering to enable older people to live independently at home for longer.
A successful life sciences strategy can help us speed up the availability of new treatments, centralise and share knowledge and specialisms, better integrate trials, and address the key clinical research challenges. The real beneficiaries will be patients and taxpayers – creating a lasting partnership will help our citizens get better and get better off.
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People in the UK are underestimating the cost of elderly care by £7bn[i] every year, according to research from Scottish Widows’ independent think tank, the Centre for the Modern Family. On average, UK adults estimate that residential care would cost £549 a week – when in reality it costs on average £866 for a place in a nursing home – leaving a shortfall of £317 every week[ii].
More worryingly, the deficit could be significantly higher in reality, since one in four (25%) people admit they have no idea how they would cover these costs for themselves or a relative. Only 15% of people are saving money on a monthly basis to pay for their own care when the time comes, and almost half (49%) say they avoid thinking about the issue because it makes them feel stressed. With an ageing population and growing care costs, the nation could be facing a care funding crisis.
Families footing the bill
Instead, half (49%) of UK adults say they will have to rely on a relative to help them cover the costs. This could leave families in a difficult financial situation, particularly as more than four in ten (42%) people have £2,000 or less in life savings to fall back on, meaning they could only cover the cost of care for a maximum of two-and-a-half weeks.
Half (50%) of UK adults believe the responsibility of helping parents to pay for care should be shared between siblings. However, almost half (48%) of those over the age of 55 still haven’t discussed who will take on this responsibility in their family. With more than nine out of ten (92%) people not saving anything to help their parents or other older relatives, this could lead to a significant shortfall in support, particularly as people estimate they could only afford to spend £69 a week on care for their parents.
A lack of understanding of the benefits system could also be problematic for many. Almost one in four people (24%) claim they would need, or expect, to rely entirely on state support, but two in five (42%) admit they don’t actually understand what benefits – both practical and financial – they would be entitled to.
An over-reliance on relatives to provide financial support already has a significant impact on families. Almost one quarter (23%) of those caring for a family member say it has put a strain on their finances. One in ten (12%) have been forced to make sacrifices to cover the cost of care for themselves or a relative, with a quarter (24%) of those people making major adjustments such as re-mortgaging their house. A similar proportion (22%) have been forced to make a moderate sacrifice such as taking on a second job to cover the costs.
Supporting relatives practically and financially also puts emotional strain on families. Of those providing care, four in five (80%) say it has had an effect on them, with more than a quarter (27%) admitting it has put a strain on their close relationships. Although women are more likely to say they have less time to themselves (48%) than men (34%) when caring for a relative, men (30%) are more likely to feel their family relationships have been impacted than women (23%).
Jane Curtis, Chair of the Centre for the Modern Family and non-exec director of Lloyds Banking Group Insurance, said: “The number of people in care in the UK will almost double by 2035. Our research shows that an over-reliance on relatives and the state could put families in serious financial difficulty. It can seem difficult to know how to prepare for the future, but to avoid a financial care crisis we all need to have an honest discussion on later life care as early as possible so no one is left footing a bill they can’t afford.
“As for state provision, it’s clear that many people simply don’t understand the social care benefits and support system. Providing clarity and raising awareness of what is and isn’t available is critical to helping people prepare for the longer-term future.”
i) We calculated based on underestimated price of residential nursing care per week (£317) (£866-£549) multiplied by current number of UK over-65s in care (421,100 according to the latest Laing & Buisson and detailed in Age UK’s ‘Later Life in the UK, August 2017’ report) including with nursing and multiplied by 52.
[ii] According to regional cost figures from Laing & Buisson Care of Older People, including England, Wales, Northern Ireland and Scotland:
|Adult population||Cost of care home with nursing per week||Amount spent in total||Percentage of national spend|
|All of UK||51,767,000||£866||£44,830,222,000||100%|
|Yorkshire and Humberside||4,270,777||£755||£3,224,437,013||8.25%|
A Newcastle University study claims that rapidly rising numbers of older people with substantial care needs will create a requirement for 71,000 extra care home places by 2025. The research – Is late-life dependency increasing or not?- was published in the Lancet on 15th August 2017
The study raises concerns about how the new places will be paid for and estimates that within four years £940 million will be required for social care in England. “If dependency prevalence remains constant, we estimate that by 2025 there will be an additional 353,000 older people with substantial care needs,” according to the project leader, Professor Carol Jagger. “While many of these people will live in the community, at current rates of provision this will mean a shortfall of more than 71,000 care home places by 2025. Our findings have considerable implications for relatives as older people will have complex needs, requiring sustained input from family carers or social care teams to support independent living.”
The number of years spent with substantial care needs for adults aged over 65 nearly doubled between 1991 and 2011, increasing from 1.1 to 2.4 years for men, and from 1.6 to 3 years for women. Sir Andrew Dilnot, a leading economist who led a government-commissioned review of social care funding, said spending on the care of older people would need to “increase substantially and quickly, although this increase does not mean that every individual will need large amounts of care.”
Commenting on the study, Nick Sanderson, CEO of Audley Retirement, said: “Britain’s ageing population brings with it significant societal challenges. High amongst the worries faced by this group is the question of later life living and the possibility of needing care. Both the NHS and local authorities are struggling to cope with the mounting pressure and traditional care packages are coming under increasing strain. Many people would ultimately prefer to remain at home as they age so it’s crucial we facilitate the development of housing that allows them to do this. High quality retirement properties with care available as and when required prepares people for changes to their health whilst enabling them to maintain their independence. There may be no simple answer to how we deal with the creaking care system, but we know the retirement village model is one that works, and we have a responsibility to drive that forward.”
It’s been a tough few weeks for the NHS, criticised over its legacy IT systems, alleged weakness to cyber-attacks and constantly under scrutiny for its spending and investment decisions. Yet, even with these high profile challenges in mind, no-one can deny it’s one of the UK’s most treasured and relied-on organisations. Our National Health Service plays a vital role in the nation’s health by providing free critical care to all regardless of background or income, even though its doctors and nurses face major budget and resourcing constraints each and every day.
The organisation is under major pressure to improve the quality of its services and financial management, even against a backdrop of financial constraints. Even with stretched budgets and challenging economic conditions, the NHS must make further investments in digital transformation programmes in order to deliver a fully rounded quality patient service and cut growing costs.
A House of Lords committee recently backed the Government to make technology uptake an ‘urgent priority’. As an organisation delivering vital services on a national scale, the NHS has already seen pockets of benefits from investments in bold initiatives to improve diagnoses and treatments, such as big data analytics, artificial intelligence (AI) and the Internet of Things (IoT). However, the pace of IT adoption across the health service has varied from trust to trust, and even across departments within trusts, which means achieving consistency across the country has long been a challenge.
With that in mind, this feature will investigate how the NHS can improve patient care through technology without compromising its values as an organisation that’s free and open to all. Additionally, I’ll take a look at what a truly digital NHS could look like and how this would improve patient services in terms of accessibility, availability and engagement with treatment plans and wider services.
Building a multi-channel health service
There are already ambitious plans in place for improving the NHS through the use of smarter IT and increased access to technology. The government has also initiated its policy to make the service ‘paperless’ by 2020, ensuring all documents are digital to improve the flow and consistency of patient information.
It was also recently announced that the NHS was investing in a new AI-powered ‘chat-bot’ service to provide support and information for mothers. This interactive resource will provide 24/7 access to approved guidance around breastfeeding, reducing the time spent on phone lines and relieving pressure on the health service, whilst ensuring mothers are given the information they need.
As some of you may already know, the first few months of parenting are typically awash with anxiety, late night trips to the hospital or frantic phone calls asking for advice and guidance. This rush for information – from breastfeeding advice to treating colic – is never ending and can require 24-hour support.
Of course, nobody wants to be making regular trips to the local hospital, so this chat-bot service provides a digital-first solution with advice, guidance and reassurance at a user’s fingertips. This new service provides cost-effective around the clock support, while also preventing unnecessary hospital visits and reducing waiting times on inbound calls into the NHS helplines.
Driving NHS IT forward
Recent research from Nuance also revealed that nearly half of NHS Trusts (43%) are investing in artificial intelligence (AI) technology, to enable patients to ‘self-help’ when accessing services. This new data, obtained under the Freedom of Information (FoI) Act, revealed that many NHS Trusts are considering harnessing technology – such as virtual assistants, speech recognition technology and chat-bots – to ease the pressure on healthcare workers across their organisations.
The research also revealed a developing approach to mobility. Nearly half (47%) of trusts now permit staff to work ‘on the go’ using mobile devices to more efficiently complete tasks such as developing patient records, saving those working in the community valuable travel time and expense.
An intelligent future
AI and chat-bots are clearly the latest buzzwords in the technology industry, but for the NHS, the power of these technologies could mean much more than just implementing ‘gimmicky’ new tools at a reduced cost. This technology has the potential to transform the wider NHS, supporting patients to self-help, as well as helping doctors with suggested diagnoses or long-term care proposals.
We are in an age in which citizens, customers and patients are all seeking the ability to self-help, to self-diagnose and to self-determine. Our NHS can meet these objectives by investing in intelligent technology that not only saves doctors, nurses and healthcare professionals vital time, but that also truly puts patients in the driving seat when considering their health and overall wellbeing.
Frederik Brabant, MD, Chief Medical Information Officer at Nuance
Due to people beginning to live longer in Britain, their health needs become more specific, meaning they need a certain type of care that will guarantee they live the best life possible. What this means, is that care homes need to use greater amounts of, and more intelligent, assistive technologies.
Greater living environments will need to be created for patients who need long-term care. This will ensure that patients are cared for appropriately when those in care require increasing amounts of supervision and attention.
Focusing on quality
Quality of care homes will be the new focus of those that are funded privately and through social care within the next 20 years. This is because it has been suggested that this strategy has the potential for people to ‘live healthier and longer lives’, as Jane Ashcroft suggested in the Silver Chic report in the future of care homes.
Design of care homes will remain important. For example, to help residents to be exposed to sunlight for the longest periods of time possible. As well as this, connectivity will also be a priority to help combat loneliness. To do this, care villages will use small bridges intersecting various gardens so that residents will closer to both their natural environment and other residents within the community.
Evolution of technology in our care homes
Royal Blind – specialists in care homes for the blind and care homes in Paisley – has assessed how care homes will be run in the future, and the technologies that will revolutionise the way people are cared for.
Technology is becoming more advanced as quality within our care homes becomes a priority. It is helping to ensure that patients remain safe within care homes while allowing them to live longer, healthier lives.
To help those living with dementia, clusters within buildings can be coloured variously with different lighting so that they are able to recognise their own living quarters. These types of technologies then, are specifically designed to ensure patient comfort, and help to guarantee their safety while living in care. Also care homes are now beginning to utilise sensors in rooms and systems within the building that alert staff when a patient has fallen, or when they have stopped moving.
Independence within the care home
To ensure that people within the care system feel independent, technology that is continuously improving will help residents live in a more self-sufficient way and will help with their specific needs.
Current technology can help monitor steps taken and the distanced travelled, as well as the heart rate of a patient. In the future, they will help to monitor fluid retention and respiratory rates, helping to lower hospital admissions, allowing patients to understand their own symptoms more effectively before they require medical assistance.
Robotics in care
Robotics will help calm down dementia sufferers who have to deal with extreme stress, used through robotic pets that can respond to human touch and respond in intelligent way.
Robots will be used to carry out general tasks that need to be carried our daily, whereas wearable robotic suits will help patients who suffer from arthritis to stand and walk. Giving them a better quality of life within the care system.
To make life easier, tasks that might be difficult will all be robotically controlled. Controlled curtains alongside voice commands that also control lights and other devices will be used to help those who are blind and have visual impairments. Care homes will be improving for both patients, their family and the staff that work within the home. The technologies that are already being utilised, and the systems that are being proposed, will help patients lead more independent and comfortable lives so that they can live a happier and healthier life for longer.