Results for 'financing'
UNITED KINGDOM HOMECARE ASSOCIATION
Drawing on data obtained from freedom of information requests, this report analyses average prices paid by councils for home care services across all four administrations of the United Kingdom. It also provides a breakdown by England’s nine government regions. The data were obtained during a sample week in April 2016 following the introduction of the new National Living Wage. The analysis found that only one in ten authorities paid an average price at or above UKHCA’s minimum price of £16.70 per hour. It also found that seven authorities paid average prices which the UKHCA believe are unlikely even to cover care workers’ wages and on-costs of £11.94 per hour. Only 24 councils had completed calculations for the costs of home care. The report highlights the low rates that many councils are paying independent and voluntary homecare providers. It argues that this underfunding is a root cause of the instability of local homecare markets and the low pay and conditions of the homecare workforce. The analysis also exposes the level of risk that councils place on a system intended to support older and disabled people. The report makes a number of recommendations, which include the need for local authorities to provide calculations of their costs of homecare.
Implementation plan which outlines a roadmap for delivering the commitments made in the Five Year Forward View for Mental Health to people who use services and the public in order to improve care. It prioritises objectives for delivery by 2020/21 and is intended as a blueprint for the changes that NHS staff, other organisations and other parts of the system can make. Key principles of the plan include co-production, working in partnership with local public, private and voluntary sector organisations; early interventions and delivering person-centred care. The plan also gives a clear indication to the public and people who use services what they can expect from the NHS, and when. It also outlines future funding commitments, shows how the workforce requirements will be delivered in these priority areas, and how data and payment will support transparency. Separate sections cover: children and young people’s mental health; perinatal mental health; adult mental health – including community, acute, crisis care and secure care; mental health and justice, and suicide prevention. These individual chapters set out national-level objectives, costs and planning assumptions. Chapters also describe cross-cutting work to help sustain transformation, including testing new models of care and ensuring the health and wellbeing of the NHS workforce.
ERNST AND YOUNG
In this report, commissioned by the Local Government Association, a journey towards better health and care for individuals is set out; driven by local system leaders and supported by a more empowering and enabling system. The report has been developed through: a review of existing literature published by partners, charities and research organisations; four workshops with the LGA and partners to define the vision, understand the system barriers from a range of perspectives and describe the required changes; and further discussion with regional contacts and the Health Transformation Task Group to sense check that barriers and key considerations are locally relevant and reflect the experience in local areas. Section 1 sets out a vision for better care and support, arguing that a reformed system needs to deliver: better health and wellbeing more equally enjoyed; better choice and control for all; better quality care, tailored for each person; and better outcomes for each pound spent. Section 2 focuses on key barriers preventing the achievement of a reformed system. These include: creating dependency through the way treatment is provided; chronic underfunding of the system and a lack of capacity to transform; fragmented commissioning incentivising treatment over demand management; and national regulations that disempower local areas. Section 3 sets out four steps to better care, which are: put people in control; fund services adequately and in an aligned way; devolve power to join up care, support and wellbeing; and free the system from national constraints. The report concludes that collectively these steps will enable localities to address challenges, deliver a better system and ultimately drive better outcomes and greater sustainability for all.
GREAT BRITAIN. Department of Health, et al
This report summarises the initial findings of a review developed in co-production with the statutory and voluntary sectors, exploring how the sector could: maximise and demonstrate its impact; build sustainability and capacity; promote equality and address health inequalities. From January to March 2015 around 4,500 people and organisations were consulted, sharing their views on the current state of the statutory and VCSE sectors, the key challenges they face, including reduced funding, and the potential of the sector, particularly in relation to equality and health inequalities, prevention and resilience, and personalisation and co-production.
ASSOCIATION OF DIRECTORS OF ADULT SOCIAL SERVICES
An analysis of the state of adult social care finances, providing in-depth intelligence on how adult social care is responding to the twin challenges of meeting increased demand and managing reducing resources. The survey seeks to explore the views of Directors of Adult Social Services across English Local Authorities on how councils are reconciling the growing numbers of people, often with increasingly complex needs, requiring care and support with the significant and sustained reductions in the funding available. The survey data sets out the concerns of councils in making increasingly difficult choices and the attempts to minimise impacts upon front line services. The report suggests that taking the growth in numbers of older and disabled people into account an additional £1.1 billion would be needed to provide the same level of service as last year. The care provision market is becoming increasingly fragile and 56 per cent of directors report that providers are facing financial difficulties. Many local authorities are going to have to pay more if providers are to be able to attract workers as unemployment falls. While directors see increased prevention and integration as their top two areas for savings for this year, next and beyond, many are struggling to balance investment in reducing future demand and costs at a time when budgets to meet existing statutory duties to provide care and support to those most in need are under such pressure. The paper calls upon the Government to urgently ensure that social care funding is protected and aligned with the NHS, including making provision for the social care funding gap alongside the funding gap for the NHS.
ACEVO. Taskforce on Prevention in Health
This report sets out a number of recommendations aimed at shifting focus and investment towards the provision of integrated, preventative care and support. It looks at three key areas: changing the culture and practices at the local level; changing national-level frameworks and incentives; and the role of long-term investment in driving transformation. The report calls for a ‘prevention revolution’, in which preventative support, advice and treatment is fully integrated into all stages of the care pathway, with the aim of addressing the wider determinants of ill-health, supporting people to manage long-term conditions more effectively, and providing treatment and support in community settings wherever possible, reducing the need for treatment in acute settings. Throughout the report, there is an emphasis on the role played by voluntary organisations in: providing preventative, holistic care in community settings; fostering innovation; strengthening patient engagement; and catalysing cultural change.
This report focusses on meeting the needs of working-age disabled adults as health and social care services are increasing integrated. It provides an empirical evidence base to demonstrate how whole person care (which is about making the connections between physical health, mental health and social care services) can be used to effectively meet these needs. The report also draws on the findings of a focus group with 12 disabled adults and carers on desired outcomes from the integration of health and social care services. Interviews with social care and voluntary sector professionals, commissioners and local authority policy to see if they are willing to include working-age disabled adults' needs in plans for future integration. The report looks at how working-age disabled adults have different needs and outcomes from older people and identifies the health inequalities they face in day-to-day life. Ten dimensions of health inequality are identified including housing, employment, financial security and quality of life. The report makes seven recommendations to inform the service response, including: taking a long term view of managing long-term conditions, viewing whole person care as a 10-year journey with matched by stable funding; debates on funding gap in social care should give consideration to the needs of working-age disabled adults; shifting resources from case management to community coordinated care to support prevention and providing a single point of contact for health and social care needs; service integration should take place across a much wider range of services to meet the needs of disabled people.
This guide sets out the issues that need to be considered when developing a business case to invest in preventive services and to ensure that any decision are based on robust and reliable data. The guide focuses on the following arguments: the importance of 'investing to save', arguing that prevention is cheaper in the long term; promotion of service innovation; placing the focus of commissioning on outcomes rather than outputs; and managing a shift in spending from acute to prevention to reduce demand over time. The guide outlines key four activities required to build a business case: understanding needs; understanding current costs; assessing possible interventions; and deciding how to measure the value and outcome of the interventions. It also provides a summary business case for prevention and using a Social Impact Bond (SBI) to finance a business case for prevention. An example case study of making a business case for prevention services in early years services in Greater Manchester is included.
NATIONAL INSTITUTE FOR HEALTH RESEARCH. School for Social Care Research
A scoping study investigated approaches to prevention services in local authorities which enable older people to retain their independence for as long as possible to maintain their quality of life and reduce pressure on local authority and NHS budgets. The study involved a survey of Directors of Adult Social Services in 9 local authorities to identify what they viewed as their top 3 investments in prevention services for older people, and interviews with lead managers for each intervention. It also reviewed local and national evidence as to whether these interventions lead to a delay or reduction in uptake of social care services This paper summarises the key findings from the research. It explains that the top 3 interventions were reablement (a top 3 approach for all of the local authorities surveyed), technology-based interventions (among the top 3 interventions in 6 authorities), and information and advice (among the top 3 in 3 authorities), while a number of other prevention interventions were identified by one local authority each. It reports on how local authorities seek evidence and guidance on prevention services and factors influencing how local funding was spent, and on assessment of the outcomes and impact of prevention interventions. It also summarises national and local evidence for the top 3 interventions.
BUCKINGHAMSHIRE COUNTY COUNCIL
Sets out a prevention-focused model of adult health and social care services which place emphasis on maintaining people’s independence and resilience; preventing deterioration into substantial or critical categories of need. The document outlines the current system challenges, the existing lack of joint working between sectors and services, a reactive approach to creating support services and networks and a lack of confidence or capacity to innovate and invest in prevention without an evidence base or business case. It then presents a framework for building the evidence for investment in prevention, proposing a measurement methodology and a definition of the target user group and of outcomes and impact. The document puts forward a new prevention-orientated service model, identifying the high‐level functions, which are shared by different agents and delivery mechanisms, on which the model rests. These are: intelligence and knowledge about the effectiveness of prevention‐related activities, bridging and building networks between formal and informal service delivery, connecting people, maximising existing resources and motivating and enabling. The document examines the core components of the model, which include an intelligence hub, a volunteer hub, community links officers, and community prevention officers. Funding and implementation considerations are also included.