Archive for March, 2013

Prisoners ‘will care for older cellmates’ to tackle burden caused by growing number of elderly convicts

  • Prison population of over 60s more than double 2002
  • Experts say younger offenders could gain skills

Young prisoners could become carers for their cellmates in order to tackle the burden of elderly inmates.

The number of convicts aged over 60 has more than doubled since 2002, but few prisons have the staff to care for them.

Experts believe younger offenders could become carers, gaining valuable skills.

One prison already operates a ‘buddy scheme’ in which inmates clean and collect meals for older prisoners.

Eoin McLennan-Murray, president of the Prison Governors Association, said: ‘It is the most cost-efficient way of offering support.’

Ministry of Justice and Whitehall sources confirmed the option is being considered.

The number of prisoners over 60 has risen 142 per cent in ten years, reaching 3,333 in 2012, and prompting a Justice Select Committee inquiry.

MPs will investigate whether elderly prisoners’ treatment ‘complies with equality and human rights legislation’ and if a national strategy for their treatment should be established.

Read more: http://www.dailymail.co.uk/news/article-2301705/Prisoners-care-older-cellmates-tackle-burden-caused-growing-number-elderly-convicts.html#ixzz2P7uicCqT


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One grey, rainy London afternoon, my 11-year-old son arrived home from school with his shirt torn and hair matted. There was a sign sticky-taped to his back. It read: ‘Kick me, I’m a retard.’

I ripped it off in fury as a tidal wave of frustration and pity surged through me. ‘The other kids called me a moron,’ he whispered, his wide blue eyes filling with tears. ‘What does that mean? Am I a moron, Mum?’

Trying to protect a child with special needs from being bullied is like trying to stop ice melting in the desert. There were calls to the school, meetings, promises of closer scrutiny in the playground. But basically, when it comes to it defeating bullying — particularly when your child is an obvious target — is like leading the charge with a butter knife.

New research, published in the Archives of Paediatrics and Adolescent Medicine this week, suggests more than half of teenagers with an autism spectrum disorder are bullied at school, compared with an estimated 11 per cent of children in the general population. It also reveals that the problem is largely ignored.

This certainly chimes with my experiences. My son Julius (Jules) was diagnosed with autism aged three. Autism is a life-long neurological disorder, chiefly characterised by an inability to communicate effectively, plus inappropriate or obsessive behaviour.

Not getting a joke, not knowing what to say, then saying the wrong things, being told off but not understanding why, doing your best but still getting it wrong, feeling confused, left out, frightened, out of synch, all day, every day, that is the reality of life for someone on the autistic spectrum.

What some people don’t know, however, is that the condition is also often linked to a very high IQ. My son walked and talked early. In fact, family and friends thought him ‘advanced’. So you can imagine my shock when, at about 14 months, Jules just lost his language skills. His brain was like a computer which had crashed.

When the paediatrician made his diagnosis, I felt a powerful, overwhelming ache of love. It was my job to stop Jules from tumbling through a hole in the world, like Alice.

My first reaction was denial. I virtually bankrupted myself ricocheting around the country seeing every available expert, all swishing in and out of doors in their white coats.

I tried everything, from karma maintenance to cranial massage. My son had so many expensive tests, I hate to think how many doctors’ children I’ve now put through university.

My next overpowering emotion was guilt. Although equally loving and supportive, fathers are better at compartmentalising. But a mother’s guilt gland throbs. Was it something I ate while pregnant? Was it the one glass of wine I drank in the final trimester? Was it something I should have eaten or drunk? Like feng- shuied organic beetroot perhaps?

After intense speech therapy, Jules started talking again when he was four. For years, experts had been telling me that he was having something they termed ‘global delay’ — a so-called pause in his development and communication skills.

Yet I always found him to be bubbling with the most intriguing questions: ‘If onions make you cry, are there vegetables that make you happy? Is a harp just a nude piano? What is the speed of dark? Is a vacuum cleaner a broom with a stomach?’ was a typical daily onslaught.

All the doctors with their stethoscopic minds couldn’t really diagnose my son. But by the age of five, the word ‘Asperger’s’ had begun to be bandied about.

‘Asperger’s is a form of autism, but at the high-functioning end of the spectrum,’ it was explained to me — at the cost of £245 an hour. ‘People with Asperger’s are often of above-average intelligence. They have fewer problems with speech, but still have difficulties understanding and processing social situations.’

I burst with optimism. It felt like getting an airline upgrade or a prison reprieve, but my euphoria was short-lived. Every expert agreed on one point: only in a small classroom with specialist teaching, protected from bullying, could Jules ever reach his potential.

Doctors, nurses, teachers, therapists, social workers, and educational psychologists all agreed that this was the case, but getting the necessary help proved a postcode lottery. The waiting lists for help in my inner-city London borough were terribly long.

When he was five, I had my son ‘statemented’, which means he had a certificate of special needs from the education department, who promised to ‘fulfil his educational requirements’.

I soon learned to decode this spiel too: an educational ‘statement’ is really just an adroit piece of jargonised sophistry which promises much but delivers little. The system is designed with bureaucratic speed-bumps to slow down a parent’s progress.

I filled in forests of forms and saw squadrons of psychologists. The technical term for this process is ‘being passed from pillar to post’. I know families who have lost all their savings appealing in the courts against a council’s decision not to fund a child’s placement to a special school.

My son was eventually ‘mainstreamed’ in a local state infants school, with the support of a very kind, albeit untrained, helper for a few hours a day.

It was woefully inadequate. Putting a child with special needs into a mainstream school is as pointless as giving a fish a bath. Being told off for laziness or chastised for disruptive behaviour, put on detention for failing to understand homework and being constantly belittled by peers — the day-to-day life of a child with special needs in a normal school — means it becomes little more than a master class in low self-esteem.

Kathy’s new book, written with her son’s permission, explores autism from the mother’s point of view

Overworked teachers treated my son as though he was a feral creature recently netted in the Amazon and still adjusting to captivity. And pupils taunted and teased him.

Most children at school strive to master maths and grammar. Children with special needs strive to make themselves invisible to avoid notice. Although by the age of eight, Jules had an encyclopaedic knowledge of tennis, the Beatles, Buddy Holly and Shakespeare, including being able to quote most of Hamlet, the only subject at which he excelled in school was ‘phoning in sick’.

Bullying made school unbearable for him. Most mornings, I had to drag him, shrieking and punching, out of his pyjamas and into school. We always planned to leave the house by 7.15am — but, like clockwork, we were usually out the door by 8.35am.

My son hated school so much, he often just wouldn’t get out of the car. Would it be excusable to call the fire brigade to cut my son out of the car I wondered, slumped on the curb with my head in my hands, Jules welded to the seat within.

‘Only fish should be in schools. It’s a prison for children. How can you make me sit in that torture chamber all day?’ I can remember the mixture of bafflement and betrayal contorting his ten-year-old face into a mask of dismay as he struggled to rationalise our daily battles.

The one person he trusted was forcing him into a place where he was ridiculed for being different and beaten up so badly that on one occasion he needed stitches in his head. The incident was brushed under the carpet as ‘accidental’.

How I envied the normal worries of other mothers, who fretted over sugar content in cereal, how to make broccoli interesting and why their offspring wouldn’t eat anything which hadn’t danced in an advert on television.

The parent of a special needs child has to be their legal advocate, fighting his or her educational corner; a full-time scientist — challenging doctors and questioning medications; an executive officer — making difficult decisions on their behalf; and also, it emerged, their full-time bodyguard against bullies.

Secondary school didn’t improve things. My son called his school ‘Guantanamo Bay’. It would take me an hour to haul him out of bed, and only then with a mixture of cajoling, begging, pleading and blackmailing. By screaming till the paint peeled off the walls, I could usually half stuff him into his uniform, but not before he’d trashed his room in the process.

My ‘brilliant’ mothering skills became strikingly apparent when I would then run back to my room and sob into my pillow. Eventually, I would summon up the strength to drag him, as he cursed and cussed, to his school gates, before dashing to work, distraught and dishevelled and Panda-eyed from mascara leakage.

The daily ordeal left me more depleted than Our Lady of Put Upon and Exhausted — the patron saint of mothers of children with special needs.

But Jules’s anxiety was understandable. Venturing out of the house when you have special needs can feel as hazardous as Scott leaving his Antarctic base camp. It’s no wonder that the hardest thing for parents like me is to stop mollycoddling.

All through his teens, I didn’t once let my son leave home without a long list of instructions and enough supplies in his backpack to set up a comfortable wilderness homestead. I was so overprotective that my friends and family would often joke that they couldn’t believe I’d ever let my son out — out of my womb, that is. Even now, whenever my darling boy walks out the door, you’d think he was emigrating.

The fuss, the worry, the long hugs and heart-felt goodbyes. But how will you ever know if your child can cope in the outside world, if you never let him out into it?

When I read about the horrific fates that have befallen other young men with Asperger’s — the tragic death of Steven Simpson, who was sprayed with fake tan and set on fire at his 18th birthday; or the autistic boy known as ZH who, in 2008, was falsely imprisoned and shackled by the police for jumping into a swimming pool fully clothed — my paranoia seems justified.

After my son was mugged at knife point aged 14, I happened to read a newspaper article which contained this comment from a police officer: ‘People with special needs are routinely targeted. I’m afraid it’s the price of disability.’

If this is the price of being born ‘differently abled’, then the price is way too high. The only way to eradicate bullying is to encourage society to be more accepting. I no longer think of people as ‘normal’ or ‘abnormal’ but ‘ordinary’ and ‘extraordinary’.

And I adore my extraordinary son. Despite all the angst and exhaustion, he has brought such joy, humour, love and compassion into my life. And also wonder. Jules is Wikipedia with a pulse. People on the autistic spectrum have a lateral, literal logic which is vivid, hilarious, honest and original. My son is one of the most interesting people I have ever met.

Since he was a little boy, he has kept me on my mental toes by asking me the most tangential questions. The latest: ‘The American constitution says you must pursue happiness. But how do you know when you’ve caught it?’ And ‘Why is there no other word for synonym?’

With my son’s blessing — Jules is now 22 — I have written a novel called The Boy Who Fell To Earth to help destigmatise autism. The book is about a single mother’s rollercoaster ride of raising a child with Asperger’s.

It’s basically The Curious Incident Of The Dog In The Night-Time — Mark Haddon’s famous book which told a tale through the voice of a teenage boy with Asperger’s — but from the mother’s point of view.

While based on my own experiences, the book is also a tribute to all the plucky, inspirational parents I’ve met who’ve shared with me their battles against bureaucracy and bullying. We now know, with diagnostic hindsight, that Mozart, Einstein, Van Gough, Warhol, even Jane Austen’s Mr Darcy, were on the autistic spectrum.

Julius tells me that my novel is a ‘celebration of idiosyncrasies, eccentricities and being different’.

And he’s right. Because how tedious it would be if we really were all the same — a case of the bland leading the bland.

Kathy Lette’s novel The Boy Who Fell To Earth is published in paperback by Black Swan on April 11 at £7.99. Kathy is an ambassador for the National Autistic society and Patron of UK Autism Charity of Anna Kennedy online. © Kathy Lette. 2013.


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Shock dementia findings are not a surprise, says charity

DEMENTIA care in North Somerset is not good enough, according to health inspectors.

The Care Quality Commission (CQC) undertook a nationwide review last year and dementia patients in North Somerset were found to have a significantly increased chance of being admitted to hospital than non-sufferers.

Nationally, dementia pat- ients in 78 of the 151 local NHS areas were found to be more likely to be admitted to hospital from their care homes, than people without the condition.

A spokesman for disability charity Vitalise said it was a ‘terrible indictment’ of the UK’s care system.

Latest figures from the Alzheimer’s Society in February 2012 showed that North Somerset could have as many as 3,300 dementia sufferers, with up to half unaware they have the condition.

The region is in the bottom 15 per cent nationwide in terms of improving its diagnostic rate.

Rob Heal, whose father Brian suffered from the illness and used to live in the specialist Poppyfields care home, said he was ‘angry and upset’ politicians and councillors do not do more to help dementia patients.

Brian Heal died, aged 73, less than a year after moving from Poppyfields in Worle when it was closed by North Somerset Council for financial reasons in 2010, despite thousands of people signing a petition against the decision.

Rob said: “There he had one-on-one care and he always had the specialised care he needed.

“When he moved to another nursing home he had about eight carers. To him they were a load of strangers and he was frightened of them because they kept changing.”

Rob said nine of the 11 residents at Poppyfields died within a year of the home’s closure and he believes that shows how important specialist dementia care is.

The CQC report also said that in a third of dementia admissions, UK hospitals had no medical notes detailing the patient’s condition on arrival.

The Vitalise spokesman said they were shocked, but not surprised by the CQC’s findings.

He said: “One of our own studies showed that six out of 10 carers suffer huge feelings of worry and guilt at the prospect of sending their disabled, frail or elderly loved ones into residential care even for just a few days’ respite, and that the issue of quality of care is the cause of their fears.

“Sadly, carers’ fears are quite justified and it’s not surprising that many family carers would rather struggle on at home, risking their own health in the process, than entrust their loved one to residential or respite care.

“They simply have no confidence in the care system.”


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High quality of care

A Swindon care in the home company, which has been in business for less than 18 months, has received a glowing report from the watchdog that is charged with maintaining high standards in the industry.

Bluebird Care, which is based in the historic railway quarter of the town, was found to be achieving all the necessary standards in the areas checked by the Care Quality Commission, including the care and welfare of its customers.

Other areas checked included the standards of staffing and of management.

The unannounced inspection was carried out in February, when the Commission spoke to relatives of elderly people who are using Bluebird Care.

The report praised the company, saying: “The relatives told us that the carers were always polite and respectful.

“One relative said that they couldn’t wish for a better service and it was ‘absolutely brilliant’ and an ‘excellent service’.”

The report added: “People were supported to make decisions about their care and their day-to-day lives. They were also supported to be as independent as possible.”

Ben Curtis, managing director of Bluebird Care – which is also in contention for a Customer and Staff Care Award in the finals of the Wiltshire Business Awards – said he was delighted with the report from the Care Quality Commission.

“Although we are a relatively new business, we have always put our customers at the heart of all we do, and pride ourselves on providing them with a good, old-fashioned service,” he said.

“We welcome the rigorous standards set by the Care Quality Commission and the fact that we are able to meet, and exceed, them is down to the dedication and hard work of the team of care workers we have, who do such an excellent job.”

Bluebird Care Swindon is currently recruiting more staff in order to be able to expand its service.

For more information, people can contact Ben Curtis on 01793 698033 or email swindon@bluebirdcare.co.uk


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Despite the widespread nature of dementia, many sufferers still live in silence

The Alzheimer’s Society guide is intended to help prevent tens of thousands of sufferers being placed into care too early when they could be looked after at home.

The advice for sufferers and their families includes researching the disease thoroughly, talking to friends and relatives and finding out what local services and financial support are available.

Research shows that the vast majority of people with Alzheimer’s want to stay in the comfort of their home for as long as possible.

But in many cases their carers – nearly always spouses or family members – are simply overwhelmed.

Many people living with dementia have been forced to leave their safe havens, which is unacceptable Jeremy Hughes, chief executive

Alzheimer’s Society chief executive Jeremy Hughes said: “Home means something special to all of us.

“Many people living with dementia have been forced to leave their safe havens, which is unacceptable.

“By seeking support early, people living with dementia may avoid reaching a crisis point unnecessarily which results in them moving into long-term care.”

Many families suffer in silence without realising there are scores of organisations that offer support and that they may be entitled to financial help even if they have savings or a regular income.

This lack of awareness means that one in 10 people living with dementia in Britain ­– nearly 60,000 people – is moved into care prematurely.

The society’s guide urges newly-diagnosed sufferers and their families to visit an occupational therapist and consider a home support package.

Its recommends that those living with the condition eat well, take their medicine and stay physically, mentally and socially active with regular activities and hobbies.

The experts also urge sufferers to stick to a routine and to plan ahead so they are happy with arrangements for their future.

Some 800,000 people in the UK have dementia – including more than half with Alzheimer’s – at a cost to the economy of £25billion a year.

The number of sufferers is expected to rise to a million by 2022.

Experts believe the condition, for which there is no cure, is caused by a build-up of toxic plaque inside the cells of the brain. Existing treatments attempt to slow the rate of mental decline but can have debilitating side-effects, including severe headaches, nausea and fatigue.

Last night the Alzheimer’s Society received a boost after it was revealed that retail giants Argos and Homebase would support the charity for the next two years.


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Skills for Care and Skills for Health have launched the Code of Conduct and National Minimum Training Standards for Healthcare Support Workers who report to nurses or midwives and Adult Social Care Workers in England.

The long awaited Code describes the standards of conduct, behaviour and attitudes that the public and the people who need healthcare, care and support services should expect of workers. The National Minimum Training Standards define the minimum knowledge workers must have, irrespective of individual job role. Both the Code and the Standards were created after extensive consultation with employers and workers across both sectors to make sure they were fit for purpose.

The two Sector Skills Councils were commissioned by the Department of Health following the Secretary of State’s speech to the NHS Employers conference on 15 November 2011, where he announced that the Government’s intention was to commission work to develop a Code of Conduct and minimum standards for education for support workers.

This Code of Conduct is based on the principles of protecting the public by promoting best practice. It will ensure that support workers covered by the code are working to defined standard’s, providing high quality, compassionate healthcare, care and support.

The new minimum training standards focus on 10 areas that are designed to cover the key knowledge for health and care workers and set out what should be covered during a period of induction in the first weeks of employment:

1. The roles of the Healthcare Support Worker and Adult Social Care Worker

2. Your personal development

3. Effective communication

4. Equality, diversity and inclusion

5. Duty of care

6. Safeguarding

7. Person-centred care and support

8. Health and safety

9. Handling information

10. Infection prevention and control

The Standards correspond to the underpinning knowledge within the Core Competences for Healthcare Support Workers and Adult Social Care Workers in England.

Care and Support Minister, Norman Lamb, said: “The new Code of Conduct and National Minimum Training Standards will help to improve standards of care by ensuring all support workers have the right skills required for their role.

“People who use these services expect the staff looking after them to provide safe and compassionate care and this is yet another step towards the better standards everyone expects.”

Skills for Care CEO Sharon Allen said: “It is absolutely critical that people with care and support needs know that the workers providing this care and support are trained to a high standard in key areas. These standards define the minimum any worker should know. Equally people who may have loved ones needing care and support need to know that workers have the right level of knowledge in the right place at the right time to provide high quality, person centred care and support. The key strength of these new standards is that they were created after a huge consultation with employers and workers across our sector to make sure they can put them into practice in thousands of workplaces and communities.”

Skills for Health CEO John Rogers said: “We are delighted to be publishing the Code of Conduct and National Minimum Training Standards. The Code should give the public, and people who use health and social care services confidence that these support workers will provide safe and compassionate care of a high standard. Following the Mid Staffs inquiry it is vital that we do everything we can to rebuild public trust in the standards of healthcare provided.

“Using the National Minimum Training Standards will ensure that new healthcare support workers who report to nurses and midwives working in England will have the key knowledge and understanding required for their role from the start. What has also been very rewarding is the successful collaboration between stakeholders in health and social care sectors to develop standards that are applicable across both sectors. We would like to thank all those who contributed to the consultation process and especially those who worked with us on the project groups.”


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Social care ‘star ratings’ set to return after review gives backing

Aggregate ratings for social care services, delivered by the CQC, would fill public information gap on care quality and boost choice for users, finds review commissioned by government.

Aggregate ratings of adult social care services delivered by the Care Quality Commission are set to return after winning backing from a government-commissioned review.

The reintroduction of an overall rating for services, scrapped to sector dismay in 2010, would fill a “clear gap” in the provision of trusted information on the quality of individual care services, enhance choice for families and potentially increase performance, found the review by think-tank the Nuffield Trust.

The independent review, which also covered health, was commissioned by health secretary Jeremy Hunt, who publicly supports the reintroduction of ratings, but wanted the costs, benefits and practicalities of doing so investigated. The review’s support, alongside that of Hunt and most of the social care sector, is likely to make the return of quality ratings irresitible.

Major information gap

“There is a major gap in the information available to the public on the quality of care of their local hospitals, GP practices, care homes and other providers; people are left in the dark,” said Nuffield Trust chief executive Dr Jennifer Dixon, who led the review. “One aggregate, comprehensive rating of providers may provide more clarity and simplicity for the public, especially if it came from one ‘official’ trusted source.”

 The review found that the reintroduction of ratings would be “most appropriate” in social care, as opposed to health. This was because the range of information available on social care services was more limited, particularly when compared with hospitals, making an overall rating easier to design. Decisions on social care were often made when people and their families were in crisis, making a simple guide to quality, such as that provided by a single rating, particularly useful.

Strong sector support

The review’s consultation process found a “clear overall consensus” in favour of the introduction of an aggregate rating for adult care services, as well as support for the previous quality ratings system, which ran from 2008-10.

Though its short lifespan meant no comprehensive evaluation of its impact could be made, a 2009 review by the outgoing Commission for Social Care Inspection found the ratings aided choice for users, were easy to understand and provided an indication of quality.

Rise of online care ratings sites

The review acknowledged the rise of online consumer ratings and information sites designed to help service users choose social care services. However, it found that use of the web by families to help choose services was low and that the proliferation of such sites may create confusion.

The review was also told that families of people in residential care were deterred from posting negative reviews of care services on these sites for fear of reprisals from providers.

Design of ratings

The review suggested that ratings for services should be updated regularly, possibly every month, to ensure they remained current. The trust also called for frontline staff and service users to be involved in designing the system to ensure it was credible, though it stressed that any system should make use of existing and emerging performance frameworks, such as the National Institute for Health and Clinical Excellence’s quality standards for social care.

The review concluded that the CQC was best placed to deliver any ratings system but warned that it would need more resources and significant support to do so, as it would have to move from assessing providers against essential standards to judging their performance more widely.


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Thousands of patients with long-term conditions and dementia could benefit as GP contract proposals are unveiled

Thousands more patients will soon feel the benefits of better care at their GP surgery as an ambitious vision to improve the lives of people with long term conditions and people with dementia becomes a reality.

From April, changes to the GP contract, which have been announced today, will see millions of pounds redirected into better care for patients.

Money that was once given to doctors for performing routine office functions like record keeping will now be used to reward steps which directly support and benefit patients. This includes better control of blood pressure and cholesterol, to prevent heart attacks and stroke, and assessing patients at risk from dementia.

In total, £164 million will be pulled away from bureaucratic box ticking exercises and into better care.

Jeremy Hunt, Secretary of State for Health said:

“Improving care for patients has always been my priority. The GP contract needs to change to make sure the excellent care enjoyed by some patients is more consistent across the country.

“Providing better treatment for people with long term conditions helps save lives and I know GPs will rise to the challenge to make sure standards of care in this country are world class and continue to improve.

“We have listened to GPs and stakeholders and made some changes to our proposals to reflect these views and now feel we are in the right place to go forward.

“I am committed to ensuring that we improve quality of life for people with long term conditions – and I want GPs to lead this change from within their own practices.”

Under the changes, GP practices will need to match the high quality care seen in the best performing practices by ensuring that more patients are offered the best standards of care in 20 key areas. These are areas that are known to have an impact on reducing avoidable deaths, for instance for people who have heart disease. This approach will be extended to other areas of care in 2014 so that even more patients benefit.

These changes could mean around 1.5 million more patients will get better care in 2013-14. This could reach as high as 3.5 million by 2014-15 and could help doctors go further in spotting early warning signs of illness. It should mean more patients get the right tests, treatments and medicines if they have diabetes, hypertension, lung disease, heart failure or arthritis. This care can not only improve the health of patients, it potentially save more lives.

GP practices will be rewarded for taking more proactive steps to identify people who may have dementia so that they and their families can receive earlier support. Rewards are also available for identifying and improving care for those people most at risk of avoidable emergency admissions to hospital.

Embracing technology as a way of championing better care will also be rewarded as GP practices will be paid for enabling patients to book appointments and order repeat prescriptions online.

The contract also incorporates the latest expert advice on the areas which will have the greatest impact on patient health. This includes improved support for cancer patients and those with depression, arthritis and diabetes.

All practices will receive a 1.32 per cent increase in current funding, allowing for a 1 per cent pay increase for GPs and practice staff, in line with public sector pay policy, and additional resources to cover non-staff expenses. There will also be a new £10 million investment in two new immunisation programmes.

Background information

Main changes

  • The Minimum Practice Income Guarantee will be phased out over seven years from April 2014 and the resulting savings will be used to increase capitation (‘global sum’) payments for GP practices. This will stop some GP practices receiving thousands of pounds more than others that care for a similar number of patients with similar patient needs – and distribute resources more equitably between practices.
  • Most of the recommendations by the National Institute for Health and Clinical Excellence (NICE) for improvements to the Quality and Outcomes Framework will be implemented in full. Implementation of two of NICE’s recommendations will be deferred until April 2014 to allow more time for GPs to work with clinical commissioning groups to ensure the necessary referral services are in place.
  • QOF reward thresholds will be increased so that more patients benefit from the best evidence-based care that can help to save lives.
  • Organisational QOF payments will be discontinued, releasing £164m which will be used to help fund improvements in patient care through implementing the improvements recommended by NICE and paying for extra services from GP practices.
  • The extra services to be commissioned from GP practices will cover:
  1. a more proactive approach to identifying people who may have dementia so that they and their families can get earlier support,
  2. improving care management for seriously ill patients or patients at risk of unplanned hospital admission such as frail older people,
  3. ensuring that patients can book appointments and order repeat prescriptions online.
  4. establishing new arrangements to help monitor the health of people with long term conditions, for example using technology to help patients manage stable conditions without having to go to their GP surgery as often.
  • This means GP practices will need to provide better services for patients in these four areas to maintain the practice income that they have up until now received for demonstrating organisational best practice (e.g. good record-keeping). The NHS Commissioning Board will shortly be publishing more detailed specifications for these new schemes.
  • We are investing up to £10 million annually (depending on take up) to GP practices for two new vaccination programmes for rotavirus and shingles.
  • As a result of the decision that GP locums should be responsible for their own employer superannuation costs, the funding that PCTs have historically used to pay for these costs is being transferred to practices.
  • Five stakeholder organisations responded to the consultation and some changes have been made to the original proposals to reflect some of the issues raised.

What changes have you made to the proposals on which you consulted?

  • We have deferred implementation of the two NICE recommended indicators rewarding practices for referral to rehabilitation services (cardiac and pulmonary) until 2014/15. This will give time for clinical commissioning groups to ensure these services are available.
  • We are phasing in thresholds for two of the indicators (on physical activity) and giving a greater proportion of QOF funding to these and the new indicator on blood pressure control to recognise the initial impact on practice workload.
  • The NHS Commissioning Board has indicated that it intends to adapt some elements of the new enhanced services to ensure that they are implemented in a phased way.
  • For 2013/14, the scheme to promote earlier diagnosis of people with dementia will focus on patients who have a higher risk of dementia because of their clinical condition (e.g. vascular disease or a long-term neurological condition). The scheme to promote greater use of online services will focus on booking appointments online and ordering repeat prescriptions online.


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Book of dreams launched by looked after children

Thirty eight of North Yorkshire’s looked after children and young people have become published writers after the launch of a collection of their poems and short stories last week.

The book, entitled Every Picture Tells a Story, brings together work from children aged six to, including care leaver. It has been compiled by staff from the Education for Looked After Children (ELAC) Virtual School. The writing covers everything from family to love, from Olympic dreams to Royalty and their own aspirations for the future. The poems and stories are powerful as well as creative and give plenty of food for thought.

Poet Craig Bradley and storyteller Christine McMahon who have contributed to the book with their own writing tips and examples of their work attended the launch at Northallerton library along with the children and young people themselves.

These professional writers have worked with the children and young people during the course of the project, accompanying them on trips and teaching them the power of words.

Craig Bradley read out poems written by the children as well as comic poems from his own collections while Christine McMahon held her audience with new twists on old tales.

County Councillor Cllr Tony Hall, North Yorkshire’s executive member for the Children and Young People’s Service who also attended the launch said:

I am very pleased to be involved in the launch of this book by children in the care of North Yorkshire.

This is a wonderful anthology and a great achievement and is a testament to the talent and resilience of these children and young people.

Our job in North Yorkshire is to support them to achieve at the highest level and to provide quality of opportunity to give them the best start in their adult lives.

The publication has also attracted the attention of celebrated playwright Sir Alan Ayckbourn and Olympic silver medallist Nicola Wilson, who have both written their own pieces for the book to show their support.

Sir Alan said:

I’m honoured to be associated with this project.

Creative writing is for me the act of sharing your private innermost self in public. Given the hardships that some of these kids have had to endure, I feel all the more privileged that they have allowed me a glimpse of their dreams. I hope others can see the potential in these talented children.

Sir Alan includes his own commentary on one of the poems which he finds ‘touching’ and makes him ‘smile’. The poem is written by a ten-year-old and is called “I Wish I had a Pony”:

I wish I had a pony

With gold and silver mane,

I’d ride him in the sunshine

I’d ride him in the rain,

I’d ride him to the moon and back

Gallop around the sun,

I wouldn’t take him home again

Until the day was done

A darker, more personal poem from the anthology called ‘Daddy’ is written by a 13-year-old:

Why don’t you love me dad?

I’m so sorry I never meant to be bad,

I sent you a letter, did you read it? It had a meaning.

You left seeming like you never cared…

We were so close but now so far away.

All I want to know is why did you hurt mar?

You broke her heart just like dropping a jar

Maybe it was because you spent all that time at the bar

You walked away and left us to cry,

I’m guessing it was easy for you to leave with a sigh.

The thing you called love was one big lie,

Always remember….I LOVE YOU BYE.

The writing is illustrated by the children’s own drawings and paintings as well as those contributed by professional and amateur artists from North Yorkshire and beyond.

Anne Williams, who is a higher-level teaching assistant with looked-after children said:

I have been honoured to be the project leader in the production of this anthology” “It has confirmed to me that the amazing young people that I have the pleasure of working with every day are truly talented individuals. Their work has brought tears to our eyes, sometimes with happiness and at others has been a poignant reminder of the difficult journey they have already travelled.

I think that they should be extremely proud of what they have created and hope that many others enjoy what they have published.

North Yorkshire has a strong record nationally of supporting children in care to achieve highly. The county has twice the national average of care leavers going on to university and up to 75 per cent are engaged in education, training or employment.

The book will be available, price £6.99, from March 7th from WH Smith in Northallerton and from 18 March larger libraries throughout the county. Schools can purchase copies through the schools’ library shop. An e book should also be available within the next couple of weeks. For further information contact ELAC Virtual School on 0845 034 9589.


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Basic care for elderly ‘lacking’

By Nick Triggle Health correspondent, BBC News

The CQC looked at standards across care homes and hospitals

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Basic care for the elderly in hospitals and care homes in England is still not good enough, the regulator says.

The Care Quality Commission report, based on a snapshot of services, found about a third failed to meet all the standards for nutrition and dignity.

It cited examples of call-bells being left unanswered, bad manners and a lack support at meal times.

It comes after the NHS was criticised by the Stafford Hospital scandal public inquiry for not putting patients first.

The Stafford report, published last month, said the NHS system was more focused on corporate self-interest than getting services right.

The Care Quality Commission (CQC) inspections were carried out before those findings were released.


In total, 50 hospitals were inspected by the CQC, with only 33 meeting all of the five relevant standards.

It is the second time the CQC has focused on dignity and nutrition in the NHS.

 “Start Quote

This is tantamount to institutionalised abuse. Where else in our society would we tolerate such neglect without a huge public outcry?”

End Quote Dot Gibson National Pensioners Convention

In terms of nutrition, standards seemed to have improved slightly, whereas for privacy and dignity the situation had worsened since 2011, the latest report said.

From the care sector, 316 of the 500 homes met all the standards.

Other problems highlighted included a lack of help in going to the toilet and lack of privacy when getting washed or dressed.

CQC chief executive David Behan said the findings were “disappointing”.

“Safe, good quality care is not complex or time-consuming,” he added.

Dot Gibson, of the National Pensioners Convention, said: “One report after another shows that we still cannot guarantee that when an older person goes into hospital or a care home that they will have their dignity respected.

“This is tantamount to institutionalised abuse. Where else in our society would we tolerate such neglect without a huge public outcry?”

Care Minister Norman Lamb said he expected “swift action” to be taken where services were not up to scratch.

“We want Britain to be the best country in the world to grow old in – but we have a lot of work to do,” he said.

What’s your experience of care for the elderly in hospitals and care homes? Please get in contact using the form below.

If you are happy to be contacted by a BBC journalist please leave a telephone number that we can contact you on. In some cases a selection of your comments will be published, displaying your name as you provide it and location, unless you state otherwise. Your contact details will never be published. When sending us pictures, video or eyewitness accounts at no time should you endanger yourself or others, take any unnecessary risks or infringe any laws. Please ensure you have read the terms and conditions.

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