Delivery of older people’s services in Edinburgh has shown good progress since 2017, according to a joint report published by the Care Inspectorate and Health Improvement Scotland.
Following an initial inspection in May 2017, the Edinburgh Health and Social Care Partnership has received acknowledgement from the Joint Inspection team across the Care Inspectorate and Health Improvement Scotland, that the review has now closed.
The latest report cites the partnerships efforts in driving forward – with pace – a clear vision and structured approach, that is now seeing positive progress in a number of areas.
It follows a challenging progress review in 2018 and contains a number of recommendations but, based on progress, the Joint Inspection team has noted that no further review activity is now planned.
Chair of the Edinburgh Integration Joint Board, Cllr Ricky Henderson, said: “We very much welcome this latest and final review, and the deserved recognition it gives all who work for, and with the partnership.
“The publication of the report in 2017, was a difficult read for all who were working in the Partnership at the time but the strategic vision, practices, and structures that have since been developed and implemented, are the backbone to the significant and good progress being made.
“Whilst there remain challenges – particularly with the current system pressures faced – the strengthened relationships built, strategic aims, and the cohesive approach to the work of the partnership, deserve this positive recognition.
“These are significant strengths for how the partnership will continue to push forward over the challenging winter period and beyond, and I would like to take the opportunity to thank every single person who directly or indirectly provides care in Edinburgh, for their incredible hard work and commitment to all in our care.”
Edinburgh College has launched a new digital care hub, in partnership with the University of Edinburgh, designed to provide greater skills and opportunities to health and social care students in the Lothians.
The Edinburgh College Digital Care Hub, located at the College’s Sighthill Campus, will equip students with the transferrable skills required to fulfil a successful career in areas including Health and Social Care, Dental and Pharmacy with a particular emphasis on technology enabled care.
The hub will focus on building students’ digital and practical skills through its state-of-the-art equipment, supporting experiential learning in a purpose-built setting.
It contains a replica medical ward with patient room, toilet and wet room facilities; an infection control and decontamination area; a reflection room; a care at home room; as well as a virtual reality room designed to give students an immersive experience which demonstrates how a patient with dementia experiences day-to-day life.
Within the care hub students have access to realistic patient simulators with true-to-life responsiveness, in a variety of care settings, enabling them to develop patient testing and care skills.
Also key to the role of the digital care hub is embedding the principles of professionalism amongst students and fostering the meta skills required to work in a care environment including communication, nurture, resilience, initiative and leadership.
The new facility hosts the Edinburgh College and University of Edinburgh Social Care Academy which provides an agile pathway to a career in health and social care specifically for school pupils.
As part of the programme, pupils study units in digital skills for health and social care, mental health, the human body, infection prevention and control and safe beginners for health and social care.
After successfully completing the programme, pupils are able to progress on to further studies with the College or university or advance into employment.
The digital care hub was launched during an event attended by representatives from key institutions connected to the College and the new hub, and brought together those with a collective interest in supporting the future of the health and care sector.
Audrey Cumberford, Edinburgh College Principal and CEO, said: “We are delighted to be launching our Digital Care Hub in partnership with the University of Edinburgh.
“The facility will provide practical learning experiences for pupils and students as well as exposing them to many sector specialisms which they ordinarily might miss out on without having access to specialist equipment in a health and care setting.
“The COVID pandemic has highlighted the importance of our health and care workers across the country and through addressing the national skills gaps in digital enabled care, the Digital Care Hub, through partnership working with industry, is ready to provide a pipeline of future workers equipped with the skills and knowledge required to meet the demands of the sector and population.”
Professor Peter Mathieson, Principal and Vice-Chancellor at the University of Edinburgh, said: “We are delighted to work with Edinburgh College on the Digital Care Hub, which will be an excellent resource for those considering a career within health and social care.
“Harnessing technology to support learning in this way and simulate real-life scenarios in the workplace will enable students to make informed choices about their future, built on their own ambitions and potential.”
For most people the recent years have been very hard. It has also showed a determination in volunteering for so many organisations, particularly the NHS.
As a whole, the foresight shown in establishing the NHS in 1948 has kept us in it’s care since that time.
This public service must be protected at all times from those who voted against it’s formation in 1948: namely, the Conservatives.
The reason this letter is headed ‘The Tories’ Coming Attack‘ is that the Conservatives are now moving to reorganise the NHS and care sector, letting private bodies have control over the running of the organisation in a major step towards a Private Health Service.
Wellbeing support for health and social care staff
The Scottish Government is asking what types of wellbeing support health and social care staff need the most from the recent £300 million announcement of a Winter Support Package.
Following the announcement of a further £4 million for workforce wellbeing, health boards and Health and Social Care Partnerships are being invited to identify the services which would most assist their staff.
The £4 million comes on top of £8 million already provided through the NHS Recovery Plan, which will support the ongoing development of a National Wellbeing Programme – including a dedicated hub and helpline, confidential mental health treatment through the Workforce Specialist Service along with time and training for staff to support each other.
Health Secretary Humza Yousaf said: “As part of the £300 million package of support for health and social care this winter, we’re bolstering staff wellbeing with an extra £4 million to look after our most valuable asset – the people who provide the care we need through this pandemic.
“We have engaged with health and social care staff around the country, to find out what they need most and how we can help them to get through the toughest winter they’ve ever faced.
“Funding will be immediately available for hot drinks, food and other measures to aid rest and recuperation based on what staff told us they needed. We are also continuing to engage with the workforce to understand what else would help them, with the possibility of developing more psychological support measures.”
Acting Director of Development and Innovation, Scottish Social Services Council (SSSC) Laura Lamb said: “The SSSC welcomes the announcement of additional funding to support the wellbeing of frontline workers across social care, social work and health care.
“The workforce continues to deliver high quality person-centred care despite facing significant challenges. They have worked tirelessly throughout the pandemic. It is vital the workforce feel valued, cared for and are recognised for the life changing work they do.
“Never before has support for the workforce been so important. Ongoing wellbeing support is essential if we are to have sustainable workforce for the future.”
Director of Workforce at NHS 24 Jacqui Hepburn said: “Over the last 18 months in particular, staff have faced unprecedented challenges and pressures, both professionally and personally, but have continued to rise to these challenges every day, while delivering vital and safe patient-centred care.
“Supporting the mental wellbeing of our workforce, as well as the physical, has always been a priority for NHS 24. To reflect the additional pressures during the pandemic, we established a dedicated online wellbeing zone which provides information, support and tips including financial advice, bereavement support, coping and self-care advice as well as a mindfulness section with access to Spotify playlists, podcasts and access to free apps.
“Bespoke wellbeing areas were also introduced in centres giving staff access to a quiet and safe space to pause and reflect. Hot drinks vending machines were changed to ‘free’ and we provided food and snacks and Wellbeing Box so to support the health of staff over winter.
“We continuously strive for new ways of supporting our amazing and hardworking team at NHS 24 and welcome this additional funding.”
The Wellbeing Hub has been used over 125,000 times since its launch in May 2020.
In the first week of the winter vaccination programme, 27,000 people have come forward to get their flu vaccine, which is a great response ((writes Edinburgh Integration Joint Board member and Forth Councillor GEORGE GORDON).
We’ve all seen the devastating effect the pandemic has had in the past 18 months so it’s really important we all play our part to limit the impact this winter.
This is a personal appeal to encourage everyone who’s eligible to get their flu vaccination this winter. COVID-19 has not gone away so it’s more important than ever to protect yourself by getting the vaccination and do your bit to ease the pressure on social care, GP surgeries and hospitals over winter.
Many of you will already have received a letter either with an appointment or asking you to book one online. I know there’s been an issue with the scheduling of some flu appointments via the national booking system.
This means some people’s appointments are not as local as would have been expected, and a few cases where people who are housebound have been asked to go to an appointment. I know how concerning this is for people who cannot travel.
If you have received a letter with an appointment that you are unable to attend, you can rearrange your appointment for a more local venue by going online at nhsinform.scot/flu-vaccine/invitations-and-appointments/rearrange-your-flu-vaccine-appointmen or ring the national flu vaccination helpline on 0800 030 8013 for help to re-book.
More local appointments are now available for people who find it difficult to travel. If you are housebound and normally get your flu jab at home then you will get it at home again this year, even if you’ve received an appointment letter.
It’s really good to see that so many people have been turning out to get their vaccinations. The Royal Highland Centre site experienced a slight delay in topping up vaccination stocks on Tuesday morning (5 October) due to the level of demand across other sites and some people were asked to return the following day.
This was resolved within an hour and I can assure you that we have good vaccine stocks in Edinburgh.
Across Scotland, GP surgeries are no longer responsible for flu vaccinations for their patients. Now, health and social care partnerships manage the flu programme. In Edinburgh we have a range of drive through and walk through clinics for adults which will open at weekends during October and November.
Edinburgh’s main site is in Lowland Hall at the Royal Highland Centre which is open seven days a week and easy to access by public transport (buses 100, 200 and 400). We also have small local clinics for people who can’t make their way to Ingliston.
Children have received a letter for their parents or carers about their vaccine. If it’s been six months since your second dose of the COVID vaccine, you may also get your COVID vaccine booster at the same time as your flu vaccine.
It’s a massive programme and this year there’s more people than ever eligible to get a vaccine which is great news. You can now get the vaccine if you’re over 50, pregnant, an unpaid carer, at risk because of an existing health condition, or because of the job that you do. You can check if you are eligible for a flu vaccine, or find more information, at nhsinform.scot/flu.
I’d really encourage you to take up that offer – go to your vaccination appointment if you have been given one or book an appointment on the online portal if you’ve been asked to do that.
Please don’t be in any doubt – flu is serious. Getting the vaccine will protect you, your family and friends, and also our vital NHS and social care services.
“The current situation is not sustainable; it is dangerous for patients and becoming incredibly difficult for staff.” – Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland
A substantial new investment of over £300 million in hospital and community care has been unveiled to help tackle what is anticipated to be the toughest winter the NHS and social care system has ever faced.
The new multi-year funding will support a range of measures to maximise capacity in our hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care.
The NHS and Care Winter Package of additional funding includes:
Recruiting 1,000 additional NHS staff to support multi-disciplinary working
£40 million for ‘step-down’ care to enable hospital patients to temporarily enter care homes, or receive additional care at home support, with no financial liability to the individual or their family towards the cost of the care home
Over £60 million to maximise the capacity of care at home services
Up to £48 million will be made available to increase the hourly rate of social care staff to match new NHS band 2 staff
£20 million to enhance Multi-Disciplinary Teams, enable more social work assessments to be carried out and support joint working between health and social care
£28 million of additional funding to support primary care
£4.5 million available to Health Boards to attract at least 200 registered nurses from outwith Scotland by March 2022
£4 million to help staff with their practical and emotional needs, including pastoral care and other measures to aid rest and recuperation
Health Secretary Humza Yousaf said: “As the winter period approaches, it is vital that we do all we can to maximise the capacity of the NHS and social care system. That’s why I’m setting out our £300 million NHS and Care Winter Package today.
“We cannot look at the NHS in isolation we must take a whole systems approach and these measures will help alleviate pressure across the NHS and social care.
“This significant new investment will help get people the care they need as quickly as possible this winter. Bolstering the caring workforce by increasing their numbers, providing them with additional support, and increasing the wages of social care staff.
“We’ve previously provided funding to ensure that adult social care staff are paid at least the real living wage. Today we’re going further and our new investment will ensure that adult social care staff who are currently paid the real living wage will get a pay rise of over 5%
“Measures I have announced today will help patients whose discharge has been delayed waiting for care and help get them out of hospital and on to the next stage in their care. This helps the individual by getting them the right care, and helps the wider system by ensuring the hospital capacity is being used by those who need that specialist level of clinical care.
“This £300 million of new funding will also fund increases in social care capacity in the community and in primary care – helping to ease the pressure on unpaid carers.
“Our NHS, social care staff and social work staff have been remarkable throughout the pandemic and today’s additional investment will help support them to deliver care to people across Scotland this winter.”
Meanwhile,the latest Emergency Department performance figures for Scotland published by the Scottish Governmentyesterday for August 2021 show that four-hour performance has deteriorated for the fourth consecutive month, again reaching a record low – while the number of patients staying in a major Emergency Department for 12-hours or more reaches a record high.
In August 2021 there were 117,552 attendances to major Emergency Departments across Scotland.
Data show that four-hour performance reached a new record low, with 75.4% of patients being seen within four-hours. One in four patients stayed in a major Emergency Department for four-hours or more before being admitted, transferred or discharged.
The number of 12-hour stays in August 2021 nearly doubled when compared to July 2021. 1,346 patients stayed in a major Emergency Department for 12-hours or more, compared to 760 in July 2021. This figure increased for the fourth consecutive month and it is the highest number of 12-hour stays since records began.
Data also show that 5,279 patients spent eight hours or more in a major Emergency Department. This is the highest figure since records began. The number of patients delayed by eight-hours or more increased for the fourth consecutive month.
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The challenge for health care workers is growing significantly. In Scotland, the army have been called in to assist the ambulance services.
“In Emergency Departments, long stays are rising drastically, and one in four patients are staying in an Emergency Department for more than four-hours. It is extremely worrying. These pressures are likely to mount further, and performance deteriorate even more as we head into winter.
“We are seriously concerned about patient safety. Long stays put patients at risk, particularly vulnerable patients, and especially with covid still present in the community. We urgently need a plan to increase flow throughout the hospital, to reduce exit block, to prevent crowding, and to ensure that patients who need it can quickly be moved into a bed for their care.
“The current situation is not sustainable; it is dangerous for patients and becoming incredibly difficult for staff.
“We welcome this afternoon’s announcement by the Secretary of State for Health and Social Care, Humza Yousaf MSP, including the recruitment of more staff and funding for hospital and community care. We hope that these measures will begin to alleviate pressures across the health system, and in particular reduce ambulance handover delays, long stays in Emergency Departments and exit block in our hospitals.
“However, while we welcome this investment, short-term cash injections do little to resolve long-term problems. We must see a long-term workforce plan that includes measures to retain health workers, particularly Emergency Medicine staff, as well as a long-term strategy for social care.”
Responding to the Scottish Government’s announcement to uplift care workers pay to just over £10 an hour, GMB Scotland Secretary Louise Gilmour said:“If we want to tackle the understaffing crisis in social care then we need to substantially increase the basic rate of pay, and for GMB that mean’s a £15 an hour minimum.
“Many of our frontline services are already being delivered on the back of wages of just under or over £10 an hour, and we know this isn’t nearly enough.
“To transform social care for the people who need it and the people who deliver it, particularly as we roll-out a national care service, then we must go further.”
The Scottish Government may also be facing industrial action from nursing staff over the winter …
NHS pay dispute in Scotland: Royal College of Nursing members to be asked about willingness to take industrial action
RCN members working for NHS Scotland are to be asked what industrial action they would be willing to take in support of their ongoing trade dispute with the Scottish government and NHS employers over pay.
The indicative ballot will open on 12 October and close on 8 November.
Eligible members will receive information on the different forms of industrial action.
The indicative ballot will be run by Civica, the independent scrutineer that organised the consultative ballot earlier this year. Eligible members will receive an email from Civica with a personal link to the online voting site on Tuesday 12 October. Weekly reminder emails will also be sent.
The result of the indicative ballot will not formally authorise industrial action. It will be used to inform the next steps RCN members might take.
Julie Lamberth, Chair of the RCN Scotland Board, said: “Industrial action is always a last resort but the current staffing challenges are causing unacceptable risks to patients and staff. The Scottish government has the opportunity to do the right thing by nursing.
“I would urge all eligible RCN members to seek out the available information on what taking industrial action means and what the implications of doing so might be. We need each member to make up their own mind and have their say in the ballot.”
Colin Poolman, RCN Scotland Director, added: “This is your chance to speak up – for your patients and your colleagues. Many of you rejected the pay offer and you know the link between fair pay and safe staffing.
“This is your opportunity to tell us what action you are prepared to take. To let the Scottish government know that the time to protect patient safety and value the safety critical role of nursing is now.”
UNISON, the union for carers, has expressed deep dismay at the decision to close an Edinburgh care home. The decision was passed by the Edinburgh Integration Joint Board (IJB) – which commissions health and social services from the City – at a meeting on Tuesday.
UNISON, Scotland’s largest union, has been campaigning to prevent the closure of five council-run Edinburgh care homes, including Drumbrae. A further four council-run homes – Ferrylee, Clovenstone, Fords Road and Jewel House are all being earmarked for closure but subject to public consultation.
Tom Connolly, UNISON Edinburgh City branch secretary, said: “The people of Edinburgh can feel very let down by this decision to close a much-needed local service, not least the elderly and vulnerable who reside in the care home and now face an uncertain future.
“UNISON will continue its campaign to save public sector-run care homes and prevent them going into private hands. People need to come before profit and UNISON will continue its fight to save Edinburgh’s public run care homes and call for all private run care homes to be brought into the public sector.”
Greig Kelbie, UNISON regional organiser, said: “The decision to close Drumbrae was made without any public consultation and is a real slap in the face to the most vulnerable people in the city.
“UNISON understands there is a substantial waiting list for homes in the area, so if the need hasn’t gone away then why should the services?”
Edinburgh Integration Joint Board is chaired by Labour councillor Ricky Henderson and membership includes local politicians Councillor Melanie Main (Scottish Greens), Councillor George Gordon (SNP), Councillor Robert Aldridge (Liberal Democrats) and Councillor Phil Doggart (Conservative).
New guidance will allow care home residents to choose a friend or relative as a ‘named visitor’ who will be able to visit them, even during a managed Covid-19 outbreak.
This is a change to current practice where most homes suspend routine visiting until outbreaks are over. It will allow those living in care homes to continue to have meaningful contact with loved ones, and balance the need for continuing infection prevention and control measures in care homes with the wider wellbeing of residents.
The change will apply to one named visitor when a care home is in a controlled Covid-19 outbreak, and a guidance note has been issued to support care homes to plan for this in consultation with their local Health Protection team.
Revised guidance from Public Health Scotland issued last week has already set out that residents should be able to receive visits from a nominated person even while they are self-isolating as a precaution (i.e. after hospital stays; after being close contacts of a COVID-19 case if fully vaccinated).
Meanwhile Social Care Minister Kevin Stewart has reaffirmed the government’s commitment to introducing ‘Anne’s Law’, to enable people who live in care homes to choose a person or persons to support them in their health and wellbeing, as called for by Care Home Relatives Scotland. A consultation on how best to implement this will be published shortly.
Minister for Mental Wellbeing and Social Care Kevin Stewart said: “Throughout the pandemic, our overriding priority in care homes has been to safeguard and protect staff and residents from infection – but at times that meant that residents were cut off from their loved ones, which we know has caused anguish and distress for many.
“The proposal for a named visitor will provide continuity of meaningful contact for care home residents in managed COVID-19 outbreak situations, helping to protect residents’ wellbeing in parallel by allowing visiting in a safer way, rather than automatically suspending routine visiting during an outbreak.
“We will further strengthen residents’ rights in adult residential settings through the introduction of ‘Anne’s Law’ and a consultation setting out our aspirations for Anne’s Law and seeking views on how best we might make it work in practice will be published shortly.”
Health and Social Care Secretary Sajid Javid justifies the Health and Care levy
This past year has been the most difficult in living memory for our country – and we have faced those difficulties together. The British people have made unprecedented sacrifices to our freedoms and our way of life to keep each other safe.
Whilst staff in the NHS and across social care have moved mountains to help those who needed care. They have treated over half a million patients with COVID-19, administered over 90 million life-saving vaccines, and cared for the elderly and most vulnerable in our society.
Despite these efforts, it was inevitable that this global pandemic would take its toll on a system that was already in need of reform. We now have a backlog of 5.5 million people waiting for treatment – and if we were to continue with business as usual this could rise in the coming years to as high as 13 million. Before the pandemic, we treated nine in 10 people within 24 weeks. That has now risen to 45 weeks.
The pressures of the pandemic have also been stark in social care, adding to the burdens of an unfair system in crisis. Around one in seven people end up paying over £100,000 for care, and often the heaviest burden falls on those least able to bear it. Meanwhile, staff in social care have worked tirelessly, even when we know they could have benefitted from better support and training.
No responsible government – especially a Conservative one – can bury its head in the sand and pass these problems onto the next one.
The Health and Care Levy announced yesterday will be a direct investment into the NHS and social care. But I appreciate it does not sit easily with everyone. No government would ever wish to go back on a promise it has made to the people – and I’ve always believed in making sure the tax burden is as low as possible.
Yet no government since the Second World War has faced unprecedented challenges of such magnitude. Last week I met health ministers from the world’s biggest economies at the G20: we are all having to deal with the consequences of this global pandemic. I am determined we face up to them.
We want the NHS to be a world-class service, and we need to put social care on the strongest possible foundation for the future. But we have to do that in a responsible way. That means spreading the burden across the broadest shoulders, and not simply borrowing in the short-term to pay for the long-term. That is what our levy does: it shares the burden across employers, employees and pensioners alike. The highest-earning 14 per cent in the country will pay over half the levy.
Together, we are making a critical investment in our country’s future. This will be the biggest catch-up plan in NHS history – delivering nine million more checks, scans, and treatments. We all know someone who has been waiting to long for such procedures.
We are going to ensure the vital work of routine operations, meaning things like hip replacements and cataract surgery do not stop. We are also investing in the next generation of scanners and screening equipment, so we are even quicker at finding and treating diseases like cancer.
The levy is also a vital first step for the reform of our broken care system. No one will have to pay more than £86,000 in care costs over their lifetime. That cap will apply to everyone – it will not matter what condition you have, where you live, how old you are or how much you earn.
We are also casting out the safety net further by expanding means-tested support, so many more people can benefit from having the costs of their care covered. In addition, care staff will now benefit from half a billion pounds of funding to deliver new qualifications, better career routes and much-needed mental health and wellbeing support.
Through these historic investments we are meeting the scale of the challenges we face together, just as we have done throughout this pandemic. In making these difficult decisions we are stepping up as a country to end the cruel care lottery and tackle the backlog. As a result, millions more people now have a better chance to live happy, healthy and dignified lives.
MPs voted through the NHS and Social Care tax rise last night
Prime Minister Boris Johnson’s statement at yesterday’s press conference on health and social care:
Good afternoon, I’m joined by the Chancellor of the Exchequer and the Secretary of State for Health and Social Care, because today we’re setting out our plan to help our NHS recover from the pandemic and build back better by fixing the problems in health and social care that governments have avoided for decades.
We all know someone whose test, scan or hip replacement was delayed or who helped to protect the NHS amid the immense pressures of Covid by putting off treatment for a new medical condition.
And now, as people come forward again, we need to pay for those missed operations and treatments; we need to pay good wages for the 50,000 extra nurses we are recruiting, we need to go beyond the record funding we’ve already provided to the NHS, and that means going further than the 48 hospitals and 50 million more GP appointments.
So today, following the most successful vaccine programme in the world, we’re beginning the biggest catch-up programme in the history of the NHS, increasing hospital capacity by 110 per cent, and enabling 9 million more appointments, scans and operations.
I have to level with people – waiting lists will get worse before they get better, but compared with before Covid, by 2024/25 our plan will allow the NHS to aim to treat 30 per cent more patients who need elective care – like knee replacements or cancer screening.
A recovery on this scale cannot be delivered by cheese-paring budgets elsewhere and it would be irresponsible to cover a permanent increase in health and social care spending with higher day to day borrowing.
For more than 70 years, we’ve lived by the principle that everyone pays for the NHS through our taxes, so it’s there for all of us when we need it.
In that spirit, from April we will have a new UK-wide 1.25 per cent Health and Social Care Levy on earned income, with the money required by law to go directly to health and social care across the whole of our United Kingdom, and with dividends rates increasing by the same amount.
This will raise almost £36 billion over the next three years, not just funding more care but better care, including better screening equipment to diagnose cancer earlier and digital technologies allowing doctors to monitor patients in their homes.
The levy will share the cost as fairly as possible between people and businesses: because we all benefit from a well-supported NHS and all businesses benefit from a healthy workforce.
And those who earn more will pay more, including those who continue to work over the State Pension Age.
The highest earning 14 per cent of the population will pay around half of the revenue raised; no-one earning less than £9,568 will pay a penny, and most small businesses will be protected, with 40 per cent paying nothing extra at all.
And this new investment will go alongside vital reform, because we learned from the pandemic that we can’t fix the NHS unless we also fix social care.
When Covid struck, there were 30,000 hospital beds in England occupied by people who would have been better cared for elsewhere, and the inevitable consequence was that patients could not get the hip operations or cancer treatment or whatever other help they needed.
And those people were often in hospital because they feared the costs of care in a residential home.
If you suffer from cancer or heart disease, the NHS will cover the costs of your treatment in full.
But if you develop Alzheimer’s or Parkinson’s, then you have to pay for everything above a very low threshold.
Today, 1 in 7 of us can expect to face care costs exceeding £100,000 in our later years, and millions more live in fear that they could be among that 1 in 7.
Suppose you have a house worth £250,000 and you’re in a care home for eight years, then once you’ve paid your bills, you could be left with just £14,000 after a lifetime of work, effort and saving – having sacrificed everything else – everything that you would otherwise have passed on to your children – simply to avoid the indignity of suffering.
So we are doing something that, frankly, should have been done a long time ago, and share the risk of these catastrophic care costs, so everyone is relieved of that fear of financial ruin.
We’re setting a limit to what people will ever have to pay, regardless of assets or income.
In England, from October 2023, no-one starting care will pay more than £86,000 over their lifetime.
Nobody with assets of less than £20,000 will have to pay anything at all, and anyone with assets between £20,000 and £100,000 will be eligible for means-tested support.
And we’ll also address the fear many have about how their parents or grandparents will be looked after.
We’ll invest in the quality of care, and in carers themselves, with £500 million going to hundreds of thousands of new training places, mental health support for carers and improved recruitment, making sure that caring is a properly respected profession in its own right.
And we’ll integrate health and social care in England so that all elderly and disabled people are looked after with the dignity they deserve.
No Conservative Government wants to raise taxes, but nor could we in good conscience meet the cost of this plan simply by borrowing the money and imposing the burden on future generations.
So I will be absolutely frank with you: this new levy will break our manifesto commitment, but a global pandemic wasn’t in our manifesto either, and everyone knows in their bones that after everything we’ve spent to protect people through that crisis, we cannot now shirk the challenge of putting the NHS back on its feet, which requires fixing the problem of social care, and investing the money needed.
So we will do what is right, reasonable and fair, we’ll make up the Covid backlogs, we’ll fund more nurses and, I hope, we will remove the anxiety of millions of families up and down the land by taking forward reforms that have been delayed for far too long.
Chancellor Rishi Sunak’s statement on health and social care, delivered on 7 September 2021
Good afternoon.
I want to address straight away the following question:
Why do we need to raise taxes?
Three reasons.
First, we need to properly fund the NHS as we recover from the pandemic.
Senior NHS leaders have made clear that without more funding we will not properly be able to address the significant backlog…
…in people’s cancelled operations, delayed treatments, or missed diagnoses.
To get everyone the care they need is going to take time – and it is going to take money.
The second reason is that social care plans announced today have created an expanded safety net.
Instead of individuals having to bear the financial risks of catastrophic care costs themselves, we as a country are deciding to share more of that risk collectively.
This is a permanent, new role for the Government.
And as such we need a permanent, new way to fund it.
The only alternative would be to borrow more indefinitely.
But that would be irresponsible at a time when our national debt is already the highest it has been in peacetime.
And it would be dishonest – borrowing more today just means higher taxes tomorrow.
The third reason we need to raise taxes is to fund the Government’s vision for the future of health and social care.
Properly funded, we can tackle not just the NHS backlog and expand the social care safety net, we can afford the nurses pay rise;
Invest in the newest, most modern equipment;
Prepare for the next pandemic;
And provide one of the largest investments ever to upskill social care workers.
In other words, we can build the modern, more efficient health and social care services the British public deserves.
To fund this vital spending, we will introduce a new UK-wide Health and Social Care Levy.
From next April, we will ask businesses, employees and the self-employed to pay an extra 1.25% on earnings.
All the money we raise will be legally ringfenced, which means every pound from the Levy will go directly to health and social care.
The Levy is the best way to raise the funds we need.
It is fair: the more you earn, the more you pay.
It is honest: it is not a stealth tax or borrowed – the Levy will be there in black and white on people’s payslips.
And it is UK-wide, so people in England, Scotland, Wales and Northern Ireland will all pay the same amount.
To make sure everyone pays their fair share, we will also increase dividend tax rates by the same amount.
And, from 2023, people over the age of 66 will be asked to pay the Levy on their earnings too.
No Government wants to have to raise taxes.
But these are extraordinary times and we face extraordinary circumstances.
For more than 70 years, it has been an article of faith in this country that our national health service should be free at the point of use, funded by general taxation.
If we are serious about defending this principle in a post-Covid world …
… we have to be honest with ourselves about the costs that brings …
… and be prepared to take the difficult and responsible decisions to meet them.
Thank you.
PM Boris Johnson’s letter to the First Ministers of Scotland, Wales and Northern Ireland and Deputy First Minister of Northern Ireland on the new health and social care reform:
National Insurance Contributions increase ‘adds insult to injury’ for families facing devastating cut to Universal Credit
New Joseph Rowntree Foundation analysis estimates that around 2 million families on low incomes who receive Universal Credit or Working Tax Credit will pay on average around an extra £100 per year in National Insurance contributions under the Government’s proposed changes.
Peter Matejic, Deputy Director of Evidence & Impact at JRF said:“We are concerned that around two million families on low incomes who receive Universal Credit or Working Tax Credit will pay on average around an extra £100 per year in national insurance contributions under the Government’s proposal.
“This extra cost adds insult to injury for these families who are facing a historic £1,040 cut to their annual incomes when Universal Credit and Working Tax Credit are reduced in less than a month on 6 October. If it presses ahead, this Government will be responsible for the single biggest overnight cut to social security ever.
“With inflation rising, the cost of living going up and an energy price rise coming in October, many struggling families are wondering how on earth they will be expected to make ends meet from next month.
“The Chancellor is in denial if he seriously believes this cut will not impose unnecessary hardship on millions of families – the majority of whom are in low-paid work.
“Any MP who is concerned about families on low incomes must urge the Prime Minister and Chancellor to reverse this damaging cut, which will have an immediate and devastating impact on their constituents’ living standards in just a few weeks’ time.”
RCEM welcomes Government funding, but warns it won’t be enough
Responding to the announcement of an extra £5.4 billion of funding for the NHS, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The announcement of this additional funding for the NHS over the next six months is very welcome.
“It comes at a crucial time when the health service enters what will likely be its most challenging winter ever, as it exits the pandemic, seeks to recover the elective backlog and faces the worst ever levels of performance in the summer.
“It is particularly welcome to see the investment in improving infection prevention control measures in hospitals, as this will continue to be of the utmost importance in the coming months. It is also pleasing to see funding to continue to improve the timely discharge of hospital patients. It is vital for Emergency Care that there is good flow throughout the hospital, which includes making sure patients have a smooth discharge from the hospital.
“While this short-term funding is appreciated, there must also be an adequate response to the sharp increase in demand and equivalent deterioration in performance. It is unlikely that this funding will be enough to help enable longer term recovery.
“The challenges that our Emergency Departments face stem from workforce shortages and capacity issues. A shortage of beds can lead to crowding, corridor care and poor flow through the hospital. Workforce shortages spread existing staff thinly and put them under severe pressure.
“These are long term issues and the only way to tackle them will be via a long-term funding plan for the health service, including a workforce plan to recruit nurses and doctors by expanding student medical and nursing places and training places.”
Dr Katherine Henderson, commenting on the announcement of a three-year settlement for health and social care, continued: “The three-year funding settlement announced for health and social care is welcome.
“But the scale of the challenges faced across the health and social care service at a crucial time of recovery mean this will likely not be enough – and the government must be realistic in the colossal task ahead for the health and social care service. It is essential that a plan to address the workforce crisis is prioritised.
“It is also welcome to see the long overdue the first steps towards a plan for social care. There has been a crisis within social care for some time, so it will be good to see the government fulfil its pledge to reform and tackle the social care crisis.
“For that to happen, it is vital that an adequate proportion of the settlement is allocated to social care.”
Commenting on Tuesday’s social care announcement by the Prime Minister, TUC General Secretary Frances O’Grady said: “We need a social care system that delivers high-quality care and high-quality employment.
“New funding for social care is long overdue. But today’s announcement will have been deeply disappointing both to those who use care, and to those who provide it.
“The Prime Minister promised us a real plan for social care services, but what we got was vague promises of money tomorrow.
“Care workers need to see more pay in their pockets now. Nothing today delivered that. Instead, the only difference it will make to low-paid care staff is to push up their taxes.
“This is so disappointing after the dedication care workers have shown during this pandemic keeping services running and looking after our loved ones.
“Proposals to tax dividends should have been just once piece in a plan to tax wealth, not an afterthought to a plan to tax the low-paid workers who’ve got us through the pandemic.
“We know social care needs extra funding. But the prime minister is raiding the pockets of low-paid workers, while leaving the wealthy barely touched.
“We need a genuine plan that will urgently tackle the endemic low pay and job insecurity that blights the social care sector – and is causing huge staff shortages and undermining the quality of care people receive.”
The TUC published proposals on Sunday to fund social care and a pay rise for the workforce by increasing Capital Gains Tax.
The union body says increasing tax on dividends is a welcome first step to reforming the way we tax wealth, but that it won’t generate the revenue needed to deliver a social care system this country deserves.
Instead, by taxing wealth and assets at the same level as income tax, the government could raise up to £17bn a year to invest in services and give all care staff a minimum wage of £10 an hour.
TUC analysis shows that seven in 10 social care workers earn less than £10 an hour and one in four are on zero-hours contracts.
Polling published on Sunday by the TUC showed that eight in 10 working adults – including seven in 10 Conservative voters – support a £10 minimum wage for care workers.
