We are Listening

Here’s my first column of the year for the EADT and Ipswich Star last week:

Happy New Year.

In the ‘lull’ between Christmas and New Year I like to reflect on what has taken place in the year behind us, as well as looking forward to the future.

One thing I’ll be hoping for in 2018 is greater participation from you, the public. Since the elections in May, I, along with my colleagues and our officers, have been working hard to give those we serve more chances to have their say and more opportunities to have their voices heard.

These are unprecedented times for local government. Savings have to be made and the way we provide our services will be changing. And we want you to be involved more than before.

Though this isn’t breaking news, our council meetings are open to the public. Members of the media regularly attend and report on them. Recently we’ve had more members of the public come to our meetings, and I’d like to see more people come along to further their understanding of how we make decisions and witness the debate between members first hand.

At our council meetings as well, the public are invited to get involved, in the form of asking a question or making a comment. In order to do this, all you need to do is send a request to www.suffolk.gov.uk/apply-to-speak-at-a-public-meeting/

However, if you can’t make our meetings, why not watch them online? All of our full council meetings are streamed online and we’ve recently upgraded the cameras in the council chamber to present a high definition quality stream to those either watching live or at a later date. You can find out more about watching our meetings online by visiting www.suffolk.gov.uk/webcasting/

We also want you to give us feedback on our services and how we provide them. We value the thoughts of those we serve, as they can help us shape what we provide and how. If you think something needs to be improved, let us know. If you feel you’re not getting the support you should be getting, we want to know. If you believe someone deserves recognition for their work, we’d like to hear about it.

You can do so by visiting www.suffolk.gov.uk/about/give-feedback-or-make-a-complaint/ but by also speaking to us using social media – we regularly respond to queries on our Facebook page, which can be found by searching for @SuffolkCountyCouncil as well as on Twitter @SuffolkCC – if you don’t already ‘like’ follow us I would suggest doing so as there is an array of useful information posted regularly.

If it’s something in your town or village that you have comments on, it may also be worth speaking to the councillor in your division, who may be able to assist. As councillors we are here to serve our residents and we are regularly working hard on local issues. If you don’t know who your councillor is, you can find them on our website here – www.suffolk.gov.uk/find-your-councillor/

We also consult residents and service users when changes are being made. In the past year we have consulted on a number of things, such as the Lake Lothing Third Crossing in Lowestoft, roadworks in Bury St Edmunds and roadworks in Ipswich. We currently have two consultations live at the moment – high needs funding and school and post-16 travel. We want your views – the better the response, the better informed we are moving forward on any potential decisions.

Last year I was joined by councillors and officers at five ‘we are listening’ events across the county – in Bury St Edmunds, Felixstowe, Haverhill, Ipswich and Lowestoft. These events are something I enjoy doing as it gives me, and others at the council, the chance to speak to the electorate about issues affecting them. It also gives a personal touch and the fact we are actively seeking views may make it easier for people to share their views.

At those events we received a number of comments which have since been acted on with the help of officers, giving positive outcomes for many.

These events are something I’m wanting to continue this year, and I hope to see as many of you as possible as and when they are held, across the county.

So why not make a new year’s resolution to get involved where you can at Suffolk County Council?

A very Merry Christmas

It’s that wonderful time of year were we all pause, relax and spend times with our loved one and family to celebrate Christmas and then the year just past and look forward to the year ahead.  However, for some it’s also a time of reflection of loved ones gone and sadly missed.  So, as you rush about maybe drop a card off to an elderly neighbour or pop round for a cup of tea and a chat about their Christmas, no one should be alone at Christmas.  It does not have to take much time but can make all the world of difference to them at this time of year.

My I wish you and your family a very Merry Christmas and a happy, healthy, and successful New Year.

Social Care article for The Guardian

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Week before last I wrote an article for the Guardian Newspaper about the future of social care and things our Government needs to consider as they ponder the way forward:

When you consider the plethora of social care papers that have come and gone down the years, irrespective of governments, you’d be forgiven for taking next summer’s review with a pinch of salt.

Yet, there is a feeling that this cannot go on for much longer. County areas are withstanding some of the greatest pressures in delivering and procuring social care services, coupled with the deepest reductions in core government grants.

If there was an easy answer, we would not be arriving at social care paper number 13.

Any solution must be long-term in its vision, but early noises suggest that next summer’s review could narrowly focus on funding options for older people.

Exploring a wide-range of options to ensure long-term sustainable funding, firstly to meet the £1bn funding gap that counties face in delivering social care, and for the individual to protect them from facing huge care costs, is paramount.

Whilst this is clearly crucial, the County Councils Network (CCN) argues for a more holistic approach, which brings together prevention, housing, workforce, and integration as well as sustainable way to fund social care.

We argue for a culture shift; turning the existing system on its head. It is currently too focused on the end result, or dealing with issues as they arise, rather than exploring ways to mitigate a person’s health troubles. From the individual’s point of view, who wouldn’t want to live healthier and independent longer?

This is best illustrated by how much media airtime delayed discharges get; an example of the reactionary nature of the system. We must shift thinking towards stopping people from entering hospital unnecessarily in the first place instead of institutionalised care; enabling them to be in control of decisions about the type and location of care they receive.

Housing reform will play a big part in this shift of mindset. The ability for people to stay at home and receive care – or at least to choose to do so – is hampered by the lack of adaptable housing, whilst for those exiting hospital, there are not enough reablement and rehabilitation services in England.

Another issue that often slips under the radar is the dearth of retirement property development: with 7,000 built yearly, whilst analysis suggests 30,000 are needed. The need to keep pace with England’s rising elderly population is obvious, but an increased prevalence of care housing and adapted properties will allow people to live independently longer. In turn, this means less demand on social care services and fewer delays in exiting hospital.

The green paper should seek to create the conditions to encourage more development of supported and retirement homes, including reforms to the planning process to better incentivise the building of these properties.

Integration of health and social care has been labelled a solution, especially in reducing demand. Yet for a variety of reasons, the agenda has not had lift-off. Considering that full integration by 2020 as originally planned is unlikely to happen, we should consider reforms to the way the current system works.

Instead of gunning for wholesale change in a short timeframe, government should be considering pooling its NHS and social care budgets as a precursor to full integration. Some counties already are; with councils and local NHS providers making joint decisions based around the individual; with the aim of keeping people out of hospital for longer.

At the same time, the NHS Tariff, which rewards acute trusts for patient contacts rather than outcomes should be reviewed; to reward providers for preventing people from entering crisis care unnecessarily.

In essence, we should try to build a preventative ecosystem that allows people to maintain their health for longer. This means widening the debate, to tightening the links between adult and children’s social care, and crucially, public health services.

It should also aim to ensure those currently ‘in the system’ live as independently as possible. Here, having consistency in carers is vital. Yet Brexit could impact on workforce projections, not least in areas such as Essex where one-third of its care home workforce are EU nationals. CCN is calling for flexibility in immigration rules to allow providers to recruit from Europe should they be unable to internally.

These solutions are only a cog in a much larger machine; there is no silver bullet to making social care sustainable. No-one is under any illusions of how difficult a task this is for a government, least of all an administration that does not have Parliamentary arithmetic on its side.

But without thinking long-term, and a culture shift that brings prevention into focus, next summer’s green paper could ultimately go the same way as its precursors.

Cllr Colin Noble, County Councils Network Spokesman for Health & Social Care and Leader of Suffolk County Council

The link to the article is:

https://www.theguardian.com/social-care-network/2017/dec/07/there-is-no-silver-bullet-for-social-care-but-ministers-must-not-dodge-the-issue?CMP=share_btn_link

 

 

 

At what age do we become ‘old’?

Here’s the column I wrote for the EADT and the Ipswich Star newspapers last week:

 I’d like to begin this week’s column with a question.

At what age do we become ‘old’?

As language changes and adapts, we as a society are good at filtering out certain anachronisms. The use of the word “elderly”, for example, is less common now. But we frequently use such catch-all terms as “older people” which, after all, is so general as to be almost meaningless.

We are all ageing and I would claim with some confidence that we all want to age well. So, if we are not “older people” now, we will all fall within this category one day.

We know that more of us in Suffolk will be aged 65 years or over in the coming years as a proportion of the population. We’re also living longer, with the gap between male and female life expectancy closing.

In addition, Suffolk is a fantastic county, with incredible assets, so it is no surprise that many people enjoy living here, retiring here and ageing here.

Unlike many other parts of the UK, we are a county without a city. Many of our greatest strengths centre around rural, country living with the benefits this provides as we support one another and look out for our neighbours. We enjoy significant formal and informal networks of support that see old and young living and working together, bringing out the best attributes of supportive communities.

I would argue our rapidly ageing population can be viewed in one of two ways: as an insurmountable, growing threat to our health and social care services, or as a great opportunity to adapt, innovate and prosper as a county.

I see this as an opportunity to be a forward-thinking county that values and welcomes its growing older population.

No single authority, organisation or sector can create this environment alone. We must work together and engage our communities if we want to see meaningful, sustainable change.

The last 10 years have seen major change. We have seen a move from centralised control to more personalised support and care delivered in the community. The coming years will bring about increasing change to our health and care services.

Inevitably, we will be working later into life which means the nature and shape of the county’s workforce will change.

Our predominantly rural setting also provides a challenge to the way  we reach potentially isolated communities. But we are already seeing examples of this in abundance, from well established schemes such as the Debenham Project to emerging opportunities created by social prescribing.

Thanks to the foresight of our health and care teams, we are already seeing the benefits of  learning what works well elsewhere. In the west of the county, we are testing out the Buurtzorg model of integrated health and personal care delivered by small teams of self-managed nurses working in the community, based on an approach developed in the Netherlands.

One issue that is perennially in the headlines is housing; more specifically, the need for more housing that caters for the changing needs of the UK population. If we are to curb the trend of 30-40 year olds living at home because they cannot afford to join the property ladder at one end of the spectrum, and 80 year olds living on their own in a five-bedroom home at the other, we all have to act now.

But the need is wider than this: as we build and adapt our homes, we must ask ourselves if they are they hardwired for the needs of an entire population. Is the surrounding transport network responsive to the needs of an ageing society? Above all, are we providing affordable, shared space that encourages an active lifestyle at every stage of an individual’s life?

Ultimately, we need to provide support for those with more complex needs, while enabling others to remain active and independent, without the risks of becoming isolated.

When it comes to being connected, the myth of an older generation out of touch with modern technology is not borne out by the facts. Nationally, more than three quarters of 65-74 year olds and over 40% of those aged 74 and over used the internet in the last three months.

From open access at our libraries and other information points, to the investment in countywide broadband, our older population is more switched on to new media than ever. This is clearly not the case for all, but the many advantages this brings – from online shopping to connecting with family – are often a valuable antidote to social isolation.

Which brings me back to my question: what we mean by “old”? There’s the old cliché that you are only as old as you feel, and that age is just a state of mind; with people living and working longer, and the cultural changes that this entails, we may be moving  closer to a society in which we need to reconsider and redefine every aspect of what we mean by ageing.

Most of us enjoy better life chances, and a higher life expectancy, than previous generations. Though not without exceptions, this affords us the opportunity to think about ageing differently.

 

 

 

Letter from the CCN to the Secretaries of State for Health & Local Government

fullsizeoutput_1cbeLast week I attended the National Children’s and Adult Services Conference in Bournemouth.  On the way down as Leaders from across the Adult Social Care Councils including me, received an email with a letter attached from SoS DH Jeremy Hunt and co-signed by SoS DCLG Sajid Javid about Delayed Transfers of Care, these happen when a person is medically fit for discharge form a Hospital and we are unable to put in place a suitable package of home or residential care quick enough, this is known in Health and Local Government as DTOC.

As winter approaches and with one of the worse Flu epidemic in the Southern Hemisphere seen in recent years (if you have not yet had the flu jab, I would recommend it, I paid £10 at my local chemist and apparently ASDA are doing them for £5) the NHS is extremely worried about the stress on hospital beds over the winter months, as they are expecting significant numbers of admissions for this simple but dangerous virus to vulnerable groups’.  So the need to feed up beds is important and there are two areas where local government is involved preventing people going to A&E in the first place and how quickly we can facilitate those who need a care package when they are ready to leave hospital obviously the more effective the system the more beds the NHS will have free to cope this winter.

The letter were somewhat condescending and effectively suggest we alongside the other 80 or so local councils responsible for DTOC are failing.  However it was a step back from the threats made earlier in the year about fines and direction of budget if the situation did not get sorted out.  Very DoH, not very DCLG but in this repsect DCLG is very much the junior partner to the might DoH.  During the course of last Wednesday at the conference it emerged that there were in fact three different letters issued, and our was the middle one not praising us but not summonsing us to Department of Health (DoH) as about 32 Councils will find themselves having to go before a panel of experts at DoH, and for experts read people who work in Whitehall, or more precisely civil servants who work in DH in Whitehall who will want to see plans for a lower DTOC target in those areas or they will re-direct monies spent of Adult Social Care to hospitals which will not deal with the issues and probably make them worse.  Adult Social Care cannot be fixed by a summons from DoH, it needs careful partnership working on the ground in each area surrounding a hospital. .  At the conference, we referred to these as naughty step letter and which one you were on – a very flippant comment given the seriousness of the issue but given the patronising letters, as if our social work teams are not working hard to provide the care packages, which they are, its the right term to use.

The issues are complex and the impression you get from the letters is that its entirely Local Governments fault and so DoH can swoop in, divert money to hospitals and all will be right with the world, sorry but this is nonsense.   Fundamentally Local Government needs funding to provide the care, it’s as simple as that, and the threat is that if local Government does not improve then it will have funding withdrawn is worrying.  this is not about simply demanding more money for Local Government has stepped up and made the savings the Government has called for but there comes a point.  Across the county grown up discussion with Hospitals and Clinical Commissioning groups are building a long term system to handle discharge and withdrawing money will not improve that one bit, quite the reverse in fact.

So, on behalf of the County Councils Network on Friday I wrote to both Secretaries of State pointing out the position of CCN member Councils and our concerns.  In Suffolk we work closely with our Acute hospitals planning prevention, avoiding having to go to A&E and when people are admitted discharge planning starts straight away, in West Suffolk the hospital’s enlighten CE Stephen Dunn has contracted beds in a Care Home with nursing to provide people a different setting to recover, what used to be called Convalescence.  As our population ages we are going to need to see a return to this sort of step down care, from our hospitals.

EADT – A new weekly column

On Tuesday in the EADT and the Ipswich Star I wrote the first of a weekly Column as Leader of Suffolk County Council, well I say weekly it will be every other week as I shall alternate with SCC’s Cabinet Member for Ipswich Paul West who will write more about Ipswich issues as I concentrate on a pan-Suffolk approach.

These will be a mixture of the issues that are happening as the papers go to print and some of my thoughts about how we develop Suffolk as a place to live and work over the next 20 years.  Suffolk County Council is a large organisation delivering services to some of the most vulnerable people in our Community but it is but one players and how we work in partnership across the Public sector, with private businesses and voluntary organisations is key to how we build the place we all want to live.

“Yesterday in Lowestoft, as I witnessed the initial stages of the ground investigations that will shape the final design of the Lake Lothing Third Crossing, I saw the good of our democratic bodies working together.

The investigations, taking place on land behind the offices shared by Suffolk County Council and Waveney District Council, is another step in the right direction to getting the £90million project, funded by both central government and the county council, completed. The benefits will not only be reaped by those living in the town, but across the wider area too. We simply would not have funding for the project had this not been the case. The business case for this project, along with the Upper Orwell Crossings in Ipswich, was put together by people who work very hard and want the best for our county.

This also rings true for the senior bosses and directors who work on our behalf. They all, like the democratically elected councillors, work hard to make a difference to Suffolk and those who live and work here. Pay in the public sector has always been a fiercely-debated issue, and even more so in recent times. It’s not just politicians and those working in the public sector – we’ve all seen the furore over the salaries awarded to the highest earners at the BBC, as well as the gender pay gap.

Last week we published our accounts, as we do every year and are required to do so. As has been reported, the majority of our staff received the 1% pay rise, in line with other public sector workers up and down the country. However, a select few members of staff received honorariums as they stepped up to fill roles, either on a temporary or permanent basis.

Indeed, they are pay rises, but they are reasonable, considering they come with greater pressures and expectations. There is no hiding from the changes that will be coming to the United Kingdom in the next two years and these people will be there assessing and dealing with those challenges. Alongside that, as an organisation we are looking to save £56million over the next four years and, along with the cabinet, these people are key to making difficult but effective decisions.

Bringing in new people to the roles would have cost the council even more money. Not just for the roles themselves, but for the cost of advertising the position. Then there is the time element too, as staff will be taken away from working on policy and serving the community as they filter applications and sit in interviews.”

Our recently introduced priorities are based on three core principles; inclusive growth, health care and wellbeing, and efficient and effective public services. These are ambitious targets – but ones I know we can achieve during the term of the administration.

This is because of the hard work and commitment of our staff, regardless of pay grade, and our councillors – and not just those in control of the administration, as opposition provides checks and balances and the chance to challenge us on policies.

Sound financial management is needed, along with careful planning and the will to find new ways to deliver and protect our frontline services. One of these methods Suffolk is leading on nationally – inspired by the work of a Dutch community, using the Buurtzorg model of care (to deliver dedicated personal and healthcare to patients in a neighbourhood) in the west of the county with our partners in health.

The work we have been doing here is something I am proud to champion in my position of Health and Social Care Integration spokesman on the County Council Network. It is something I truly believe is a strong contribution to the national debate about how we re-shape the healthcare system to serve the ever-changing age profile of our communities. I’m sure there will be more of this to come in the weeks and months ahead as the trial continues.

We, and our partners, work extremely hard to provide the best for our residents. Despite the challenges we will come up against, our staff continue to excel every day in a concerted effort to make savings and provide a better life for those we serve.

Things have to change

Last Monday in my role as Chairman of the Improvement and Efficiency Panel of the East of England Local Government Association (EELGA) I chaired a conference at the Cambridge Genome Campus Conference Centre, probably the most impressive venue in East Anglia.  The conference was entitled Positive Ageing and co-convened by the Eastern Academic Health Science Network (EAHSN), which is an organisation within the Health system dedicated to new learning and bringing technology to the fore in the Health world, the other co-sponsors were NHS Confederation and Public Health England.

About 200 people from across the region’s Health and Social Care system gathered to hear speakers and life experiences of older age and how we, as a system, can help shape a positive vision and reality for people as they age in our communities.  An ageing population is often talked about but just living to a ripe of age is not enough it has to be a positive experience or what the point and that is the point I made in opening the Conference.

Here is conference brochure summary of what the day entailed:

‘With a significant ageing demographic the East of England is well positioned to be at the leading edge of accelerating the testing and scale up of self-care technology and health services in a way which can help make ageing work better for everyone.

This conference, led by Eastern AHSN, the East of England LGA, Public Health England and the NHS Confederation, will bring together NHS, local government, industry and academia stakeholders and aims to strengthen emerging solutions, new ways of working and shared plans for achieving healthier and happier ageing across the region.

In particular it will look to:

  • support the STPs to meet their ambitions on this agenda
  • identify opportunities to work collaboratively to further positive ageing agenda
  • position the region at the forefront of the UKs research and innovation communities.

The conference will be structured around six themes which include:

  • Defining successful ageing – What are the real demographics of ageing?
  • Sowing health habits – What can we do to ensure our own health and increase the chance of both a long life and a healthy life?
  • Rethinking work – How can society ensure the health and economic benefits of work for more people into older life?
  • Breakthroughs in technology – How can new research and innovations radically change our concepts of what old age means?
  • Connecting with others – How can we develop caring communities and multi-generational social networks?
  • Preserving purpose – How can health and social care systems focus on maintaining quality and purpose of life above the drive for extending life?’

And here is the link to the presentations from the day and if you have a look please look out for the Buurtzorg Health Care Model as that is a programme I am championing here in Suffolk and is a part of our contribution to the national debate about how we re-shape the healthcare system to better serve the changing age profile of our communities.

http://www.eelga.gov.uk/events/east_of_england_positive_ageing/

 

 

 

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