Digital Inclusion and an Ageing Population

digital-inclusion-150x150A couple of weeks ago I had was invited by SEEFA (South East England Forum on Ageing) (www.SEEFA.org.uk) to take part in a House of Lords Symposium on Digital Inclusion and an ageing population. It was my first time in a Lord’s Committee room and I had the pleasure to sit next to Lord Filkin who hosted the event. As we chatted we discussed the House of Lords report of a couple of years ago which he co-authored about the state of readiness of UK PLC for an Ageing Population and its premise that one of the early warning sign is A&E performance which was most apropos given the poor figures published that week.

Journalist David Brindle from The Guardian chaired the meeting where we heard from a number of speakers including Paul Burstow MP the former Care Minister and from around the table people discussed what is meant by digital inclusion and how to drive it forward, the discussion took place before an invited audience and the thoughts captured for a report based in part on the discussion that was had. For my part I talked on being careful not to replace community and human interact for a new digital interaction as loneliness is the key issue here and no amount of technology can replace friends and family, technology can enable friends and family to keep it touch but it can’t replace them.

One of the things I learnt and pondered about was ‘Digital Fossils’. In this area we all too easily say when the current generation of older people have passed because within the next generation most people can use a laptop and tablet they always will but as technologies change, people can get struck at a stage of learning new things and so the new technologies may pass them by and they will struggle to use the emerging platforms. With the fast pace of change in digit technology IT literate today does not necessary mean IT literate tomorrow. This sound daft until you stop to think about it. How many of us are comfortable with email and word and excel and our CD collection then talk with younger people and see if they do the same and increasingly they don’t. They use WhatsApp, SnapChat, Google docs and have a Spotify account for their music or download it from iTunes, with email being how you communicate with the old folks! So interestingly it’s not as far-fetched as it sounds and thus adds to the challenge of making sure inclusion is a key element as we develop digital services now and in the future.

The future of adult social care and support: a roundtable discussion

As a part of the Department of Health’s ‘Caring for our future’ engagement exercise yesterday I attended a conference to discuss the up and coming Social Care white paper with such leading lights as Lord Norman Warner who was a co-author of the Dilnot Proposals, David Behan CBE the Department of Health’s Director General of Social Care. and Paul Burstow MP the Care Minster amongst others.

Lord Warner opened and spoke of the need for structural reform to the NHS and Social Care.

When you think that in Suffolk the Health System spends more that £4.5Billion it puts into context the figures he quoted such as 75% of NHS spend is for those with long term medical needs and that over £50% of the total spend is in the Actue Hospital Sector.

Interestingly he spoke of the Kidderminster effect where an independent won a Parliamentary election seat about saving a hospital that should have shut as a part of structural change and how there is much that MPs and the public alike will need convincing off.

He went on to say that without fundamental reform you won’t get the financial services industry to come up with the insurance and financial planning products; nor integration of the Social Care and CHC care assessment and you won’t get true portability.

He concluded that “There isn’t really another structural show (Dilnot) in town”

In answer to a question about how to drive integration of Adult and Social Care Assessment he said that in his opinion you have to define what integration means in legislation to make Health Services engage.

Next up was Frances Patterson QC who spoke about the recommendations of the Law Commission Report and right on the middle was perhaps the most significant element of al before the Social Care bill, if it results in a new care assessment process and the bar is set too ‘low’ then the costs will frankly bust local government in a one swoop!

The David Behan shared some of the latest thinking about the Social Care white papers and In answer to a question about Health and Well Being Boards David Behan said people keep asking can we do it and we have said all along that you don’t need permission.

However it strikes me that in my experience we accept we don’t need permission but Health do they need it is writing in triplicate to do anything.

Next came round table discussions and David Behan sat in on my tables and I was able to expand on the Suffolk Flexicare approach to helping shape the Care and housing markets, As Caroline Tapster the Chief Executive of Hertfordshire was sitting next to me throughout the morning I did have to acknowledge that I somewhat shameless stole their initial work on replacing Sheltered Housing with Extra Care Housing and expanded on it to drive forward Suffolk Flexicare.

Then came a session with the Care Minster Paul Burstow MP and a number of searching questions were put to him including one from me about the need to have it legislated to allow monies to shift around the system if savings are made and that if this meant that Acute Hospitals wards closed as a result the Heath and Well Being Boards have a Leadership Role to play in explaining to Residents why this was a great step forward as a more intelligent spend of the systems monies rather than cuts. David Sprasons my fellow regional Chairman of the Lead Member Group form the Midlands made the point that if we could shift 1% of the money by making improvements to long term care needs, getting older people out of the acute Hospitals wards and into Residential Care with medical supervision, a far better place to rest and recover and find new ways to better support people and prevent them presenting to the Acute’s in the first place we could pay for all of Andrew Dilnot’s Proposals without any need for additional monies to come into the system.

In answer to both of these Paul Burstow welcomed the thoughts and said this was in part about creating the framework to allow these things to happen and he hoped the Social Care White Paper would address these points and it was in part about MP’s and the General Public understanding what we are about.

After the sandwich lunch we then had a meeting of the Chairmen of the Regional Networks to discuss the morning and action points we could take away to discuss with our respective MPS to lobby for the Changes the system needs, the changes older people need, the changes we all need.

Now just leaving to go back to London for the very first meeting of the National Learning sets ministerial launch event for Health and Well Being Board early implementers, as I am Suffolk’s lead on this, but more of that later.

Panorama last night – An Ageing Society

I thought the Joan Bakewell peice last night really got to the heart of the issues we, as a county face, in dealing with our aging population, clearly she understands the subject fully and what I though was very interesting is that she did not seek to present nayone route as the soultion to all our problems.

What pleased me most, if that is the right way of putting it, in all the issues around this difficult subject is the approach we are taking in Suffolk. Suffolk Flexicare has as one of its objects is to create an enviroment here in Suffolk where both private companies can come in and develop significant care villages and more local RSLs can build more and more Extra care albeit on a lesser scale but perhaps more routed in comunities.

We are also, through our Home First service, a national lead on re-enablement stratergies I recall going to a the first Department of Helth Conference on this about three years ago at the Oval, it was actually a bit boring because we were already doing the thinks they were talking about doing.

Today, Suffolk Home First  is such a success that those we provide it for, and we provide the service free to the people of Suffolk, we have over a third of people do not need an on going service. Simply put this saves the Council a considerable sum of money and is better for the customer as well.

The only thing I though that was not quite right last night was that beyond extra care a residential nursing home for those people you are very frail and for higher end dementia is most appropriate and serves an important function in our community. Unspoken was nursing care facility at the heart of the Extra Care Charity home in Birmingham, which on a smaller scale would not be achievable on site.

Provision of the right type of variety of housing, care and support that remains in place during these difficult times and the Royal Commission on how we pay for it all, is most timely or as Ms. Bakewell rather intimated that politicans talk and people just get older, we need to begin to reach conclusions and start implimenting policies now!

Unlike last time, just as with Labours redicous green, white and the staggeringly uncosted ‘Free Care at Home Bill’ we will not be seeking to make our voices heard on the front page of the Times, but rest assured in the background I know a number of Portfolio Holders are  trying to help influence policies for our aging residents that are of real benefit.

I look forward to David Behan and the Care Minister Paul Burstow MP presenting the findings of the Royal Commission and their thoughts but unlike the farcical situation of the lack of finanical figures, and the embrassed looking David Behan announcing dates that were constantly missed and deadlines disappearing that dogged Labours Care Green paper; this future paper will have figures attached so we can all clearly see how and who will need to pay for it.

Fingers crossed!

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