A&E medics tell Hancock: No evidence yet for replacing four-hour target | News | Health Service Journal


The Royal College of Emergency Medicine has contradicted Matt Hancock’s suggestion that the four-hour target should be replaced, saying there was no evidence yet of a viable replacement.

Source: A&E medics tell Hancock: No evidence yet for replacing four-hour target | News | Health Service Journal

Print-your-own gun debate ignores how the US government long provided and regulated firearms : The Conversation


The current debate over a Texas company’s “right” to allow anyone to download blueprints to its 3D-printed guns is following the same well-trodden terrain as every firearms fight for the past few decades: differing interpretations of the Second Amendment.

Cody Wilson, the founder of Defense Distributed and the creator of the first working plastic gun in 2013, argues it’s about every American’s right to bear arms. “I believe that I am championing the Second Amendment in the 21st century,” he told “CBS This Morning.”

On the other side are the federal judge who is temporarily blocking the release of the blueprints, the eight state attorneys general who sued Wilson’s company from putting the designs online and gun control advocates across the country who want the government to do more to regulate firearms.

This misses the point. Government regulation and the gun industry are not natural enemies. They have a historical synergy that long predates Supreme Court rulings on the constitutionality of gun control legislation. It was not until 1886 that the Supreme Court even addressed the federal government’s ability to regulate gun ownership. For most of the nation’s first century, the government perceived its constitutional duty as providing guns – not protecting an open-ended “right to bear arms.”

My research on the history of the government’s intervention in the arms industry suggests a return to its role as guarantor of the gun trade would allow it to do more to reduce gun violence and mass shootings without trampling on the Second Amendment.

 

Source: Print-your-own gun debate ignores how the US government long provided and regulated firearms : The Conversation

Why is the government waging a war against disabled people? : The Guardian


Ministers’ social care and welfare reforms represent a deliberately prejudiced, vicious attack on a significant minority of the population

The chancellor, Philip Hammond, made no mention of social care in his autumn budget. Photograph: Kirsty Wigglesworth/AP

A recent United Nations report on its inspection into the UK’s record on disabled people’s rights was described as a “17-page-long catalogue of shame” by one commentator, who wrote:

Over the past seven years, cuts to benefits, social care, the legal system and local authority funding have effectively put decades of slow, painful progress into reverse.

Cuts in social care funding have made a mockery of would-be progressive policies on personal budgets and direct payments. Cuts in day services and restrictions on access to freedom passes have marooned many disabled people behind their four walls.

We have also seen disabled students’ allowances cut; a reduction in funding of Access To Work, which made it possible for many disabled people to get into and stay in work; and greatly increased reporting of disability hate crime – including incidents against disabled children.

The chancellor, Philip Hammond, in his autumn budget, made no mention of social care; the Care and Support Alliance saying that the “government failed to recognise the immediate crisis in social care”.

The government’s latest proposals delaying a promised green paper on social care until next year don’t include any disabled people or organisations in the team of “expert advisers”.

Disabled people of working age won’t be addressed in the green paper and we can get some idea of what’s in ministerial minds from a recent social care debate in the House of Commons. Social care minister Jackie Doyle-Price repeatedly emphasised the part yet more welfare reform will play in the government’s future thinking for this group.

Over the past seven years, the government has not so much increasingly failed to secure disability rights under the UN convention on the rights of persons with disabilities as appeared to attack those very rights.

Successive governments have denied this, but with suggestions that disabled people have died shortly after being identified as fit for work, or killed or contemplated killing themselves after the withdrawal of welfare benefits, it is difficult to see this as merely a matter of misguided policy or economic exigencies.

It is becoming increasingly difficult not to associate such catastrophic policies with something deeper, something more visceral. We have to ask why does this government and its recent predecessors seem so bent on harassing disabled people? Is there something about us they just can’t stomach?

The present government particularly has made cuts to social care and reforms to welfare benefits that – without exaggeration – can be said to have damaged and spoiled the lives of millions. We know that thousands of disabled people live in fear of the brown envelope through the door; that some have even starved to death after their benefits have been cut.

These are not isolated cases. They affect all groups: people with learning difficulties; people who are dying; those with major physical and sensory impairments; with painful and enervating long term conditions; with the most severe mental health problems.

Modern governments talk a lot about “evidence-based policy”, but evidence has highlighted the cruel, draconian effects of these social polices.

We need to look way beyond ideological discussions about whether or not policy is “fit for purpose”. Instead, we must ask where this apparent underlying loathing of large groups of people comes from. What is there about us as disabled people that prompts such extreme measures?

Of course we know that governments like ours clutch at a different rationale. Their attacks are not on disabled people per se, they say, but those pretending to be disabled, the “shirking” rather than the “striving” disabled people.

Sadly, it is disabled people indiscriminately – and those close to them – who are suffering appallingly through these measures, not some imagined cohort of con-people or impersonators.

The current direction of travel of social care and welfare reform doesn’t merely represent harsh policy or even reactionary ideology. Instead it is a deliberately prejudiced, vicious attack on a significant minority of the population.

Governments and policymakers haven’t caught up with the reality that medical advances and social and cultural changes mean that the nature of who we are as a population has changed. There are now many more disabled people. Making our lives increasingly difficult may kill some of us, but it won’t seriously change the maths.

The failure of policymakers is that so many disabled people still face appalling and increasing barriers to employment, education, training, family and social life. It’s not getting rid of us that welfare reform should be about, but about challenging and ending these attitudinal, institutional and cultural barriers. And to do this, this government needs to start very firmly with challenging itself and its ministers.

  • Peter Beresford is emeritus professor of social policy at Brunel University London, professor of citizen participation at Essex University and co-chair of Shaping Our Lives

 

Source : Why is the government waging a war against disabled people? : The Guardian

Why Liverpool is bidding to become an autism-friendly city | Social Care Network | The Guardian


Autism champions around the city are being taught how to recognise the signs that someone may have the condition and how to handle challenging behaviour

Source: Why Liverpool is bidding to become an autism-friendly city | Social Care Network | The Guardian

Personal budgets allow people to control their own support and their own lives | Social Care Network | The Guardian


social care network: adult social care hub Policy Personalisation Social care Older people Disability England

Source: Personal budgets allow people to control their own support and their own lives | Social Care Network | The Guardian

Two years ago we called for reform in care homes. We’re still waiting | Social Care Network | The Guardian


social care network: leadership, learning and development hub social care network: adult social care hub Regulation Policy Work practices Careers Care workers Social care Carers

Source: Two years ago we called for reform in care homes. We’re still waiting | Social Care Network | The Guardian

A learning disability commissioner? Views from the social care sector | Social Care Network | The Guardian


Five years after Winterbourne View, Sir Stephen Bubb says a commissioner is needed to protect the rights of people with learning disabilities

Source: A learning disability commissioner? Views from the social care sector | Social Care Network | The Guardian

Too many councils are failing to meet their Care Act duties | Social Care Network | The Guardian


Local authorities are letting vulnerable people slip through the net when giving advice about care

Source: Too many councils are failing to meet their Care Act duties | Social Care Network | The Guardian

Why do social care providers get less support than their NHS counterparts?


Original post from The Guardian

‘………………………..By Felicity Dormon and Patrick Hall

When health providers are failing, governments act. The same is not true in social care – but the sectors need to learn from each other to make integration a success

 ‘If a hospital bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall,’ Aneurin Bevan famously said. But is this the case in social care? Photograph: Dominic Lipinski/PA
‘If a hospital bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall,’ Aneurin Bevan famously said. But is this the case in social care? Photograph: Dominic Lipinski/PA

Integrated health and care services have been the goal of central policies and local discussion for some time, and moves to devolve health budgets to areas such as Manchester and Cornwall are giving integration yet more impetus. At the Health Foundation, we’ve been thinking about approaches to improving quality in the health and social care worlds, and how they might be bridged for integrated care.

The differences between the two sectors are stark. Social care is provided by thousands of unique, often small private and third sector organisations. NHS providers are mostly state run, large organisations, holding a lot of sway with local commissioners. NHS providers are generally seen as too big to fail – social care providers can and do go out of business. The NHS average wage is £29,754, while most homecare providers struggle to pay more than minimum wage.

These differences are also evident in the approach taken to supporting quality improvement. In health, there is an implicit assumption that central government has ultimate responsibility for quality. This is encapsulated in former health minister Aneurin Bevan’s phrase “if a hospital bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall”. Several health secretaries have repeated this phrase when recently asked about their role.

Despite various attempts to remove the formal responsibility of the secretary of state, the national, political and quasi-religious status of the NHS means that when health providers are failing, governments act.

The Health Foundation has argued that there is too little support for NHS providers, and national action has focused too much on levers such as payment systems and performance management. Even so, the national stance has consistently been that responsibility for provider transformation goes beyond providers themselves – encompassing their commissioners, and requiring regional or national support programmes.

In social care, the story is different. The reverberations of bedpans once reached town halls, but now they struggle to be heard by even the most perceptive councillors. For various reasons, the purchaser-provider split genuinely transformed how social care is delivered, accelerated by the need to provide the choice and control for people using services. This continues in the Care Act’s market shaping duties, albeit with a duty to have regard to “the importance of fostering continuous improvement” in a diverse care market.

As more care is being delivered by the voluntary and private sector, improvement support in social care has been increasingly seen as the responsibility of providers themselves. It is largely given through good practice guidance provided by organisations such as the Social Care Institute for Excellence, Think Local Act Personal and Skills for Care – the most recent example being the joint websiteCare Improvement Works, mapping resources against regulatory requirements. Direct support is generally only available on an individual consultancy basis.

Where the delivery of statutory functions (such as assessment, care planning, review and safeguarding) has remained largely the work of the local authorities themselves, peer review has played a significant role, and is viewed positively by those involved.

So in health there is recognition that improvement takes support beyond the boundaries of providers, and in social care much less so. Why is this? A large contributor could be ownership; a feeling that we should support publicly owned organisations to improve (hospitals) but privately owned organisations (care homes) should sort themselves out. This perhaps explains why support for general practice in health is a much overlooked area. However, the idea that resources to support change will be feeding into profits seems laughable in the current financial climate.

 Scale also has a role to play. Health has a strong national and regional component, whereas social care focuses very much on the market within a council. And a third issue may be understanding of outcomes. More transparency in performance in health may mean more attention is paid to it. In social care, there has been very little information to judge quality of care on until recently.

The Five Year Forward View, devolution to city regions and the implementation of the Care Act dramatically changed the health and care landscape, and demand joined up thinking about how to improve quality. Where will the reverberations be heard from integrated provision, multi-speciality providers and local government run hospitals?

Health and social care can learn from each other. The focus on peer support and learning in social care could usefully be picked up by health, including support for commissioners. And in social care, more support for providers could allow them headspace to look beyond the day to day, and regional coordination could facilitate learning and spread of innovation. Some aspects are being explored, for instance through the recently announced pilot of peer reviews for Better Care Fund activities. It is important that the supportive stance of peer review is carried through to implementation.

Beyond mechanisms for improvement, the task of bringing together very different cultures should not be underestimated. Support for both those leading change and those providing care will make success much more likely. If we are serious about integration, we should confront and discuss our cultural assumptions about improvement at a national and local level, and take the best from health and care’s different approaches to supporting improvement.

  • Felicity Dormon is senior policy fellow at the Health Foundation and Patrick Hall is practice development manager (policy) at the Social Care Institute for Excellence.  …………’