@CareQualityComm State of Care Report: Reform is Overdue

Last week the Care Quality Commission (CQC), the Health and Social Care regulators said in its 2020 State of Care Report that the COVID crisis has both exposed and exacerbated existing problems in adult social care. The CQC recognise that the sector which is already fragile, faced “significant challenges” around access to PPE, testing and staffing, and that coordinated support was less readily available to social care providers than for the NHS.

The State of Care Report says the long-standing need for reform, investment and workforce planning in adult social care has been thrown into “stark relief” by the pandemic. They have called for long-term funding and a new deal for the care workforce, which develops clear career progression, secures the right skills for the sector, and better values staff. There is also a need to invest in their training and support.

Ian Trenholm, Chief Executive of CQC, said:

“Failure to agree a funding solution continues to drive, year on year, instability in the market, and COVID has exposed and exacerbated that, particular in terms of funding. Money has been made available by the government, but it’s all short-term funding. What is required is a longer-term funding solution But it’s not just about money, it’s also about staffing and professionalising the adult social care workforce, making sure that working in adult social care has the prestige that it deserves. … every year we talk about social care being fragile. Now is the time for action. COVID has pushed social care even closer to the edge and we need to make sure that action takes place now.”

Boris Johnson said in his first speech  as prime minister, in July 2019 that his government would fix the crisis in social care once and for all, but no reform has yet been proposed despite more than 15,000 people dying from Covid-19 in England’s care homes. Covid-19 has also exposed further the inequalities in the service that exist for people from black and minority ethnic backgrounds, people with disabilities, and people living in deprived areas who have suffered more severely from its impact. The CQC press release about the report can be read here.

Another report on a similar topic, has been released by Skills for Care on thier Workforce Intelligence Website. They have released their report, “The State of the Adult Social Care Sector and Workforce in England” which amongst other things indicates that the vacancy rate is 7.3% (equivalent to 112,000 current vacancies). Their findings with a really useful infografic summary are available for access Here

What will #Scotland #Socialcare Look Like in the Future?

Last weekend the first part of a Scottish Social Care Special Report on the future of social care Post Covid-19 by Pennie Taylor, the former BBC’s Health Correspondent. It went out on Sunday’s @BBCWeekendGMS between 9.30 to 10am. In the report insiders shared their experience of working in what has become a a very pressurised system.

The report featured Annie Gunner Logan, Chief Executive of the Coalition of Care & Support Providers in Scotland, and Dr Donald Macaskill, Chief Executive Officer of Scottish care, the representative body of the independent care sector which includes private, voluntary and charitable organisations and #HighlandHomeCarers. In the report those interviewed discuss many aspects of the current commissioning system, which seems to be encouraging a ‘race to the bottom’ rather than the person focused care that everyone would like to see. They also begin a discussion on what a ‘National Care Service’ might look like and why it is not the panacea that many think it might be.

You can listen in to the report by going to this link within BBC sounds

https://www.bbc.co.uk/sounds/play/p08ns8b3

or alternatively by clicking here on the Good Morning Scotland listen back programme page https://www.bbc.co.uk/programmes/m000lspv

If you use the second link the special report begins at 1.32.20 and continues to 2.o2.59.

My favourite quote from the programme

“There is something wrong with a system when you can earn more for walking a dog in the city Edinburgh than you can for caring for a human being”

The second part is on next Sunday and I’ll be tuning in.

@BloggersNurse Challenge: My Best Days in Nurse Lecturing

I am posting for the challenge at the last minute again. I have to say that this is one of the most difficult topics for me to write about. As a Nurse Lecturer I often think the best days are behind me and that I was probably more effective when I was working in Acute Care. My students probably think the same most of the time, even though they are too young to remember me from those earlier career days.

So I am not attempting a history/reminiscence lesson here. I am going to be quite predictable and pick my student’s graduation days. They are a once a year reminder of why I do my current job.

It’s not about me at all; the day is all about them and how they feel when they are finally awarded their Master’s Degrees. Nothing makes me happier in work than seeing how proud they are when they finish. Many have overcome many obstacles to get to the end of their programmes. These can include, family hardships including deaths within the close family, financial concerns, acting as carers to their children and often a carers to their parents as well. Many deal with personal illness and in some cases are also faced with a lack of support for all their effort within their workplaces, that I sometimes fail to understand.

They all show great perseverance to get to the end no matter what good or ill befalls them. (More about this whole topic at another time when I finally get to the end of my own Doctoral studies.) So the picture I have chosen to head the article is my favourite picture from last year’s graduation and I am not even in it.

For the sake of balance I thought I’d better show a few more successful students with my colleagues. You know who you all are (and a big sorry to the students who are not here!)

2019
2018

For those of you who don’t know, I am the Programme Leader for the Gerontology Programmes at the University of the West of Scotland. You can find out more about our MSc in Gerontology (with Dementia Care) programme by CLICKING HERE

You can also find out about the other work I am involved in by following @AlzScotCPP on Twitter or going to the Facebook page of the Alzheimer Scotland Centre for Policy and Practice. You can get to this by CLICKING HERE.

Please ‘Like’ us when you get there!

#DementiaAwarenessWeek 2020 in Scotland

Its Dementia Awareness Week in Scotland. It ends on the 7th of June so this post only just makes it in. In previous years the team I work with @UniWestScotland   are usually heavily involved in promoting the week and supporting several events that are on. See this 2018 post for example. https://wordpress.com/post/raymondsolderpeopleblog.wordpress.com/4957

This year though has not been the same. No events to attend and nothing to organise. 😦

So what we have done instead is support everything online that we could. See @alzscot and @AlzScotCPP

We also decided it was time to have our own Facebook Page which you can visit HERE 

Also came across this resource this week. A booklet to help people with dementia in long-term care settings #StaySafe . This free book was developed by Lynne Phair and care home manger Jim Watt who adapted it from a draft prepared in Canada by Gerontologist & Dementia specialist Gail Elliot, formerly of McMaster University, Ontario, Canada. You can find it by CLICKING HERE 

There is a similar resource for staying safe at home which you can download FROM HERE

 

Easter Advice on PPE; April 2020

Next week many of the final year undergraduate nursing students at my University go out to join the health and social care workforce. The University, my colleagues at UWS and I are very proud of the 1,200 UWS students joining the frontline fight against COVID-19 next week – a huge thank you to those who have volunteered to join the workforce, to help protect us all 🌟 https://www.uws.ac.uk/…/uws-students-join-nhs-frontline-co…/ #WeAreTogether

However, its far from a bed roses out there, particularly in relation to the Personal Protection Equipment (PPE) that you all require. On Tuesday the BMA published a snapshot survey that 2,000 doctors had responded to. According to their survey, more than half of doctors working in high-risk environments said there were either shortages or no supply at all of adequate face masks, while 65% said they did not have access to eye protection. Alarmingly many felt pressurised to work even in high-risk area despite not having adequate PPE. The shortage appears worse among GP’s with more than half saying they bought their own and only a small number feeling adequately protected. See BMA Survey HERE

So if you are going out to look after our older people and others who may have COVID-19 what do you need to know?

Health Protection Scotland have a page dedicated to COVID-19 that provides an extensive guide to using PPE in the fight against COVID-19  that includes a number of workforce education resources. You can access them at https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-infection-prevention-and-control-in-healthcare-settings/

With a weekend to go this would be a good time to sit down and do some reading and learning if you haven’t done this yet. If you do encounter someone with COVID-19 as some inevitably will, then make use of these COVID_19 NICE Guidance and make your clinical colleagues aware of them.

Finally, if you are concerned about your PPE or the supply of PPE, in Scotland there is a helpline which has has been set up for services registered with the Care Inspectorate regarding access to personal protective equipment (PPE).

All services who are registered with the Care Inspectorate and are providing social care support, who have confirmed/suspected cases of COVID-19, and have an urgent need for PPE after having fully explored local supply routes/discussions with NHS Board colleagues, can contact a triage centre that is being run by NHS National Services for Scotland (NHS NSS). This helpline is to be used only in cases where there is an urgent supply shortage after business as usual routes have been exhausted and a suspected or confirmed case of COVID-19 has been identified. The following contact details will direct providers to the NHS NSS triage centre for social care:

Email: support@socialcare-nhs.info

Phone: 0300 303 3020. The helpline will be open (8am – 8pm) 7 days a week.

This helpline is not for NHS staff or for NHS providers who have an NHS BAU supply route.

Looking after Yourself and Your Team: Some Resources for Healthcare Workers

For a change this week I thought I’d turn my attention to the workforce currently looking after our older people.

So if you are a healthcare worker here are a few resources that you and your team can turn to and try out in the coming weeks as this unprecedented, once in a hundred years, health crisis continues.

The first thing that I would like to share is some timely advice from the Queen’s Nursing Institute, Scotland (QNIS) from Hilda Campbell, Chief Executive of COPE Scotland and QNIS Honorary Fellow has provided the following wee ideas of things that could help you look after yourself and create some ‘me time’. Even if it is just a few minutes. You can access her Blog piece here

It also includes other links within it which are worth following up. It would also be a good idea to share this resource with all the staff that you are working with.

The next resource I am going to suggest is from the Kings Fund and it looks at compassionate leadership in this time of crisis. it discusses the idea of an ABC of compassion at work, suggesting that leaders need to help provide Autonomy and Control, a sense of Belonging and a promote feelings of Competence. working in a compassionate way will aid in supporting your whole team through this stressful time. For more about this see: https://www.kingsfund.org.uk/blog/2020/03/covid-19-crisis-compassionate-leadership

On a similar theme this is a paper recently published in the BMJ by Greenberg N., Docherty M., Gnanapragasam S., Simon W. (2020)  Managing mental health challenges faced by healthcare workers during covid-19 pandemic BMJ; 368 :m1211 You can access it here.

The paper looks at measures that healthcare managers need to put in place to protect the mental health of healthcare staff having to make morally challenging decisions. Its brief and well worth reading particularly about aftercare; what needs to happen once this crisis passes.

Currently NHS staff are also being granted free access to a number of mental health apps to support their health and wellbeing as they work around-the-clock to treat coronavirus patients.

The apps, which include platforms to proactively improve mental health as well as sleep improvement programmes, will be freely available until December 2020.They include Unmind, a platform that provides a range of tools to help with stress, sleep, connection and nutrition; Headspace, a mindfulness and meditation app aimed at reducing stress and building resilience; Big Health’s Sleepio, a clinically-evaluated sleep improvement programme, and Daylight, a cognitive behavioural technique to manage worry and anxiety. You can access them all via this page of the NHS Employers website https://www.nhsemployers.org/news/2020/03/free-access-to-wellbeing-apps-for-all-nhs-staff

The final resource and perhaps the most important is to be found on the Scottish Association for Mental Health (SAMH) website. They have collected together all the resources that can help and protect everyone’s’ mental health and wellbeing as they cope with the stresses brought about this pandemic and the stresses caused by of social isolation. We would urge to make use of this site and please share it with all your staff and patients

Thanks to my colleagues Janette Barrie and Constantina Papadopoulou for suggeting some of the material posted this week. In the meantime Stay Safe!

Suggestions for Things to Do While Isolating

I am going be quite choosy here and not give a huge long list. So let’s start with a brilliant initiative called Luminate@Home. Luminate runs a diverse range of activities and events that celebrates our creative lives as we age. It holds avery successful annual festival here in Scotland that usually takes place in May. In response to the fact that lots of older people at home or in care homes right now who are having to isolate from the wider world for a while they have launched a new programme of online creative activities

Luminate@Home are uploading short films every Tuesday and Friday at 2pm, on Luminate’s facebook page and on their YouTube or Vimeo channels. The films are designed to inspire and guide you through a creative activity that can be done at home or in a care home. The activities are presented by professional artists and feature different arts forms including crafts, poetry, music and dance. The films will be left online so you can access them at any time.

My next suggestion is a Scottish Care initiative called Tech Device Network. They are inviting businesses, organisations and individuals with spare technological devices to donate them to care services. All you have to do is click here to get in touch and tell them what you are able to donate. Scottish Care will then connect you with care services who would benefit from receiving the devices and jointly will arrange delivery/collection. As they state at this time this could have significant benefits for mental wellbeing, reducing distress and maintaining connections with loved ones for a vulnerable population and those supporting them. A meaningful way to connect our communities at this time and hopefully one with long term positive outcomes.

Last suggestion is from the Centre for Better Ageing who put up a useful blog post about keeping active in isolation. Its at https://www.ageing-better.org.uk/news/how-we-can-all-keep-active-home-during-coronavirus-crisis

Remember everyone its important to keep up your strength and balance at this time. Let’s get back out fitter than we were when we got locked-down.

That would be a positive achievement!

 

 

 

#britgerontology Statement on COVID-19

Well, I said I thought I would post something about Coronovirus in my next Blog, so I’ll keep my promise.

This however does not come from me this is the statement released on the 20th. of March 2020 from the President and Members of the National Executive Committee of the British Society of Gerontology which I am a member of. This statement was made in relation to the unfolding political, policy and media rhetoric concerning age divisions that have emerged during the response to the COVID-19 pandemic which I have at times found quite concerning. My apologies about the length of the statement but it makes some excellent points that we should all consider during this worrying time.

The statement urges Government to reject the formulation and implementation of any policy based on the simple application of chronological age. The BSG call on government and media organisations to be cautious in their use of language so that we continue to foster generational and societal cohesion during the course of the pandemic. Only by bringing the generations together in this time of crisis can we ensure that the least damage is done to people living in the UK and other countries. The statement goes on as follows:

“We affirm the prime goal to control and limit as far as possible the spread of COVID-19. To achieve this goal requires a clear focus on evidence-based practice, using high quality research. We fully support action taken to limit physical interactions, maintain hygiene standards and restrict non-essential travel, and we understand that actions to contain and delay infection will require disruption to our everyday lives.
We urge the Government to ensure rapid COVID-19 testing for our front-line health and social care workforce and the wide range of individuals and organisations who are leading the response to the pandemic. We are also in favour of providing tests for the wider population. This allows people to respond appropriately to the pandemic, ensuring that the right people isolate themselves at the right time. Wider testing is also essential to provide access to robust data that can be used for research and modelling to assist us now in responding to and containing the virus, and in preparing better for future pandemics.
However, for the reasons set out below, we object to any policy which differentiates the population by application of an arbitrary chronological age in restricting people’s rights and freedoms. While people at all ages can be vulnerable to COVID-19, and all can spread the disease, not all people over the age of 70 are vulnerable, nor all those under 70 resilient. Older adults are actively involved in multiple roles, including in paid and unpaid work, civic and voluntary activity in local communities, and providing vital care for parents, partners, adult children and grandchildren. Quarantining the more than 8.5 million people over 70 years of age will deprive society of many people who are productive and active and who can be a key part of the solution by supporting the economy, families and communities. If blanket measures are taken to quarantine older people when others in the population are not quarantined, this places additional burdens on families, communities and businesses, and causes harm to those individuals.

  1. As a population group, it is wrong and overly simplistic to regard people who are aged 70 and above as being vulnerable, a burden, or presenting risks to other people. Many people in this age group are fit, well, and playing an active role in society. Older people participate in paid work, run businesses, volunteer, are active in civil society and the cultural life of communities, and take care of family members including parents, spouses/partners, adult children (especially those living with disabilities), and grandchildren. There are currently more than 360,000 people over 70 in paid work, including one in seven men between 70 and 75 and one in sixteen women. Almost one million people over the age of 70 provide unpaid care, including one in seven women in their 70s. One in five people aged between 70 and 85, over 1.5 million people, volunteer in their communities. People in good health are especially likely to volunteer at older ages with almost a third of those in their early 70s doing so. Older adults should not be excluded but should be seen as a vital and necessary part of economic and community life.
  2. Serious health risks particularly identified for coronavirus are prevalent across the population. Not only do high risks exist across age groups, but also many people in older age groups have no underlying health conditions. Almost half of people in their early 60s have one of a range of health conditions (hypertension, heart disease, diabetes, lung disease, asthma or cancer). Almost one in five people in their 60s have two or more of these conditions. More than 30% of people in their 70s have none.
  3. It may be correct that age itself on average is presenting a risk for coronavirus even without other health conditions. However, this will not be the case for all individuals, amongst whom biological age and immune responses vary greatly. More importantly, this will on average be a gradually increasing risk with any specific age being an arbitrary point on this line. Choosing an arbitrary age, such as 70, presents the age risk as binary. This poses dangers for people below as well as above the age threshold. People below the age threshold will not be charged with the same level of responsibility for preventing the spread of COVID-19 and may falsely believe that they are not at high risk of serious illness or death. Government messaging that people aged 70 and over are vulnerable due to their age runs the risk that other groups may not take seriously messages about the need to maintain physical distance from others and to self-isolate. Messaging about how to avoid catching and spreading coronavirus should apply to everyone irrespective of age.
  4. If people are to be motivated to change their behaviour, they need to accept that they are personally at risk (perhaps due to an underlying health condition or family circumstances). Sweeping age-related discrimination is unlikely to achieve the desired behaviour change. People who feel fit, strong and healthy will feel that the message does not apply to them and will characterise themselves as belonging to a group apart. The age-based messaging also risks pitting young against old. It may make older people feel resistant to what they are being told, which they do not see as applying to their situation. Media, government and public health professionals should strive to use language that resonates, rather than obfuscates, how people identify in their everyday lives.
  5. People of all ages, when staying at home or trying to distance themselves physically from others, remain members of families, friendship networks and communities. All measures should be implemented with an awareness of people’s need for social support and solidarity. It is clear that physical distancing needs to happen across the whole population at once, and sensible rules for maintaining mental and physical health during this period need to be employed. We cannot implement a policy that will severely weaken the physical and mental health of some age groups through isolation while others are more protected. Given the centrality of both mental and physical well-being, there is a need for clear guidance on what people can do to maintain and improve their physical and mental health while keeping physically apart from others. This will only be effective if the message from Government is not divisive around age.
  6. Research points to the fundamental importance of social connections for personal well-being and physical and mental health. The COVID-19 crisis has prompted considerable discussion of loneliness and social isolation amongst older people suggesting, quite wrongly, that these are vulnerable states that apply to older people alone. Increasingly, media discourse is also promoting the view that all older people are lonely and socially isolated. Contrary to this discourse, the evidence shows that loneliness and social isolation affect people of all ages. Recent studies suggest that young adults may be at greater risk of loneliness than older adults, with one in ten people aged 16-24 years being often lonely, compared to three per cent of people aged 65 and over. We also know that people can be lonely or socially isolated even when living with others. Loneliness and social isolation are already intractable social issues that warrant thought and action about connectedness and support across all age groups and communities. Evidence shows that being seen to be part of community life can act as a buffer against feelings of isolation, give people a sense of meaning in life, and protect against depression. Voluntary and community organisations, charities and statutory organisations should receive financial and structural support during this time to continue their longstanding work on tackling isolation and loneliness regardless of age. They should also be supported and encouraged to develop new strategies to improve the number and quality of people’s social connections during the current time. This should include using both old and new communication technologies, ranging from radio and TV to the internet and digital devices, to facilitate social connections between people of all ages. We should be thinking of this period as an opportunity to bring people and generations together, especially by helping to bridge digital divides across society where these exist.
  7. Living alone is a separate issue that has not been adequately considered or addressed. While this is an issue that disproportionately affects people aged 75 and over, especially older women, it affects all age groups and generations. About a third of men aged 80 and over are single, divorced or widowed, but this is the case for 70 per cent of women in this age group (see Table 4). There is an implicit assumption in much discussion about COVID-19 that people will have co-resident family members to look after them, to recognise that they are ill, to keep them hydrated, to help them if they are unable to get back to bed after going to the toilet, to try to encourage some nutrition or to call an ambulance. Co-resident family members can also advocate for hospitalisation or hospital care if needed. If people live alone and no-one is permitted to see them, who will do this? With a simple message to older people who live alone that they must cut themselves off from others, we are also conveying the message that we expect them to become ill without care and even die. Some countries have constructed and converted isolation centres to enable people with coronavirus to move to a place where they can be cared for appropriately, thus isolating them from families and friends but also offering access to care. There is an urgent need for clear policies aimed at supporting people who live alone of all ages. Equally, we need policies that can provide testing, intermediate care facilities (potentially requisitioning hotels, student accommodation, or office buildings), and tangible support for people who live alone.
  8. As well as health and social care workers, family and friends who will need to provide care to people who become unwell from the front line of society’s response to the pandemic and will need to be acknowledged and treated as such. For many people with families who they love and with whom they live or who live within close proximity, it is anathema to leave them to be severely ill, self-care in that state, and potentially die alone. Overwhelmingly, family members will provide hands-on care for one another. They will ignore entreaties to physically distance as they tend to their children, their spouses/partners and their parents and grandparents, knowingly taking risks as they do so. Families will do this for the loved ones they live with, and those they do not live with. To expect otherwise is to ignore the interconnectedness of families and the behaviour of people. Here, rather than tell families to ignore each other, we need to offer rapid testing, advice and supplies (masks where useful for intimate care, eye protection, gowns, gloves, sanitisers, soap). We should also beproviding financial support for people faced with additional costs associated with managing daily life when family members have coronavirus, such as keeping the washing machine running and purchasing cleaning and hygiene products. We need to ask people to isolate as connected clusters rather than keeping loved ones apart. We need to work with human behaviour and not against it.
  9. Special thought should be given to how people might connect with loved ones who live in care settings. Denying people the chance to see their friends and relatives where the physical and mental wellbeing of both depends on that contact, and where other forms of contact may well not be facilitated, is a most drastic curtailment of human rights and needs. Testing becomes crucial, to know who has had the virus, who may be immune, and who may be able to visit in a safe way without danger. Policy and practice should seek innovative ways for people to visit their loved ones virtually, or across physical or spatial barriers. We need to have a much more nuanced and evolving discussion of this particular challenge.
  10. Some common sense is also needed about so-called “self-isolation”. Socially isolating in a large house with a garden, good internet connection and a steady income is a completely different experience to socially isolating in a tiny flat, with no internet and under financial stress. Online food and other deliveries, which feature as a key policy response to coronavirus, are not an option for a large number of people, do not apply at all in many rural areas, and are already difficult to obtain as companies struggle to meet surging demand. We need to find a way to allow people to walk or cycle to local shops, to take exercise (for themselves and their pets), and to wave at one another and make social connections while maintaining a safe distance and observing hygiene requirements, without being singled out or intimidated. We need to think about sustainable policies, perhaps staggering who can go out for what purpose and when, how many people can be at particular places at a particular point in time, and national and reliable delivery of hand sanitisers to food shops and pharmacies on entry and exit. Maintaining physical and, especially, mental health whilst keeping people safe and well is a priority. Exercise, personal mobility and human contact are key to healthy ageing and need to be promoted long beyond the current pandemic.
  11. A key message from research on social aspects of ageing is that policy and practice should be attuned to the diversity of older people in countries like the UK. The older population is far from homogenous and differs substantially according to such characteristics as age, gender, ethnicity/race, sexual orientation, disability, socioeconomic status, marital status, household composition, place of residence and care roles. Given the diversity of older people, and the considerable social and spatial inequalities that characterise later life, broad-brush policy approaches based solely on chronological age are likely to disproportionately disadvantage some groups. They may also ignore the specific needs of marginalised groups of older people, including those who have particular health conditions, live in long-term care settings, are homeless, or are imprisoned. Research on ageing has made considerable progress in recent years in drawing attention to the heterogeneity of older people. It would be a highly retrograde step if this progress was undone by policy measures that reinforce the view that all people over a certain age share a particular set of characteristics.
  12. As well as preparing policies for living through this pandemic, we need to think about death, and the potential for death rates not witnessed for generations in the UK. We need sensible, realistic and emotionally supportive frameworks for attending funerals, and for coping with individual and collective grief. Such frameworks are needed regardless of the age of people coming to terms with loss.

In this unprecedented period, we call for urgent and ongoing data collection and rigorous analysis of social and economic inequalities, and of the impact of inequalities through this crisis on the living conditions of people, their mental and physical health, and mortality. We call for urgent policy action to redress these inequalities. COVID-19 is bringing into stark vision the impact of many years of politically motivated austerity policies that have substantially eroded health and social care services and community and voluntary sector support. The crisis demands an urgent reversal of these policies and calls for future investment in social as well as health care. In particular, we call for the social and domiciliary care workforce to be fairly treated. We call for them to be protected as front-line workers against this epidemic. We call for their high levels of skill to be recognised not only in the form of words, but also in terms of their pay, job security and working conditions.
If physical distancing policies are to succeed, they need to take account of who people are, how they perceive themselves, how they behave, and their emotional needs. Such policies will be difficult to police, and enforceable sanctions are hard to imagine. We need to carry the hearts and minds of the nation with us in the months ahead if we are to ensure the least physical interaction and least spread of the disease. The COVID-19 response emphasises more strongly than ever before the need for co-ordinated ageing policy that cuts across government departments.We note that policies identifying an arbitrary chronological age for restrictions of human liberties are out of line with approaches in other jurisdictions, including Scotland and Ireland. People of all ages are privileged with the same rights and policies need to be applied at population level.

Ageism – the stereotyping, prejudice, and discrimination against people on the basis of their age – has detrimental consequences for societies and individuals. We reject firmly the ageist and stereotypical assumptions that underly public and policy pronouncements that rely solely on the application of chronological age.

We close by declaring our strong support and admiration for clinicians making hard decisions, including, in due course, potentially about rationing life-saving resources. In anticipation of these, we stress that it is not possible for clinicians to make moral judgements about the value of human life based on age. Faced by the pressures of a pandemic, clinicians will in all likelihood know next to nothing about the lives of the people they are being asked to treat and cannot weigh one life against another. All clinical decisions for access to testing and treatment as they unfold should be made on clinical need; using age alone as a criterion for decision making is fundamentally wrong.”

It’s Allied Health Professions Day! Let’s Celebrate Their Work #AHPsDay #AHPsDayScot #ProudToBeAHP

There are fourteen different healthcare roles recognised as Allied Health Professionals (AHPs); each one of them carrying out an important role in the lives of the people that they are caring for. If you want to find out more about the 14 professions see the following page at Health Careers

So this week rather than focusing on a paper or a topic that’s in the news let’s  just highlight what the 14 professions do and how they make a difference.

As part of the day a Google site has been created and on the site is a whole lot of material of use to help people understand AHP roles and the contributions they make. The site can be found HERE 

It includes video, NHS Recruitment information, some materials from the AHP’s  professional bodies and some teaching materials.

The Nursing Midwifery and Allied Professions group at NHS Education for Scotland have also released a series of videos from their AHP staff on the programmes that they are currently involved in which you can view at https://twitter.com/NESnmahp

This week the Alzheimers Scotland Blog “Lets Talk About Dementia” are also running a serieds of Blogs on AHP contributions to Dementia care which you can access at https://letstalkaboutdementia.wordpress.com/

So lots to celebrate and be proud of if you are an AHP. AND if you are an AHP reading this Blog have a great day and keep up the good work!

Identifying and Managing Frailty in Care Homes

People in care homes are the most likely group of people in society to experience Frailty. However the Registered Nurses working in care homes are the least likely to receive any education or training specifically targeting frailty issues. They are though, a crucial component of care delivery to frail older people and are in an excellent position to support frail people who have complex care needs and comorbidities and are at risk of unplanned admissions to secondary care (because that is what they are doing every day).

Identification of frailty is important because aspects of the factors contributing to it may be reversible.

In July an article by Lynn Craig, a Senior Lecturer, Northumbria University and Clinical Development Managerwith North Tyneside Clinical Commissioning Group, published an article

Craig, L., 2019. The role of the registered nurse in supporting frailty in care homes. British Journal of Nursing28(13), pp.833-837.

In the article she explores frailty and the role of the nurse in assessing for frailty particularly in relation to 4 aspects, nutrition status, polypharmacy, exercise and cognitive function; areas which she suggests nurses could target in order to better support reducing the negative health outcomes of frailty.

Usually I’d provide a link to let you see the article for yourself but this time you will need to look for it and download it yourself.

If this has sparked an interest in frailty you should probably look at

Janet’s story: Frailty. which is an NHS RightCare resource that compares a suboptimal care pathway with an ideal pathway. which you will find at https://www.england.nhs.uk/rightcare/products/ltc/