@ScotHumanRights Call for an Immediate Return of Social Care Support

I think I am getting a bit more random about when I decide to post to my Blog. I’ll need to get back to being a bit more consistent especially now I have new students looking at it. However today I couldn’t ignore this.

Research published on the 6th of October 2020 by the Scottish Human Rights Commission has shown that a considerable proportion of people who use social care support at home have experienced either a reduction or complete withdrawal of support during the COVID-19 pandemic.

The new monitoring report details how the removal of care plans during COVID-19 has had a direct and detrimental effect on people’s rights, including potential unlawful interferences and non-compliance with rights contained in the European Convention on Human Rights and the United Nations Convention on the Rights of Persons with Disabilities. Rights affected include people’s rights to physical and psychological integrity, private and family life, and to independent living in the community.

Evidence from research participants showed how the reduction or withdrawal of care and support at home has led to circumstances in which people were left without essential care, such as assistance to get up and go to bed, to wash and use the toilet, to eat and drink, and to take medication.

The report sets out 24 recommendations for action, including:

  1. The Scottish Government and the Convention of Scottish Local Authorities (COSLA) should jointly commit to the return of care packages and support at pre-pandemic levels, as a minimum.
  2. The Scottish Government should immediately establish data collection mechanisms to monitor the nature and extent of the reductions and withdrawals of care packages.
  3. The Scottish Government and COSLA should develop an emergency decision making framework for social care which is grounded in rights-based principles of inclusion and participation in decision making, and transparency. This should also meet critical human rights standards.
  4. The United Nations Convention on the Rights of Persons with Disabilities (CRPD) should be incorporated into Scots law and therefore into policy design and delivery so that this situation never happens again

Judith Robertson, Chair of the Commission, said:

“Social care is an essential investment in realising people’s rights, particularly those of us who are disabled, older or provide unpaid care. Delivered properly, social care should enable people to access their rights to family life, health, education, employment and independent living in the community, among others. That’s why the Commission is deeply concerned about the reduction and withdrawal of social care support to people during COVID-19, and the impact this is having on their rights.

While the report is concerning I am absolutely sure that what is documented here is probably occurring across the UK. Concerning times for all and only goes to show that we need to “…build back better” as this report highlights.

To access the full report CLICK HERE

@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!

#CarersWeek 2020 #MakingCarersVisible

Her Royal Highness, Princess Anne, the Princess Royal; possibly my favourite Royal because she follows the Scotland Rugby Team, through all their ups and downs; has recorded a special message of thanks and support for unpaid carers to mark this year’s Carers Week. The Princess Royal, who is President of Carers Trust talks about the indispensable role of unpaid carers supporting people who cannot look after themselves because of an illness, disability or mental health problem. She also highlights how hard is for the public to see, far less recognise, just what a difference unpaid carers are making every day to improving the lives of others. You can watch her video below just click on the play arrow.

 

New figures released this Carers Week  (8th – 14th June 2020) show an estimated 4.5 million people in the UK have become unpaid carers as a result of the Covid-19 pandemic. This is on top of the 9.1 million unpaid carers who were already caring before the outbreak, bringing the total to an estimated 13.6 million.

2.7 million women (59%) and 1.8 million men (41%) have started caring for relatives who are older, disabled or living with a physical or mental illness since the outbreak began.

You can read the full report here.

I might not be a fan of her political views but this video from Angela Rayner Chair & Deputy Leader of the UK Labour Party and Shadow first Secretary of State contains the message that I would like all current carers to here.

As Angela states I also have had many experiences of being a unpaid carer a well as a paid carer like many nurses and healthcare workers. In times of family distress it is often us that our families turn to with some expectation that we will take control and help no matter what’s going on elsewhere. If you are one of these paid and unpaid carers you have my best wishes, admiration and support. Almost always it’s the paid caring role that’s the easiest.

Carers ARE amazing, but it’s because they HAVE to be! So don’t just be sympathetic and  inspired by what they do take action to ensure carers are visible, valued & supported.

You could star by making a pledge for Carers Week at https://www.carersweek.org/

Matt Hancock the Health Secretary posted a video as well but for me adding that one would be a step too far…

April @BloggersNurse Challenge: the Retention of Healthcare Staff

Last week I said I’d look at the topic of retention and said that would be interesting once this lockdown phase of the COVID-19 story passes. However, before we get to my thoughts on this you need to understand the context.

So rather than give a history lesson this article by Poly Toynbee in the Guardian on the 25th April does a much better job than I would ever do. See https://www.theguardian.com/commentisfree/2020/apr/24/year-nurse-tories-10-years-bad-care-nhs-crisis

As Poly says

…retention isn’t difficult, there is nothing insoluble about it. Pay them decently, give them as clear a career path ahead as doctors enjoy, and see what happens.

So getting beyond the politics of a pay rise, cancelling healthcare workers student debt, improving healthcare workers working conditions and terms of employment and providing a career path that includes recognition of health care workers in the care home and social care sectors… what does the professional literature suggest.

In a systematic literature review published last year Brook et al (2019) looked at the issue of retaining early career nurses. Early career nurses are important because it is in the transition from student to registered nurse that that the losses to the profession are at their highest.

So what did they say about retaining staff in the first year of practice. Firstly, employers have to offer a transition to practice programme. The form that the programme takes, be it preceptorship, mentoring programmes, residency programmes, internships, externships,orientation to practice programmes or clinical ladder programmes is not as important as having one in place. That is because of the message that it sends out; that the organisation by doing this is indicating the importance attached to their newly-qualified staff and this alone is enough to positively influence recruitment
and retention; especially if the organisation is perceived to be investing in the workforce to a greater extent than competitors.

Interventions with the highest benefit appear to be an internship/residency programme
or an orientation/transition to practice programme that incorporates formal teaching, a preceptorship element and possibly the addition of a mentorship element. They suggest that programmes need to last 27–52 weeks in duration. These findings align with
support that is already offered in USA, Canada and Australia. In the UK preceptorship and mentorship are embedded in our culture so we may be starting from a good position.

Unfortunately most of the studies done looking at this topic have been done in high income economies. The quality of their findings have also been affected by inconsistent and incomplete description of the interventions, missing detail of some components of the intervention and variations in methods of evaluation across the studies Brook et al (2019) reviewed indicating that many of the studies on this topic so far were not conducted using rigorous research methods of evaluation. The quality of this review, like many others has been  limited by the quality of the study reports that are available.

What is of interest is not the interventions but a need to refine and review already established transition programmes. If the programmes focussed more on the elements of teaching, preceptorship and mentorship and considered how these added to the new staff nurses experiences then more successful programmes might result. However, variation in the quality of mentors, preceptors and teaching are bound to affect the outcome of support programmes; so Brook et al (2019) suggest reviewing these before you start out.

The full review is available and published as follows

Brook, J., Aitken, L., Webb R., MacLaren, J., Salmon, D. (2019) Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review, International Journal of Nursing Studies, Volume 91, Pages 47-59,
ISSN 0020-7489.
https://doi.org/10.1016/j.ijnurstu.2018.11.003

Unfortunately it does not appear to be open access.

So to the UK response to Coronavirus. Effectively all 4 nations in the UK have just sent all their students out into practice prior to completing their education at a time of crisis. It is not likely that the usual transition programmes that most hospitals and employer they are being sent to are running, or will be in place for them, or even considered, until this lockdown ends and something like ‘normal’ service is resumed.

What happens this month and over the next few months may well shape the outcome of hundreds of new students attitudes towards their profession. Are they going to transition well into their new roles with more limited support? Will the NHS and other employers consider offering better support to those who have commenced ‘early’ to help them out in the current situation? Will the Government follow through on the plans it says it has to better support and reward front-line health and social care staff? Will the COVID-19 situation encourage people to join health and social care professions or will it put them off?

I really don’t have the answers to the above questions. We will just have to wait and see… but I am worried already and angry at how depleted the nursing workforce has become and how badly the successive Conservative governments have treated Nursing and  other AHP professionals.

If nothing else, its time to change or my profession will become less attractive and the recruitment and retention problems existing at the moment will only worsen.

(You can follow me on Twitter @uwsraymondduffy)

 

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!

#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.”

UK’s First Map of Cancer Care Support

Apologies, my Blog went missing again last week and it was nothing to do with Christmas shopping.

This week I thought I’d let you know about about a new resource which might be helpful to a number of people, health care professionals, carers and people facing up to cancer in particular.

After a successful trial, the UK’s first comprehensive directory of cancer support services, The Cancer Care Map was launched earlier this year. It helps people find cancer care and support services in their local area, whether National Health Service, charity or community-led. The directory is regularly updated and is accessible online HERE

This might not be the best time of year to try and run around organising new services but if my post make a difference to one person’s life in 2020 then that’s a success!

In the meantime I wish all my Blog Followers and reader’s a very Merry Christmas. I’ll try and post next Friday but no promises…

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Who Said That an Ageing Population is a Bad Thing?

I’ve missed another week, but here I am back again. This week I am bringing a new report by The International Longevity Centre (ILC-UK) called “Maximising the Longevity Dividend”.  While older people and an ageing population are often painted as a risk to our economy, this new research shows that the UK’s ageing population brings economic opportunities through older people’s growing spending, working and earning power.

Their research has found that households headed by someone aged 50+ have dominated total expenditure (excluding housing costs) since 2013. And spending by older consumers will continue to rise significantly over the coming decades, from 54% (£319 billion) of total consumer spending in 2018 to 63% by 2040 (£550 billion).

Those 50+ also shift their spending towards non-essential purchases such as leisure, transport, household goods and services.

People aged 50+ are also making an increasingly significant contribution to the economy by continuing to work.. The share of the workforce aged 50 and over rose from 26% in 2004 to 32% in 2018, and it could account for 37% by 2040. People aged 50 and over earned 30% of total earnings (£237 bn) in 2018 and this is expected to rise to 40% by 2040 (£311 bn). The ILC have said that supporting people aged 50 and over to remain in the workforce could add an additional 1.3% to the UK GDP a year by 2040.

To read and download the report CLICK HERE.

AS David Sinclair, Director of the ILC, says

As the population ages there are enormous economic opportunities, but these are currently being neglected. We’ve become accustomed to hearing our ageing population talked about as a bad thing – but the reality is it could be an opportunity. However, we won’t realise this ‘longevity dividend’ through blind optimism about ageing. Instead, we need concerted action to tackle the barriers to spending and working in later life.”

New Website for @RealisticMed Launched

A new website dedicated to practising Realistic Medicine has been launched this week. Realistic medicine refers to putting the person receiving health and social care at the centre of decisions about their care and creates a personalised approach. It encourages health and care workers to find out what matters most to their patients and clients so that the care of their condition fits their needs and situation. Realistic medicine recognises that a ‘one size fits all’ approach to health and social care is not the most effective approach for the patient or for the NHS.

Its important to older people because it encourages services to adapt to the way in which people with multiple, complex and frequently changing conditions require to access care and support. Those people are primarily over 65. Current models of healthcare services are stretched and there is need to re-examine how we can deliver person-centred and integrated healthcare that embraces both statutory and non-statutory agencies. Cath Calderwood, the Chief Medical Officer for Scotland has said, realistic medicine involves

  • Listening to understand patients problems and preferences;
  • Shared decision making between healthcare professionals and their patients;
  • Ensuring that patients have all the understandable information they need to make an informed choice;
  • Moving away from the ‘doctor knows best’ culture to ensure a more equal partnership with people;
  • Supporting healthcare professionals to be innovative, to pursue continuous quality improvement and to manage risk better;
  • Reducing the harm and waste caused by both over-provision and under-provision of care;
  • Identifying and reducing unwarranted variation in clinical practices

The new website which you can access HERE, features resources, good practice case studies and the contact details of Realistic Medicine Leads within the NHS Scotland Boards.