[Closed] Lets talk about the NHS and Social Work.

Elderly people?

Mixture of ages and conditions. The young patients are pretty much the only patients we see because they get better and can be discharged quickly with outpatient follow up.

The NHS is skint cos it's run badly.

Well it's not news is it, ever since central government instructed local authorities to carry out deep cuts it was clear that it would have a knock on effect on the NHS.

http://www.bbc.co.uk/news/health-12430754

The Tory claim that they would cut the deficit not the NHS was always misleading nonsense. The same amount of money to do more is as good as a cut in funding.

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Can you expand on the "run badly" bit?

Is it any surprise that the NHS is skint when it is paying for things that social work should be paying for?

Presumably the social work is NHS & not private, if so it's the NHS's tab anyway so all things are equal.

ernie - it is indeed not new news. It 's however interesting to see that what various people in the NHS warned would happen has actually happened.

NHS Highland is now responsible for funding social care as well. Can't say this new arrangement has been a success.

Presumably the social work is NHS & not private, if so it's the NHS's tab anyway so all things are equal.

If only that was true. NHS only pays for a very small part of nursing home accommodation - i.e. the care part as far as i am aware.

The rest of the patients are not receiving rehab as they are at as good a level as they will get to - they are waiting on places in nursing homes or packages of care to become available. Some of those people have been waiting for months and will be waiting for many more

Its called waiting for death to arrive, been there with my dad, mates mum and a few others,so called care packages are made to sound like the state is doing you a big favour, wrong the state should be providing for you in your aged years.

Lots of homes are closing down due to poor management, failed staff practices and same with some larger chains who are picking and choosing which patients they want, unless they get paid enough via family top ups.

So where else can elderly people go NHS hostels eg hospitals, to just deteriate and then die, and then a problem is over with.

Can you expand on the "run badly" bit?

OK, one example. There is one drug for which the NHS only has one supplier. This drug can be bought from abroad for a fraction of the cost. End result is that thousands are denied better health as CCG's will not prescribe.

As a social worker in community care, I can tell you it's because there are not enough suitably qualified workers in insufficient posts, carrying too many cases to get sufficient through-put; not enough affordable, quality care home places or people willing/able to do the job of community care work for the money or paysto create robust/safe/personalised packages of care and a myriad other reasons mainly to do with lack of finding and the magnetization/corporatisation of social care. If we want health and social care to work it needs to become non privatised, non profit making integrated and funded properly by us all. Can't have something for nothing and no one should be trying to profit/make money from it.
That'll be 10p please.

As a social care worker JoJoA1 for President/FM/PM/God

As a social care worker JoJoA1 for President/FM/PM/God

That would be a world that would be worth living in.

If we want health and social care to work it needs to become non privatised, non profit making integrated and funded properly by us all. Can't have something for nothing and no one should be trying to profit/make money from it.
That'll be 10p please.

election next year if cam/blair and mates doesnt start a war with Russiam or anyone else, vote for the one who say they will do something, not the current shower who have taken everything

Interesting to know what anyone else would have done, we were a country massively in debt and some cuts had to be made somewhere, even the other lot would have had to have done so - Personally I am annoyed at Brown and Blair who pissed 15 years of massive economic growth and tax revenue up the wall

Not saying I like where the cuts have been made but the NHS is probably one of the better off areas as their budgets were ring fenced.

I agree with the mismanagement- wife is a doctor and the PCT's were an utter joke, ran out of budget or refusing the pay the hospitals for treatments - she works in a & e and they only paid for about 80% of the patients.
Also some of the problems we are seeing now is a long time issue whereby the hospitals were allowed to run large deficits for years and now they are being called to account.

On the other hand I think the budget for social care in England is held by the local councils so that is where the budget cuts are causing a knock on effect to the NHS wards

Reasons are a) massive cuts in LA budgets (hence the way they in turn massively underfund home care and residential care - result crap care for the most vulnerable, giving rise to all the scandals we hear of) and b) unimaginative and jobsworth senior management in social care who doggedly refuse to stand up to government publicly and tell them some home truths, and c) as jojoA1 says, the introduction of rubbish private sector corporations into both health and social care who manage to be simultaneously inefficient and money grabbing.

So we end up with total fragmentation of health and social care behind all the rhetoric of joined up thinking and pooled budgets. Neither the ConDems nor sadly Labour have answers here. Their introduction of the private sector has just made things worse. Perhaps only the Greens (yes really!) have the right idea.

But the other sad thing are that there are so many people working in this sector (hello jojo A1 and wanmankylung!) who are committed to good public services and want to make a difference. And no-one in senior management and government listens to them. Bottom up not top down I say. Listen to the workers' voices.

What sort of rehab unit, wanmankylung? If neuro rehab, email me (in profile) and I might have some ideas for you.

For a variety of reasons I'm agreeing with andyfla - wife trains newly qualified social workers, and relatives are fighting to get LA funding for my aunts care home sorted, seems desperately over complicated and short staffed.

Mixed rehab unit. We have stroke & neuro, ortho, elderly, vestibular all under the same roof. It's a nice caseload that keep you on your toes. Funnily enough the stroke rehab side of things doesn't suffer the bed blocking that the other parts do.

For a variety of reasons I'm agreeing with andyfla

From experience telling unimaginative and jobsworth senior management in social care that one day it may be them under the sheets or other side of the table, makes them go quiet and try to help, something they dont seem to understand before, and especially when you also remind them that the day they need home,care home or nursing care is coming closer every day.
Home fees are set by a profit making company, home fees paid are set by councillors who try and save money to waste on daft ideas, and keeping their senior management happy and in jobs.
Difference in home fees paid by the council and those wanted by the home providor are paid for by the family,or pension/savings/.

In Scotland the NHS and Social Work are merging - some council areas have done it already, such as Highland, but how each area merges and how things operate on the ground will be different from area to area, depending on the needs of the local population, geography, socio economic factors etc. The aim is to have both organisations working more effectively to meet people's needs. It's a good idea in theory!

Of course the impetus to merge has only come about because of the gigantic savings NHS and Social Work are forced to make because of the cuts from central government. If it was such a no brainer and going to deliver a better service we'd have been doing it for years.....

Being a Social Worker I can empathise with the OP's experience. I've tried to get packages in place for people to be discharged and although they've been technically classed as a delayed discharge, they're not delayed enough, until they reach the point automatic fines get issued to the council. By this time the care provider I've lined up can't provide the service.....hopefully integration will reduce the stupidity of this. There are more reasons than just money for people remaining in hospital when they're fit to leave though, for instance, if they are deemed to lack capacity and there is no welfare guardian or power of attorney in place to make decisions on their behalf. Obtaining the power to make these decisions can be lengthy.

On your last point - we seem to have a fair number of patients whose capacity status changes regularly, not that it is apparently delirium related. That may be part of the problem.

Only on this, normally you talk complete and utter tosh!

Shortbread's point about sometimes being unable to act due to capacity issues and legal proxy is an important one. There are delicate balances to be found and weighty decisions to be made when we seek to limit or remove a person's right to self determination. These processes take time (often more than they should due to an overburdened court system). The 'systems' were strained and clunky engines already before the sand of austerity was poured in.

If you truly care about Westminster's destruction of the NHS, [url= http://nhap.org/ ]there is a party for which you can vote.[/url] Or just vote for the usual suspects, and watch it washed out from under your feet.

[i]I work in a rehab unit. In that rehab unit there are 40 beds. We have 6 or so patients actively receiving rehab. The rest of the patients are not receiving rehab as they are at as good a level as they will get to - they are waiting on places in nursing homes or packages of care to become available. Some of those people have been waiting for months and will be waiting for many more.

Is it any surprise that the NHS is skint when it is paying for things that social work should be paying for?

What are your thoughts on this?
[/i]

Thoughts? That tax-payers money is been badly spent.

The money been spent by the NHS ought to be allocated to whoever it is responsible for putting the care-packages though.

[i]The NHS is skint cos it's run badly. [/i]

Having spent the last 12 months working in the NHS I'm not going to disagree with this. Especially in my area-of-expertise, IT - where it is seriously scary how much money is wasted without due-process and by folk who quite frankly, haven't a clue how to run/manage and especially deal with suppliers.