Westminster Eye: An insight into the week of politics 28 November - 2 December

28 November
On Monday Simon Kirby MP received an answer from the Minister to his question on what assessment the Department of Health has made on the findings of the Shaping our Age report by WRVS on loneliness. Minister Anne Milton said that the Department of Health welcomes the Shaping our Age report and has noted its findings. She added that the engagement exercise, Caring for Our Future: Shared ambitions for care and support, was launched on 15 September 2011, and will last until early December. This engagement exercise will cover among its six themes prevention, integration, quality, personalisation, shaping local services, and financial services. After the engagement exercise, the Government will set out its response to the Dilnot Commission in the spring, with full proposals for reform of adult social care in a White Paper and progress report on funding reform.

Helen Jones MP asked what discussions had taken place with Ministerial colleagues on the likely effect of the Local Government Resource Review on social care. Bob Neil MP replied that the Secretary of State for Communities had regular discussions with ministerial colleagues on a range of issues.

29 November
Tuesday saw the Chancellor George Osborne deliver the Autumn Statement. The statement contained a commitment to raise the basic state pension by £5.30 and the pension credit by £5.35. He also announced that the pension age was being raised from 66 to 67 in 2026. Finally total managed expenditure in real terms was to fall by 0.9% for the years 2015-16 and 2016-17 following the current spending round.

The previous week Jim Dobbin MP had asked how much of the extra £70 million funding announced for re-ablement has been (a) spent by and (b) allocated to each Primary Care Trust and on what services this money has been spent. Paul Burstow provided a response on Tuesday. He said that the Department of Health had announced on 5 October 2010 that £70 million of extra funding would be allocated to Primary Care Trusts (PCTs) to be spent across the health and social care system to enable the NHS to support people back into their homes after a spell in hospital through re-ablement. Allocations to PCTs were made on 4 November 2010, and details on this are available here

Following the extra £70 million re-ablement monies the Government allocated to PCTs in 2010-11, on 4 January 2011 the Department announced a further allocation of £162 million to PCTs for winter pressures funding on social care services that also, benefit the NHS.

Examples of the kinds of services PCTs could invest in included further investment in re-ablement services, to help people regain their independence and reduce the need for ongoing care. Details on this are available here

He continued by saying that the spending review and 2011-12 NHS operating framework announced further funding to PCTs in financial years 2011-12 and 2012-13 to develop local reablement services in the context of the post-discharge support plans submitted to strategic health authorities last December. This funding totals £150 million in 2011-12 and £300 million in 2012-13, and is contained within recurrent PCT baseline allocations. Details on this are also available here and here 

It is for PCTs in partnership with local agencies to commission services to meet the healthcare needs of their local populations, taking account of local and national priorities.

Chris Skidmore MP wanted to know how many people over the age of (a) 65, (b) 75 and (c) 85 years were admitted to accident and emergency centres in each of the last 10 years for which figures are available. Replies are awaited. Minister Simon Burns MP replied saying that patients are not admitted to accident and emergency (A&E) centres; though they may be admitted to other hospital departments following an attendance at an A&E department. Statistics for admissions to A&E are therefore not available. Statistics are available for attendances at A&E departments though not for the exact age ranges requested, and have only been published since 2007-08. The 2009-10 admissions for ages 60-69 were 1,186,933; for ages 70-79 114,954; for ages 80-89 991,054 and for ages 90-99 256,618.

Several MPs asked what the Communities Minister what assessment had been made of the effect on the third sector of reductions in funding for local authorities. Jim Cunningham MP asked what steps the Government is taking to ensure house building schemes take into account the needs of older people. Replies are awaited.

Helen Jones MP followed up her recent question with two more relating to communications between the Departments of Health and Communities and Local Government. She asked what recent discussions had been held with Ministers in the Department of Health and Communities on the possible extra costs for the NHS of local authorities introducing changes to the criteria governing eligibility for social care. Her other question asked what estimate had been made of the possible extra costs which will be incurred by the NHS as a result of local authorities introducing changes to the criteria for eligibility for social care, broken down by region. Replies are awaited

Dilnot Commission member Lord Warner asked the Government what would be the cost to the Government of the cap on lifetime care costs proposed in the report of the Commission on Funding of Care and Support if that cap was increased from £35,000 to (1) £50,000, (2) £60,000, (3) £70,000, (4) £80,000, (5) £90,000, and (6) £100,000. A reply is awaited.

Baroness Greengross received a reply on Thursday to her question about the Government ‘s assessment of the impact of (a) hospital admissions, and (b) emergency hospital admissions, on health outcomes for people with a diagnosis of dementia. In replying Earl Howe said that they know that people with dementia stay longer in hospital and that there is room for improvement in the quality of their care. He said that was why improving the quality of care in general hospitals is one of the Government's four key priorities for improving dementia care services. The Government want to see people with dementia only admitted to hospital when absolutely necessary and, when they are in hospital, to receive high-quality care from staff trained to care for people with dementia.

On 21 September 2011, following a year-long project funded by the department, the Royal College of Nursing launched a new commitment to the care of people with dementia in general hospitals. The commitment is a guide to promote a positive experience and support the delivery of dignified care for people living with dementia and their families, in hospital.

During the ninth day of the Committee stage of the Health and Social Care Bill in the Lords, Baroness Bakewell moved an amendment regarding how well NHS services met the needs of older people. This would require the board's annual report to be measured by how effectively it met the needs of older people; and were intended to test views on the creation of a commissioner for older people.

Baroness Jolly highlighted the forthcoming consultation on social care in the New Year, and asked if an older person's commissioner was likely to be included in the next Bill. Responding, Earl Howe, the Minister, said he was sympathetic to the amendments, and completely understood their motivation. However, he said that the government already received advice from the UK Advisory Forum on Ageing on steps to improve well-being and independence in later life. The national clinical director for older people, Professor David Oliver, also held regular meetings with organisations such as Age UK and WRVS, he added. In terms of a future health Bill, he said that the government "certainly do not have a closed mind" on the issue of an older people's commissioner.

Jim Dobbin MP followed up on his question of last week to ask the Secretary of State for Health what assessment he has made of the reasons for delayed hospital discharge. Paul Burstow MP said that based on the latest information, about 61% of delayed transfers in October are attributable to the NHS and 32% to social care, with the remaining 7% being attributable to both in October 2011.

He continued that no one should be made to stay in hospital longer than necessary. The NHS and social care must work together to ensure people have the support they need on leaving hospital. The new Clinical Commissioning Groups will bring together general practitioners, specialist doctors and nurses to shape the best joined-up local care for patients, helping to avoid unnecessary delays. The Department has allocated additional funding to help people return to their homes after a spell in hospital-by 2012-13 this will be £300 million per year. This money will help people to leave hospital more quickly and get settled back at home with the support they need.

Jim Dobbin MP quizzed the Minister over how many delayed hospital discharges there have been of (a) under and (b) over 75 years old in each region since May 2010. Paul Burstow MP produced a table providing this information. Most recent figures showed that the Department collects data only on people over 75 years for acute delayed transfer of care and that the figure for the final quarter of 2011 was 1,806, the highest for the year.

Jim Dobbin MP also asked the Minister what assessment he has made of the costs to the NHS of delayed hospital discharge. Paul Burstow MP replied saying that the Department of Health does not collect data on the cost of delayed transfers of care. Data on the number of delays are published each month by the Department.

He added that significant sums of money had been made available in this spending review period to reduce the level of delayed discharges to a minimum. In the last financial year, an extra £162 million was made available to local health and care services to spend on front-line services, and an additional £70 million of funding was available for spend on helping people to return to their homes after a spell in hospital. This money was aimed at helping people to leave hospital more quickly, get settled back at home with the support they need, and to prevent unnecessary admissions to hospital. This year, there is £150 million available for re-ablement and £648 million for social care spend that also benefits the NHS.

1 December
Also on Thursday John Hemming MP asked the Health Minister when he expects to publish the Government's response to the Dilnot Commission's report Fairer Funding for All. A reply is expected shortly.

Posted by Steve Smith, Public Affairs Officer, WRVS