Three quarters of people with mental health problems receive no help at all

A report has been produced by a mental health taskforce set up by NHS England. Findings show that around three quarters of people with mental health problems receive no help at all. Ministers have agreed that more needs to be done, and have committed an extra £1bn a year by 2020, helping to treat 1 million more people per year- the next five years will build the foundations for the next generation.

Prime Minister David Cameron said: "We should be frank. We have not done enough to end the stigma of mental health. We have focused a lot on physical health and we haven't as a country focused enough on mental health." Poor mental health can drive a 50% increase in costs in physical care, and with suicide and self harm on the rise we need to take action now to provide the same level of support to mental health patients as we do for the physically ill.

Mental health problems represent the largest single cause of disability in the UK. The cost to the economy is an estimated £105 billion per year- roughly the cost of the entire NHS.

One contributor to the report stated: “The NHS needs a far more proactive and preventative approach to reduce the long term impact for people experiencing mental health problems and for their families, and to reduce costs for the NHS and emergency services”.

The priority actions for the NHS by 2020/21, taken from the report are:

1.       7 day NHS- right care, right time, right quality

2.       Integrated mental and physical health approach

3.       Promoting good mental health and preventing poor mental health- helping people lead better lives as equal citizens

Of course, a 7 day NHS already exists for emergency care, but to offer the full range of mental and physical health services 24/7, funding is needed.

The extra £1bn will come from the £8.4bn the government has already promised to the health service during this parliament, but is on top of the extra money that has already been promised to children’s services. The funding is intended to go towards:

·         600,000 more people getting talking therapy

·         Every A&E to get a mental health liaison team

·         Maternity units to get perinatal psychiatry to catch depression in new mothers

·         Extra help for children and young people with eating disorders

·         More crisis teams to keep people out of hospital

The worry here is that the money isn’t ringfenced, so will it be used to pay off some of the current NHS debts rather than on enhancing the mental health service?

Currently, less than a tenth of NHS funds go to mental illness and severe cuts since 2010 have left 5000 fewer mental health nurses as well as 8% fewer mental health beds. Professor Sir Simon Wessely, the president of the Royal College of Psychiatrists, says mental health funding has been cut by 8%. As budgets are reducing, mental health care such as social care and residential housing is facing more pressures and the level of service is suffering as a result.

Figures obtained through a Freedom of Information request showed the budgets for mental health trusts fell by 2% from 2013/14 to 2014/15.Of the 53 out of 59 mental health trusts in England which responded to the FOI request, 29 said their budget would be lower this year than last.

People with a serious mental illness are asking for the same level of treatment that they would get if they had a serious physical illness. But despite mental health affecting one in four people and being both the largest single cost across the NHS and the most common reason for days lost from work, mental health has been neglected, and lagged far behind the support available for physical health. Let’s hope that this changes now that it has been recognised by the Government and that the money is used to improve the mental healthcare in the UK, achieving the parity of esteem that the NHS sees as a key priority. 

Drinking too much alcohol can lead to dementia in later life

Did you know that over nine million people in the UK drink more than the recommended daily amount?

Statistics from Alcohol Concern show an estimated 7.5 million people are unaware of the damage that drinking could be causing to their body- a seriously worrying figure.

Other statistics:

·         5.9% of global deaths were down to alcohol consumption

·         Harmful use of alcohol results in the death of 2.5 million people annually

·         Alcohol is the 3^rd leading lifestyle-related cause of death in the nation

·         Alcohol misuse costs England around £21 billion per year in healthcare, crime and lost productivity costs

·         Worldwide about 16.0% of drinkers aged 15 years or older engage in heavy episodic drinking

A recent study, from Alzheimer’s Society, shows that by drinking more than four and a half units of alcohol a day, your brain will age faster, increasing your chance of developing dementia.

The 850,000 people in the UK currently living with dementia is expected to rise to over 1 million in the next 10 years. The economic impact exceeds cancer and heart disease- an alarming fact, since there is no cure.

Some small lifestyle changes can significantly decrease your chances of developing dementia:

• eat a healthy diet
• maintain a healthy weight
• exercise regularly
• don't drink too much alcohol
• stop smoking
• keep your blood pressure at a healthy level

With alcohol awareness week upon us, we want people to know what support is available to those who are suffering or know someone with alcohol misuse issues.

At Embrace-Learning, we offer the course ‘Awareness of Alcohol and Substance Misuse’. This course aims to help learners identify the signs that service users are using illegal drugs or misusing legal drugs like alcohol. It enables learners to provide people in their care with more effective guidance and non-judgemental advice about ways of tackling their issues.

We also have a range of e-learning courses for the health and social care sector here. For more information about any of our courses, or to purchase one today, call Embrace-Learning on 0161 928 9987.

Alcohol Awareness Week runs from the 16-22^nd November. For more information visit https://www.alcoholconcern.org.uk

advisory or mandatory?

When is mandatory training not mandatory?

Apparently when it applies to the social care sector.

There’s something a bit wishy washy about labelling training as mandatory when there is no actual requirement to complete said training. Or worse still, when there is a stated ‘requirement’ to do the training (by the CQC) but there are no real consequences when the training is not completed. Unless you count a slightly lower inspection rating as a real consequence. Is it just me or is it slightly baffling that there is no legal requirement to complete any training in the delivery of social care?

Care providers themselves determine whether a training course is mandatory or not. Some will deem it mandatory while others will consider it optional. While the CQC may require that a service trains their staff to a minimum standard, this is not legally binding. It seems training is a ‘should do?’ rather than a ‘MUST DO!’

The training of care workers in the new Care Certificate is advisory rather than mandatory. The Care Certificate which is promoted as the basic or minimum entry level course is not actually a qualification as we understand the term.  It is not on the National Qualification Framework (NQF) but it is considered a Continuing Professional Development (CPD) course. This is a fantastic introduction to the world of care work and is indeed a minimum requirement for care workers. It is not, alas, mandatory unless deemed mandatory by the care provider.

We have a long way to go before we have a professionalised and regulated social care workforce. There are many reasons why it is important to achieve this. First and foremost is the quality it will bring to the care of the growing number of elderly and vulnerable people in our society. Secondly it will attach a greater value to this incredibly important work and allow carers to follow a career path with pay scales that reflect the importance of this work.  Is it the case that the current status of care work is an accurate reflection of how we as a society value care work? That is, not very highly. We are quick to jump on stories of poor care and express horror and outrage when people are abused and otherwise mistreated but when we scratch the surface a little and look at the way workers are trained and what they are paid, it is clear that the explanations for these behaviours cannot be simply dismissed as the actions of ‘rogue carers’.

Better pay will in turn attract and hold on to the right calibre of person needed by this growing social care sector. The resulting lower turnover of staff will add to the stability of the workforce which, again, will benefit the end users.

A better trained workforce with professional status will help care workers achieve something approaching parity with their health sector counterparts. This in itself will go a small way to greasing the wheels on the journey to an integrated health and social care system. The disparity in training, pay and conditions does nothing to facilitate the team spirit needed when workers are required to work across professional and organisational boundaries in the pursuit of an integrated health and social care system.

There’s an old adage that ‘Ignorance is no defence in law but training is’. I’m sure the day will come when training is, itself, a legal requirement. 

Integrating Health and Social Care

Integration of health and social care has been on the agenda since the turn of the century and has been talked about for a good deal longer. Will we still be talking about it at the turn of the next century or will someone actually be doing something about it?

Is your organisation doing something about it or are you, like the majority, merely paying lip service to what is, admittedly, a noble cause?

The logic is faultless but the application seems to be a good deal more complicated than some would have us believe. We know it’s desirable but is it really possible to bring two systems together to work seamlessly in the delivery of care? It can be difficult enough to get professionals of a similar discipline to work as a team when managing complex health and care packages. When we ask them to work across professional and organisational boundaries we’d better make sure the infrastructure is there to support them. But what is this infrastructure? What does it consist of and who is going to take responsibility for maintaining it? Are the differences in culture so different that we will never truly have an integrated system?

Multidisciplinary teams already exist to manage complex needs. We only need to look at the cases of NHS continuing healthcare to see that it is possible for decisions about health and social care to be made coherently and it is a credit to many of those teams that they can unpick the myriad of needs affecting patients and put together packages of care that meet the needs of the whole person and indeed the needs of those around them. It strikes me however, that it is not so much the decision-making or the ‘design’ but the implementation of those decisions and designs that is the real challenge of integrating health and social care. I wonder whether the fundamental differences in a)culture and b)training for clinicians in healthcare, as opposed to those in social care,  are such that there will never really be a genuinely integrated health and social care system. This sounds defeatist from the outset but I think it highlights just two areas (and there are many more), that need to be addressed if we are going to achieve this holy grail of a truly integrated health and social care system.

It’s worth shining the spotlight on some of the most complex cases requiring input from health and social care services. The provision of NHS continuing healthcare, by definition, applies to people with long term health and social care needs where the dominant need is deemed to be a ‘health care need’ as opposed to a ‘social care need’. So here’s the thing, what is the difference between health and social care? When does one begin and the other end?  As with many other things, it is the boundary, the borderline, the areas that are most difficult to define, where clarity is needed. It is at these professional and organisational boundaries where problems arise and where problems must be resolved in order for integration to occur.

We will consistently be returning to the questions of infrastructure and health versus care culture. It is surely a given that training will be key to any integrated system of health and social care. It is clear that joined up working can only be enhanced by joined up training. It is not entirely clear to me at present which organisations are really taking the lead in this integration of health and social care at a local level. NHS organisations and Local Authorities certainly have responsibility to design such a system but where is the guiding light? Where is the beacon that shows that people are receiving a genuinely joined up, integrated health and social care system? Is such a thing possible?

Dementia

Dementia levels are stabilising

Dementia remains one of the most critical health and social care challenges facing the UK and other European countries. However, recent news in the world of dementia and Alzheimer’s suggests that dementia levels in the Western Europe countries, including the UK, are stabilising. A Study shows that the number of people over 65 with dementia has dropped by 22% in the UK and it also dropped by 43% in men in a study taken in Zaragoza, Spain. It appears that two key reasons for optimism in the treatment of Dementia are that people are increasingly better educated about the condition on the one hand, and general living conditions for the populations as whole, have improved. Although dementia levels have decreased in this age group, it is still set to increase in the older age groups as people are living into their 80s and 90s. With no cure and few effective treatments dementia has an economic impact that exceeds cancer or heart disease.

Why modern life is making Dementia in your 40s more likely

A recent study by Colin Pritchard suggests that dementia is starting 10 years earlier and is affecting more people in their 40s and 50s. This early onset has been linked to environment factors for example the fact we have quadrupled our road and air transport, which means there is an inevitable increase in air pollution, exposing everyone to a vast range of noxious substances. There will always be contention surrounding the causes of dementia and indeed what steps need to be taken at a global, national and local level. Thankfully there is some consensus around what can be done to ease the burden on those with the condition and those who care for them.  As with so many other conditions, awareness and education are absolutely central to any strategy aimed at improving the lives of those affected.

Education

All NHS staff are now required to have specialist training for dealing with dementia within the next four years. A study has shown that too many health workers do not know enough about the condition, which is leading to major failings in the care of the most vulnerable patients. Just half of those with dementia are actually formally diagnosed, and even though a quarter of hospital patients suffer from the disease, research suggests that they actually receive much worse care than other patients. There still far too many accounts of people in care settings ending up without food and water, as well as the neglect of other aspects of their welfare.

What is important to know about dementia?

People often talk about dementia as a ‘memory thing’ without really understanding how the condition works. We rarely discuss causes or how to prevent it.  More importantly we often lack the knowledge about how to deal with it. For example the most common generally accepted cause of dementia is a disease which causes the brain cells to degenerate and die quicker than they would normally. The changes usually happen because of a build-up of abnormal proteins in the brain. Just knowing this simple fact can be helpful. If we understand some of the fundamentals, then we are less likely to get agitated or annoyed at anything the patient is doing. If I can understand and identify the different stages of dementia I am far more likely to be able to understand how the condition will affect behaviour in the future. If nothing else, I can make preparations for myself and the person I care for. I need to be able to identify the difference between the early, middle and late stages of dementia and the symptoms. I firmly believe that completing a short course, whether it be in the classroom or online can have a real impact on the lives of carers and, by extension, the lives of those they care for. 

Dementia Awareness Week 2015

Dementia Awareness Week 2015 starts today!

Life doesn't end when Dementia begins and Alzheimer's Society is encouraging everyone to #DoSomethingNew this week - try out a new activity or hobby, find something you've never done before!

Why not try e-learning! Have a look at our Dementia course here, with a free demo available:

http://www.embrace-learning.co.uk/Website/Pages/Courses/Course_Information.php?course_id=90

This e-learning course has been developed for anyone who is new to, will soon be involved in, or is currently involved in caring for someone with dementia, whether within the family or as a professional, either at home or as part of a team in a residential facility.

Learners will find out about the meaning of the term dementia, its causes and the possible effects the condition may have on people as it progresses. The course also looks at the importance of good communication and interaction between carers and the people they support and identifies strategies for coping with challenging behaviour.

The on-line materials include quizzes and activities to help reinforce learning as students work through the course.

For more information call 0161 928 9987.

An anonymous article by a care team worker on the fourth year of redundancies and the effects on team morale. The pertinent question is raised of why after four years of drip-fed redundancies, there has been no change to management staffing levels? Surely there are far fewer people to manage now.

Management decision making (or the lack of it) is also addressed, raising further questions.

http://www.theguardian.com/social-care-network/social-life-blog/2015/jan/21/redundancies-social-care-job-cuts