The ‘Red Tape Challenge’ does Health and Social Care

Red Tape

We all knew it would come in time. This wonderful government idea to slash all that awful ‘red tape’ that stops people doing what the government otherwise would stop them doing finally arrives at Health and Social Care.

I had a brief look at some of the provisions detailed as ‘red tape’ for which the government is asking for comment and quite frankly, I am horrified.

What I might see as essential protections, they are presenting as ‘red tape’ and asking for feedback about potential abolition.

This is a consultation so it’s really important that as many people as possible to contribute and in the joyful spirit of openness, the website allows up to see the live commenting on others. I wonder how those with less technological access or knowledge are able to comment quite so openly about some of the provisions up in the air.

But openness and accessibility only seems to go so far and for the government departments responsible they seem to be after whipping up public distaste of ‘red tape’ although actually, we really do need to move from the idea that bureaucracy is necessarily bad.

There is a separate website entirely to focus on ‘ regulatory enforcement’ and where it might be unnecessary.I feel robust regulation (and thus, enforcement which has to follow as a result) is essential. The big problem with social care and health regulation since the CQC was established was the ‘light touch’ type approach which had been taken and the ‘back office’ regulation and not enough enforcement.  I really really hope that it is not cut back further. I want to see more regulation and stronger enforcement, not less of it.

But back to the ‘red tape challenge’. I want to share some of the provisions ‘up for discussion’ that the government has classed as ‘red tape’.  I’m solely concentrating on what is up under ‘Quality of Care and Mental Health Regulations’ as I felt that was the area I knew best. The numbers refer to the list of these ever so demanding provisions in the Excel list here.

39 is that oh so burdensome (!!!) regulation that requires the Care Quality Commission ‘to monitor and access for monitoring purposes, people who are deprived of their liberty’ and necessity to report this to the Department of Health.

40 is a nice one about requiring people ‘who assess Deprivation of Liberty’ to have an enhanced CRB.  – clearly unnecessary because.. er.. people who lack capacity and may potentially be subject to DoLs aren’t likely to be vulnerable, right? I think there’s an issue about effectiveness of CRBs in general but a bit worrying that that’s considered ‘red tape’.

43 is much more worrying as it is the obvious ‘red tape’ which introduced IMCAs as a safeguard for ‘those who have noone to speak on their behalf’ making them mandatory in abuse and review situations. RED TAPE??

55 is another ‘good one’ which ensures that IMHAs are ‘of an adequate standard’ because clearly, that is unnecessary (!?!)

Obviously there are many many more – I’ve just, for reasons of time, picked out a few that interest me personally but do have a look at them and COMMENT.

I’m frankly insulted that some of these provisions are even considered to be ‘red tape’  but as there’s an open consultation, it’s important that as many people as possible who know and understand the implications of removing them, to contribute.

If the government want to know what ‘red tape’ is in terms of adding unnecessary burdens, I’ll gladly explain about how useful (or not) it is to spend time recording how much time I spend on ‘smoking cessation’ work or time spent ‘clustering’ people according to diagnosis into tiny little tick boxes which are, clinically, unhelpful in order to get the ‘Payment by Results’ systems which will never work well, up and running. THAT’S red tape.

But it seems to be red tape that potentially infringes on the rights of those who might be least able to protect their own that they are classing as ‘red tape’ here.

Contribute to the consultation and let’s tell them how important some of these provisions are.

Oh, and someone should tell the Department of Health that the GSCC doesn’t exist anymore as they seem to have forgotten on their Professional Standards page (published this week!) but we know how much interest the Department of Health has in social work and social care so shouldn’t really be surprised.

Pic by Martin Deutsch@Flickr

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Care Lobby 2012

Londra - The House of Parliament e il Big Ben
Today there will be a lobby and representation made to Parliament by the Care and Support Alliance – which is an umbrella organisation of a number of charities and representative groups for people with disabilities, illnesses and their carers.

The Care and Support Alliance is campaigning to change the current system of care which exists, claiming there is a ‘care crisis’ which needs fixing and is pushing the government to act on Dilnot’s proposals to change the system of funding for social care.

There is much that needs to be changed – not least the funding of care which at the moment is very dependent on location. It is a postcode lottery of funding in every sense of the word with different local authorities having very different systems which creates a very extrinsic ‘unfairness’.

But there is  more that needs to be changed than just creating a more equitable national system of payments for care. There is much about the way care is delivered, commissioned and organised that needs changing too.

There needs to be an improvement not just of the quality of care that is delivered but the quality of support that is offered to families of people who have care needs. While the government can have as many meetings about improving dignity in care as they like, these reports will all sound the same unless they do more to change the fundamental way that services are financed and delivered. Currently pushing costs between health and social care is detrimental to those who need support from both and until there is both better integration of budgets and greater attention to the fundamental needs of

I am very much in support of the Lobby today. For those who are not able to take part in person (like me, as I’ll be at work), there are ways to take part and show support online both on Facebook and Twitter.

Everyone needs to push on this point. We have to actively engage with the government to show them how much this matters and how much it matters that social care is important as a political issue. Health and Social Care are intrinsically connected and money pushed between one and the other without proper systems will cost more to both but not much in money, in quality and length of life, in stress and distress to those who need care and those who provide it.

The government has to act. Please join the Lobby or the #Twobby to make our voices heard together.

photo: Gengish/Flickr

Changing Adult Social Care – The Select Committee Reports

Yesterday after collecting both written and verbal evidence, the House of Commons Health Select Committee published their report into Social Care.

It makes very interesting reading and is written accessibly so I would highly recommend that anyone with an interest in this area reads the original but I wanted to pick up on some of the themes myself as there were such crucial issues raised.

The main theme I picked out (and you don’t have to be very astute to click with this one!) is the need for continued work towards integration – not only between health and social care which has become a bit of an old chestnut, but also with social housing.

The figures the report pulls out are that 50% of GP visits and 70% of hospital days are required by older adults as well as half housing association tenancies.
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Is the CQC fit for purpose?

There was an interesting article in the Guardian yesterday about the Care Quality Commission which was set up as a new regulatory body for health and social care in 2009.

The CQC is headed by Cynthia Bower at a salary of £195,000 pa who was previously the Chief Executive of the West Midlands Strategic Health Authority – responsible for Stafford Hospital at the time it was found to have been providing substandard care.

How she was able to take post at the CQC is quite staggering to me, as an outsider but there she is, responsible for the regulation of health and adult social care services. You’d think it was the opening of a black comedy. Maybe it is.

There are some chilling facts that the Guardian have uncovered and they deserve repeating – over and over again – because the CQC is responsible for the regulation – not only of hospitals but of every care home and domiciliary care agency in England.
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