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DH:  Why do self-payers have to pay a higher rate than the local council for the same care in a home? - Costs should be capped & the means-tested threshold increased under major changes to the funding of adult social care in England, the Commission on Funding of Care and Support recommends in its final report Fairer Care Funding

Instead of individuals paying all their care costs until they have assets of less than £23,250, as under the current system, the proposals would mean that those with high care costs would only pay up to a set amount and after that their care costs would be paid for by the State.

Among the recommendations in the report are:
* Individuals’ lifetime contributions towards their social care costs – which are currently potentially unlimited – should be capped.  After the cap is reached, individuals would be eligible for full state support.  This cap should be between £25,000 & £50,000 (with £35,000 being the most appropriate & fair figure, cost the State around £1.7bn)

* The means-tested threshold, above which people are liable for their full care costs, should be increased from £23,250 to £100,000

* All those who enter adulthood with a care & support need should be eligible for free state support immediately rather than being subjected to a means test

In the next 20 years, the number of people aged 85 & over in England is projected to double to 2.4m.  The current adult social care funding system (conceived in 1948) means that those with assets of more than £23,250 are liable for the full cost of their social care needs.  A quarter of 65 year olds today can expect to face care costs of over £50,000 and for one in 10 it will be more than £100,000.

The Commission believes that this combination of a cap and the higher means-tested threshold would ensure that no-one going into residential care would have to spend more than 30% of their assets on their care costs.  Under the current system, at the extreme, people face losing over 90% of their assets.
Press release ~ Commission on Funding of Care and Support ~ DH comment ~ NHS Confederation comment ~ JRF Comment ~ ippr: New ‘super carer’ role needed to spearhead reform of home care for old people ~ TUC Response ~ King’s Fund response ~ WAG comment ~ NHS Confederation Wake-up Call ~ LGA response ~ Building a Society for All Ages ~ Financial care models in Scotland and the UK ~ Future demand for long-term care in the UK: A summary of projections of long-term care finance for older people to 2051 ~ JRF:  The material resources and well-being of older people ~ The material resources and well-being of older people ~ JRF: Older People – A Better Life ~ Disruptions in family and work life: Implications for support in later life ~ Research Project: ‘Disruptions in family and work life ~ Inequalities in health in an ageing population, patterns, causes and consequences ~ Full of Life government campaign ~ DWP – Preparing for an Aging Society ~ ‘Boomers and beyond: intergenerational consumption and the mature imagination’ ~ EHRC: Just Ageing? ~ Older People and Ageing Research and Development Network (OPAN) ~ Integrating health and social care: Where next? ~ Related recent previous item (Then scroll down to item: Newswire – CSJ:  Often ‘out of site & rarely protesting’ and therefore ‘out of the political mind’) ~ Directgov: care homes

BHFProvision of Care should be a ‘given’, but how it is provided should be continually checked for ‘Method of Delivery’ Best Practice - An independent Palliative Care Funding review has recommended money should be allocated based on individual patients’ specific needs, rather than just their age and type of disease.  The report has highlighted that someone’s 'phase of illness' – stable, unstable, deteriorating or dying – should be used to help the NHS fund palliative care properly.

The recommended changes have been called a 'per-patient tariff’ and England would be the first country in the world to use the system if the Government adopted the ideas for both adults & children.  The report says the changes could save the NHS £180m and cut hospital deaths by 60,000.

This review is an important first step to readdressing the balance so heart patients get the care they deserve.  British Heart Foundation associate medical director, Dr Mike Knapton, said: “There are 750,000 people living with heart failure in the UK and they often have a poorer quality of life, more limited access to palliative care services and a worse life expectancy than many cancer patients.

This review is an important first step to readdressing the balance so heart patients get the care they deserve based on need, not diagnosis.  These recommendations now need to be seriously considered alongside the Dilnot report on funding older people's care.”

The BHF is working with Marie Curie Cancer Care and NHS Greater Glasgow and Clyde on a 5-year programme called 'Caring Together' to develop pioneering end of life care for heart failure patients.
Press release ~ Caring Together ~ Marie Curie Cancer Care  ~ NHS Greater Glasgow and Clyde ~ BHF: Heart failure ~ Gadgets saving millions of pounds in adult social care ~ DH:  We need a system that ‘protects them from public sector bean counters’ ~ Newswire – LGA:  A cheaper (but effective alternative) to personal care ~ Related press release ~ Social Care Institute for Excellence (SCIE): Social Work Practice Pilot Sites ~ Direct payments - arranging your own care and services ~ ScotGov: Self-directed Support Strategy ~ The Individual Budgets Pilot Projects: Impacts and Outcomes for CarersDH: Personal Health Budgets ~ Personal health budgets Learning Network ~ National Council for Palliative care ~ NICE: Supportive and Palliative Care ~ Scottish Partnership for palliative care ~ NHS Scotland: PC guidelines

LGA:  Local Decisions require local knowledge - Bus passengers will be hit with years of fare hikes & cuts to services unless Government gives local people more say on where £bns of public money is spent, council leaders warned recently.  The Local Government Association, which represents more than 350 councils in England & Wales, is pressing for radical reform of the way private bus companies are subsidised.

Handing control from Whitehall to local areas will increase competition among operators, and ensure that the subsidy is targeted more effectively.  Councils say they should be able to impose conditions on the public money provided to support bus services.  They could agree with bus companies to protect existing routes, insist on new routes or offer reduced fares to job seekers.

The Office of Fair Trading (OFT) referred the local bus market to the Competition Commission in January 2010.  The commission is carrying out a comprehensive investigation to see if any features of this market prevent, restrict or distort competition and, if so, what action might be taken to remedy the resulting adverse effects on competition.
Press release & links ~ Competition Commission (CC) is looking at ways to open up more bus markets across the country ~ CC: Local Bus services ~ OFT: Local Bus Services ~ LGI&D:  Rural Transport ~ Sustainable Rural Transport ~ Defra: Rural transport ~ Defra: Buses ~ Action with Communities in Rural England ~ Community Transport Association ~ Commission for Integrated Transport:  Rural transport

Virtual lessons save lives in reality - A huge virtual reality training facility in Sennelager, Germany, which uses the latest 3D gaming technology, is helping British forces, from individuals to entire battle groups, prepare for operations in southern Afghanistan.

Before departing for theatre, troops spent hours in simulators and replica operations rooms at the Sennelager Training Centre in Germany, driving virtual vehicles and commanding computer-generated ground patrols.

Two different training units use the gaming-influenced technology:
* The Combined Arms Staff Trainer (CAST) allows headquarters personnel to fight on-screen battles during a week-long exercise which tests commanders' plans and the performance of operations room staff.

* A separate 5-day course at the Combined Arms Tactical Trainer (CATT) sees drivers & ground forces drafted in to digital missions, using vehicle simulators to increase the level of tactical complexity. 

Lifelike imagery from theatre is beamed onto flatscreens and backed up by real Afghan actors who are on hand to role-play situations with the exercising troops. More than 140 mock vehicle cabs, turrets & firing points are housed in metal containers in a huge warehouse-like space that is roughly the same size as a football pitch. Troops under training fight digital foes, with on-screen operations viewed through a simulator's periscopes or weapon sights.

Personnel are routinely immersed in virtual wars for hours - and the level of reality is such that some will experience 'simulation sickness' similar to the effect of a roller coaster. As well as lifelike graphics, realistic terrain and sound effects, small details - such as engines overheating if left idle for too long - are played out.
Press release & links ~ Virtual reality Parachute Trainer ~ DSTL: Major Incident Simulation ~ Largest Global Wargame ~ Improved UK Testing facilities for Joint Combat Aircraft ~ Coalition Warrior Interoperability Demonstration (CWID) ~ Defence Science and Technology Laboratory (Dstl) ~ Network Enabled Capability (NEC) ~ Combined Federated Battle Laboratory network

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