P 05
Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon
Inquiry into the Priorities for the Health, Social Care and Sport Committee
Ymateb gan: Age Cymru
Response from: Age Cymru
Consultation Response
Priorities of the Health, Social Care and Sport Committee
August 2016
Introduction
Age Cymru is the leading charity working to improve the lives of all older people in Wales. We believe older people should be able to lead healthy and fulfilled lives, have adequate income, access to high quality services and the opportunity to shape their own future. We seek to provide a strong voice for all older people in Wales and to raise awareness of the issues of importance to them.
We are pleased to respond to the Health, Social Care and Sport Committee’s consultation on its future priorities. We have ordered our response to focus on priorities for the first 12-18 months of the Committee’s work and then comments on the potential longer-term work programme for the second half of the Fifth Assembly.
Priorities for the first 12-18 months:
· We welcome the committee’s decision to look immediately at the issues of winter preparedness and the sustainability of the health and social care workforce in Wales. The issue of excess winter mortality disproportionately affects older people, for example through avoidable slips, trips and falls or due to cutting back on heating out of fear of the cost. We will respond separately to the call for evidence to this inquiry.
· The sustainability of the health and social care workforce is an issue of central relevance to the older people of Wales. We therefore welcome the Committee’s commitment to an inquiry investigating the resilience of the current and future workforce to ensure that it is fit for purpose and sustainable into the future.
· With regard to other priorities that we would be keen to see the Committee pursue in its initial period, the sustainability of social care funding continues to be an issue of considerable concern. We note that it has not been outlined in the initial discussions for the longer-term work programme. Whilst we acknowledge that the Health and Social Care Committee of the Fourth Assembly did a considerable amount of work on social care legislation and policy, this was largely led by the legislative programme and did not directly address the question of funding and sustainability. We note from a recent release of National Strategic Indicators from Statistics for Wales that the rate of older people supported in care homes by local authorities has declined. However, the rate of older people being supported in the community has also declined[1], suggesting that funding squeezes are impacting on the care of vulnerable older people. This is a cause of considerable concern for us, given that Wales has an ageing population and that the Welsh Government’s stated objective is for older people to be given care support in the community in order to delay or prevent the need for residential or nursing care. If people are not provided with sufficient and timely social care support this can result in growing pressure upon the NHS.
Priorities for the second half of the Fifth Assembly:
· We welcome the Committee’s intention to look at the issue of integration of health and social care services. Improved integration of health and social care, with the aim of providing a person-centred service was a key ask of the Age Cymru 2016 National Assembly for Wales manifesto. We would like to see any such inquiry cover the operation of intermediate care services in Wales and the impact that the Intermediate Care Fund has had on helping keep older and vulnerable people out of hospital and in their own home.
· Likewise, we welcome the intention to hold an inquiry into the issue of loneliness and isolation among older people. This is an increasingly important issue for older people. We recognise this issue potentially cuts across the work of more than one Assembly committee, for example because many of the issues that contribution to greater social isolation of older people (which may contribute to their feelings of loneliness) derive from the broader social and environmental context in which older people live, for example cuts to transport services and closure of community assets and facilities that older people were using where they would have benefited from contact with other people. However, it is widely accepted that feelings of loneliness can impact negatively upon both physical and mental health. Tackling loneliness in a preventative fashion would therefore have beneficial impacts for both the individuals affected and potentially the health and social care services that end up supporting them.
· We are pleased to see the Committee’s intention to look at the use of antipsychotic medication in care homes. However, we note from both the Andrews Report (Trusted to Care) and the Tawel Fan inquiry that the inappropriate use of antipsychotic medication, especially for people living with dementia, is not restricted to care homes and we would therefore encourage the Committee to look at the issue in this broader context.
· We would recommend that in the second half of the Fifth Assembly the Committee consider reviewing the initial impact of the Welsh Government’s dementia strategy which it is proposing to release at the end of 2016. Age Cymru carried out the research that underpinned the Older People’s Commissioner’s ‘More than Words’ report and we believe it is essential that significant improvements are made to the quality of life for people living with dementia in Wales and their carers. Monitoring the implementation of the Welsh Government’s strategy is a key element in ensuring improvements are taking place.
· Finally, we believe it is imperative that in the second half of the Fifth Assembly that the Committee consider the effectiveness of the implementation of the Social Services and Well-being (Wales) Act 2014. In fact we were surprised to see this topic absent from the list of priorities initially discussed for the longer-term work plan. If there is to be a significant shift towards a preventative agenda, with consequent positive impacts for both health and social care services in Wales, it is essential that the implementation of the Act is scrutinised to ensure that it is having the intended effect. For example the provision of appropriate and accurate information and advice, the operation of the eligibility criteria and the commissioning and use of advocacy should be kept under review to ensure that the preventative ethos is being embedded in practice.
We hope these comments are useful and would be more than happy to provide further information if required.