P 66
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: Fforwm Gofal Cymru
Response from: Care Forum Wales
Care Forum Wales welcomes the opportunity to help identify the key priorities and issues facing the Health and Social Care Sector. We are a membership organisation for Health and Social Care Providers in Wales representing over 450.
We particularly welcome the inquiry on Health and Social Care workforce to which we will be providing a separate response, but in broad terms, we will be highlighting:
· The effect of commissioning practice on the terms and conditions of the workforce;
· Appropriate pay and terms and conditions and career structure and in particular how to increase them when around 70% of direct costs relate to staffing and income is dependent on public funding;
· improving NHS commissioning of pre-placement training for nurses within the independent sector;
· reducing the impact of nurse shortages through delegation of nursing tasks in appropriate circumstances;
· improved access to training for social care workers aged over 25.
There are wider challenges faced by the health and social care sector that we would like to see covered in the Committee’s forward work programme, although some of these could perhaps be incorporated into the proposed inquiry into the integration of health and social care, were it to take a partnership-based approach and include services commissioned and not just directly provided by the statutory sector:
· the demographic challenges to be met by health and social care provision;
· commissioning and inspection to meet the ideas and values of the Social Services and Wellbeing Act (Wales) and the working of Regional Partnership Boards
We would also expect the committee to consider secondary legislation to be issued under the Regulation and Inspection of Social Care (Wales) Act, which could have a significant effect on the health and social care sector dependent on the changes made.
As regards the additional proposed inquiries, we would offer the following thoughts on those aspects that most affect our members:
· Primary care – the inquiry should ensure that residents in care homes have equal access to primary care services with other citizens, as highlighted by the Older People’s Commissioner and promised by the previous Health Minister.
· Efficiency within the NHS – independent providers can provide care to keep people out of hospital either in care homes or in their own home and can be used as step up / step down / re-ablement facilities. In order to work most efficiently providers need to be recognised as partners. We would also like to see more innovative work such as using care homes as community assets to deliver clinics etc. where premises are not available and using down-time between busy home care periods to provide additional services such as falls prevention.
· Over prescription of anti-psychotic medication – we would suggest that the focus of the inquiry needs to be on when anti-psychotic medication is necessary and what other solutions there are for dealing with behaviour that challenges. We would be happy to share experiences from the sector in implementing such approaches.
· Ambulance Services – we could provide information on the factors leading to ambulance call outs by care homes and suggestions about how to reduce the number.
· Loneliness and isolation – we could offer information on the role of the care sector in combatting this in terms of both the role of care homes, including for example as day centres and the provision of support with care at home visits. The success of Monmouthshire County Council’s Raglan Project shows that wider social wellbeing outcomes can be met through more imaginative use of resources but also require a change in the approach to commissioning.