Steve Gaston’s Post

Initiatives are great but we need action Well done the Government of South Australia (SA) for their Wellbeing Hub initiative . A partnership between Preventive Health SA and the South Australian councils, the initiative aims to support local engagement is meaningful physical, social and mental health activities across the ages. Digging in deeper to Preventive Health SA, I see they have a raft of partners, priorities and agencies working towards a range of important strategies.  Their website is easy to navigate, and the strategies are well written, but with the exception of a few councils applying the Wellbeing Hub principles, I wasn’t able to find any information of translation of actions to practice? There is little denying that the SA hospital system is at breaking point due to incoming patient traffic and lack of residential aged care bed discharge pathways for older people. Australian Institute of Health and Welfare data reveal older Australians have the biggest impact to the National health system through GP and hospital presentation, with a three times greater occurrence of hospitalisation than those under 64 years. The Preventive Health SA website reveals people’s physical activity and walking engagement continues to decline, while preventable hospitalisation continues to increase. A primary reason for this health crisis is the growing sedentary behaviour across all age groups, that culminates in later life to poor and declining physical and mental health. I realise getting people involved in positive physical activity pathways is not easy, but are we doing enough?  Appointing more agencies and releasing strategic plans without a focused effort on the translation of evidence to action is like only doing half the work. How much more broken does the system need to be before we do something about it? We can do better by older Australians.   

I have been heartened by the strides made in implementing independent camera monitoring in dementia communities. The dedication of conscientious, forward-thinking care leaders like Signature Senior Lifestyle Limited and Maria Mallaband Care Group Ltd that prioritise safety, integrity, and transparency is truly admirable. CCFTV is regularly brought distressing incidents reminding us of the urgent need for transparency across the whole of the care sector. It is disheartening to receive messages from families facing 28 days of eviction notices for their loved ones without proper communication or justification. The recent case brought to us, an 88-year-old mother receiving an eviction notice simply for her daughter raising legitimate concerns that are not sufficiently addressed is deeply troubling. Such actions undermine the principles of dignity and respect that should underpin every aspect of a person’s care provision. While it is essential to acknowledge care providers that go above and beyond to ensure the safety and well-being of residents, eviction should never be used as what families say is a punishment for contacting the CQC and safeguarding. Instead, providers must engage in open dialogue, offering support and guidance to address any issues that arise. I recall a personal experience where I sought to work collaboratively with a care home provider to address concerns about my mother's well-being. Despite my transparent intentions, my request to install a safety monitoring device was denied, prompting me to take covert action out of concern for my mother's welfare. The subsequent discovery of failings within the facility highlighted the critical importance of transparency and accountability in ensuring the highest standards of care. The emotional toll of such experiences cannot be overstated. Families grappling with guilt and anguish over the care of their loved ones deserve better. Revenge evictions, driven by a desire to silence criticism rather than address systemic issues, only exacerbate the trauma and erode trust in the care system and can often bring providers repututal damage. As advocates for vulnerable individuals, we must demand greater accountability from care providers and regulatory bodies. Transparency, compassion, and a commitment to continuous improvement must guide our efforts to uphold the dignity and well-being of those in care. Care England Care Quality Commission

Quick summary of The Labour Party’s manifesto commitments relating to Health & Social Care 🤒NHS becomes not just a sickness service 🧠mental health has same attention &focus as physical health. ⏱️ 18 weeks from referral for consultant-led treatment of non-urgent health conditions 🏥pool resources across neighbouring hospitals to introduce shared waiting lists to allow patients to be treated quicker. 🏡 Neighbourhood Health Centres, bringing together existing services such as family doctors, district nurses, care workers, physiotherapists, palliative care, & mental health specialists under one roof. 🧑🏽⚕️publication of regular, independent workforce planning, across health and social care 🪧reset relations with NHS staff 🩻 introduce a new ‘Fit For the Future’ fund to double the number of CT & MRI scanners 🍼ensure that trusts failing on maternity care are robustly supported into rapid improvement. 👩🏼💼implement professional standards and regulate managers 🚫 ban vapes from being branded and advertised to appeal to children 🍔 banning advertising junk food to children along with the sale of high-caffeine energy drinks to under-16s. 🧕🏽prioritise women’s health as reform the NHS. 🇬🇧 National Care Service, underpinned by national standards, delivering consistency of care across the country. Services will be locally delivered, with a principle of ‘home first’ that supports people to live independently for as long as possible. 💷 establish a Fair Pay Agreement in adult social care. This sector collective agreement will set fair pay, terms and conditions, along with training standards 🩺 establish a Royal College of Clinical Leadership to champion the voice of clinicians. 💊 create a Community Pharmacist Prescribing Service, granting more pharmacists independent prescribing rights

The Conservative Party manifesto is more of the same (ie precious little) for social care and I agree with Jane Townson. Jane cites today's challenges – unmet need; poor commissioning; fragmented services; unstable markets; a struggling workforce; declining quality; and ineffective regulation. I also agree that; "Caring for each other is a fundamental human need and ... that Politicians who ignore this are ignoring what is important to most of us." "The demographic shifts are also increasing the demand for care services, and, "We do need to transform how we fund, provide, and enable access to care. All I would add is that supporting people to live well in a place that people can call home is a must which should be at the heart of government policy, and that should not ignore people needing 24/7 support. Home care and residential care have people with different circumstances. There is so much need, that this should not a competition, of one social care sector against another, nor should this be about the NHS (or Government) against any sector or the group of people it serves. Policy should support people irrespective.

This makes me so angry ! People in the UK are not lazy scroungers, they are not avoiding work and hiding behind 'sick notes'. To say so is dangerous, disingenuous and an outright lie. The reason people cannot get back to work or back into work is because they are unable to do so - waiting times for NHS treatment are ridiculous, not just to see a GP for a diagnosis but for mental health services, for physiotherapy and general diagnostics. If we cannot meet the target for urgent cancer treatment in the UK then you can be sure that no other service is functioning well. This means that employees in work have to work harder, businesses have to provide private health alternatives (which worsen the NHS crisis) productivity falls and costs to consumers increase. Changing the sick note process and employing 'professionals to provide this service' is pie in the sky madness - we dont have sufficient Doctors and Nurses for the NHS so where will they find people capable of providing this service? This ridiculous postering and gaslighting has to stop. https://lnkd.in/dJbh45dP

General Practice embodies the essence of comprehensive, patient-centred care. It is the discipline of providing generalist, whole person care, recognizing that the myriad aspects of an individual's life collectively influence their physical and mental well-being. This approach necessitates dedication—allocating time to listen, inquire, and genuinely engage with patients. As GPs with expertise in Mental Health we welcome the $888 million, over 8 year investment in mental health services, but are devastated that this will in our opinion further fragment the broken system of care about which Mental Health advocates have been warning for some time. If these funds had instead been invested in GP led psychological care as part of whole person, longitudinal care in the community it would have resulted in higher quality, lower cost care with better long-term outcomes. By integrating insights into the various dimensions of our patients' lives, General Practitioners deliver a spectrum of healthcare services unparalleled in other medical fields. This includes preventative measures, early interventions, and maintaining consistent care over time. Particularly in the realm of Mental Health, General Practitioners play a pivotal role in Australia, offering assessment, treatment, and ongoing support for the majority of mental health conditions and all form of distress, with psychological care being a primary reason for consultations. It is concerning that the expertise and value of General Practice has been overlooked by policy decisions that favour episodic treatment models that fragment patient care. Recent budget allocations have underscored this trend, emphasizing 'low intensity digital services' and establishing Head to Health Hubs and Mental Health Centres that sideline General Practitioners from integrated patient care. This not only undermines the critical role of General Practice—the most cost-effective healthcare model in Australia—but also neglects the necessity of investing in preventive care and the broader psychiatric, psychological, and General Practice workforce. Despite claims of healthcare investment, the current focus remains narrowly fixed on alleviating symptoms rather than addressing underlying causes. This perspective fails to recognize the comprehensive benefits of General Practice, both in terms of patient outcomes and cost-efficiency. It is imperative that future policies re-evaluate and affirm the integral role of General Practitioners in cultivating a healthier nation. We call on our government to make public policy in conversation with experienced mental health GPs. We are on the ground and we know what works. Ask us…   Australian Institute of Health and Welfare 2021. Mental health services in Australia. Canberra: AIHW. The Royal Australian College of General Practitioners, General Practice: Health of the Nation 2023, East Melbourne, Vic, RACGP 2023

The Conservative Party manifesto is more of the same for social care. In 2019, Boris Johnson promised he had an oven-ready plan to fix social care. This proved to be soundbite over substance. The government scrambled to produce a White Paper, People at the Heart of Care, which reflected the transformative vision of the Care Act 2014. Whilst the principles were sound, the system has lacked the investment and policy architecture needed to realise them. Many of today's challenges – unmet need; poor commissioning; fragmented services; unstable markets; a struggling workforce; declining quality; and ineffective regulation - stem from failure to align resources and incentives with the goals of the Act and later reform proposals. The Conservatives say they will implement a cap on social care costs from October 2025. This is what they promised five years ago when they had a large majority and we have seen little tangible progress. Whilst the Conservatives have made good progress on encouraging uptake of digital social care records, they have not yet landed key workforce policy proposals. Nor have they invested enough to address pay and terms and conditions of employment for the workforce. Our Homecare Association manifesto sets out a roadmap for action for an incoming government. We want to see policies enabling people to remain at home, with a focus on early support and prevention. Collaboration across health, care, housing, and the voluntary sectors is vital. So is amplifying the voices of those needing and giving care. We need investment in the workforce as well as in technology solutions, which enable us to meet rising demand and complexity of need. Pooling risk and investing adequately is crucial for improving accessibility to care. More funding will enable commissioning for value and outcomes, effective regulation, and high-quality provision. My comment: "Caring for each other is a fundamental human need and underpins our survival and evolution as a species. Politicians who ignore this are ignoring what is important to most of us. "Today, dramatic demographic shifts are increasing the demand for care services. To cope with this, we must change our approach. "We need to transform how we fund, provide, and enable access to care. "With smart strategies, collaboration, and investment, we can build a future where more of us remain healthy for longer. Supporting people to live well at home must be at the heart of government policy.” https://lnkd.in/eh6-CPct #homecare #manifesto #ConservativeParty #UK

Dear Ministers Matt Keogh and Mark Butler, Attn: Hon PM Anthony Albanese and Hon MP Bill Shorten Concerns Regarding the Regulation of Counsellors in Australia I want to address concerns about the qualifications and regulation of counsellors in Australia, especially regarding self-regulating bodies like PACFA and ACA. While these associations are important, their standards may not align with those of regulated professions like psychology. Some members of PACFA and ACA seem to have only two years of qualifications, such as a direct Master's degree in counselling or psychotherapy, without a prior Bachelor's degree in the same field. In contrast, entry-level psychologists require a minimum of six years of accredited training. This raises concerns about the qualifications of clinical counsellors in these associations, as they may lack the clinical training required for psychologists. Currently, members of PACFA and ACA can become clinical counsellors without a specific degree in clinical counselling, unlike clinical psychologists who must complete a degree in clinical psychology. This situation raises questions about the integrity of the titles awarded by these associations, as some members may claim expertise without the necessary qualifications. My personal experiences highlight the need for clarity. I was supervised by an ACA member who was not actively practising at the time of questioning and had an exemption from the association for her OPD hours and supervision. This resulted in significant issues in my practice due to her lack of adherence to professional standards. Despite this, the ACA continued to list my supervisor as a registered practising counsellor. Issues like this could mislead clients about the status of the profesionals. These discrepancies raise serious concerns about the self-regulatory nature of associations such as ACA and their responsibility to ensure that members meet professional standards. Clients cannot fully trust the services offered by these self-regulating associations due to these inconsistencies. I urge the establishment of an independent regulatory body for counsellors and psychotherapists, similar to AHPRA. This would ensure that practitioners are evaluated based on qualifications rather than membership in self-regulating associations, enhancing public safety and service quality. While professional associations are important, their dual role as regulatory bodies can create an anti-competitive environment. Evidence shows that effective regulation enhances service quality and public trust (Baldwin & Cave, 1999). When associations hold too much power, it can lead to imbalances and anti-competitive behaviour. References: Baldwin, R., & Cave, M. (1999). Understanding Regulation: Theory, Strategy, and Practice. Oxford University Press. Websites: www.theaca.net.au www.pacfa.org.a www.psychology.org.au www.ahpra.gov.au www.psychologyboard.gov.au Healthcare agencies such as Medicare and Bupa to take note.

In our latest thought piece, Pro-Vice-Chancellor for Health Ann-Marie Cannaby and Pro-Vice-Chancellor's Strategic Advisor Dame Eileen Sills share their thoughts on how the new Labour government can improve health and social care in the UK: As we welcome a new government coming into power, we recognise the challenges that they and all who work in the NHS face. The Secretary of State for Health and Social Care, Wes Streeting, described himself as stunned at the NHS’ failings in his first statement in the role. Many who work in the service may agree with his remarks, but, despite outdated facilities, old technology and staff shortages, the NHS is still striving to deliver safe and compassionate care. Between us we have over 75 years of experience as nurses, and we know that our colleagues get out of bed everyday with the drive and determination to provide quality patient care and uphold the NHS’ reputation. Many of our colleagues believe this is a good career, with opportunities, rewards and experiences that are valued. The last few years have been tough, with staffing issues, the horrors of Covid and the strikes and discontentment of professional groups. A constant need to do more with less, without the incentives, respect or sometimes the support to do so, has led to many leaving the service, retiring early or moving abroad. Our challenge is to have enough people to care for our communities, and we need to put education at the centre of this regeneration. Access to health and social care education and access to NHS care itself are interlinked - and both require reform. Keir Starmer’s new government has committed to raising the number of NHS appointments by 2 million per year in its first year. The plan is to incentivise staff to carry out additional appointments out of hours. Our view is that asking the current workforce to do more in the same way is unlikely to achieve these aims. The government needs to consider how to increase access to care across more hours and days, smoothing out the peaks and troughs of activity. This requires more flexible working patterns, enabling people to work part-time, remotely and flexibly, while using our fixed assets and resources more efficiently. These are conversations that NHS executives have had for years and, for such initiatives to be effective, we must first address the workforce shortages in health and social care provision. This is why education should be the focal point of the new government’s approach. To read more of their thoughts, go to: https://bit.ly/3WcigZ7 #NHS

The true value is in the savings.