Pooled resources key to future care of over-85s in health 'timebomb'

Susan Rout

Dr McWilliam

First published in News Herald Series: Photograph of the Author by

OXFORDSHIRE’S growing elderly population – set to soar in the next 20 years – has been branded the county’s “number one health care challenge”.

The number of people over the age of 85 in the county is predicted to increase by 168 per cent between 2011 and 2035, from 14,683 to 39,400.

That’s higher than the average for England of 139 per cent. West Oxfordshire faces a predicted rise of 221 per cent.

Groups representing the elderly have repeated warnings of the “time bomb” of care for pensioners that needs to be addressed.

The figures have been released in Oxfordshire County Council director of public health Jonathan McWilliam’s sixth annual public health report.

Dr McWilliam said: “The elderly population is the absolute challenge for all public services.

“If we are going to make the best of the public money we have to do things differently.

“Organisations like the NHS and local government need to work more closely together.

“We need to empower people to find their own solutions and we need to strengthen the voluntary sector and carers so they can play their part.”

The main recommendation in his report, which has been implemented, is to pool the council’s adult social care budget and GP-led Oxfordshire Clinical Commissioning Group (OCCG) community health budget to stop duplication.

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The combined budget is now £188m, and will be spent on everything from carers and day services to mental health services and palliative care.

But county council leader Ian Hudspeth conceded this was not new money as it was being taken from existing budgets.

He said: “What we have got to do is reduce the need people have for assistance by making them healthier. We’re also looking to see if we can fund different ways of caring for people.

“For instance, we currently spend £46m on 1,500 people in care homes and we look after 3,000 people in their own homes for £23m. We want to work with our district council colleagues to get more extra care housing built.”

OCCG’s Dr Steven Richards felt pooling resources was a step in the right direction.

He said: “We think there are real benefits for patient care by having a single pooled budget.

“It gives us the best possible chance of using taxpayers’ money more efficiently to the benefit of our population.”

But despite the growing pressures there are more potential spending cuts on the way.

The OCCG took over from the county’s Primary Care Trust in purchasing health services on April 1 and has had to make savings of £25.6m in its first year.

The council’s spending on adult social care increased from £129m in 2009 to £172m this year, but it plans to make £18m of savings in the area by 2017.

Oxfordshire Pensioners’ Action Group chairman John Mackie, 74, said: “The ageing population is a tremendous challenge.

“It is a problem no Government wants to face – we have got a timebomb there and they do not know what to do with it.

“The pooling of funds is a better idea, but it probably is not going to be enough because the population is a figure that just goes up and up.”

Oxfordshire Community Foundation chief executive Jayne Woodley said: “Ten years ago we would not have thought more than two million people would be using food banks in the UK every week.

“If you think about 10 years’ time, it is a time bomb.

“But it does not have to be a ticking timebomb, it is something we can tackle now.”

‘It’s something I try not to think about’

Wantage pensioner Susan Rout, 67,  said budget cuts to services she may rely on when she reaches the age of 85 were a concern.

Mrs Rout, a retired chemist with no children, of Aldworth Avenue, said: “It is something I try not to think about, but I know I have to think about it.

“I am very fortunate in being very healthy and able to do everything I want to.
“But I have a close friend a couple of years older than me who suddenly lost the use of their legs and has gone into a care home.
“The concern is those services not being there when I reach 85 because the funding just not being there.  It makes sense to create more links between these professions because it does strike me that the left hand does not know what the right hand is doing at the moment.
“I do not think it is going to be enough, but then on the other hand, I can understand why they cannot do more because the money is not there.
“It is a big job for someone. I hope they have got what it takes.”

Recommendations

DR McWilliam recommends introducing one pooled budget between Oxfordshire County Council and Oxfordshire Clinical Commissioning Group by October 2013. This budget should bring together the council’s adult social care resources and the OCCG’s community health resources.
The Health and Wellbeing Board should be re-designed to oversee the management of this money. The use of the cash should be guided by a single plan, agreed by both parties, and driven by revamped targets and outcome measures.
 By 2014, local authorities, the commissioning group, Age UK and carer, voluntary and faith representatives should create proposals to tackle loneliness amongst isolated elderly people. This should be overseen by the Health and Social Care Board.
In the 2011 report, which made recommendations until 2013, Dr McWilliam suggested introducing a sub-group to the board to tackle the problem led by representatives from the council and OCCG.

 

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