Forum

Citation

Jenkins, K.G. (2013), "Forum", Social Care and Neurodisability, Vol. 4 No. 3/4. https://doi.org/10.1108/SCN-07-2013-0025

Forum

Article Type: Forum From: Social Care and Neurodisability, Volume 4, Issue 3/4

Welcome to the Forum section of Social Care and Neurodisability, your opportunity to post responses to articles from previous issues and to raise awareness of forthcoming events, consultations, policy initiatives, etc. This edition of Forum has been compiled by Dr Keith Jenkins, who looks forward to your responses by e-mail or post.

Dr Keith G. Jenkins, CPsychol, CSci, AFBPsS, National Brain Injury Centre, St Andrew's Hospital, Northampton, NN1 5DG. Tel: +44 (0) 1604 616767, E-mail: mailto:KJenkins@standrew.co.uk

Neurodisability services in the age of austerity

As I write this Forum, the Chancellor of the Exchequer has just been announcing his spending review. Across many areas of government expenditure there is the expectation of further cost savings, typically ranging from 5 to 10 per cent. The driving philosophy is stated as, “high-quality public services at a price we can afford”, and “a state we can afford”. As regards healthcare expenditure, there is the “reassurance” that expenditure will rise from the £96 billion it stood at when the Coalition came to power (2010), to £110 billion by 2016. But what does this mean in reality for those of us working in health and social care supporting people living with neurodisability? This spending increase equates to roughly 15 per cent over 6 years, approximately 2.5 per cent per annum, so well below the average inflation rate for the first three years of the Coalition, 3.53 per cent. In reality then, in case you had not already noticed, in your hospital, community service, nursing home, and so on, you are looking at cuts in resources. What can be done? Especially, given that the effects of an ageing population and continued additions to the range of treatments available will likely increase demands on our health and social care resources.

In the spirit of Forum, I have some thoughts about how we can respond to the inevitable pressures that will result from scarcity of resources. It would be good to hear your responses to them, and other ideas that you would like to contribute to the discussion.

1. Identify new sources of funding. For example, could motor insurance companies be expected to contribute through an annual levy to the funding of rehabilitation and other services for people with an acquired brain injury that are used by their customers, i.e. the victims of road traffic accidents? This would be similar to, for example, elements of the system in Australia. Instead of requiring individuals to use civil litigation to win funding for rehabilitation/care, contributions to service provision could ensure relevant access, and also reduce the cost of litigation. This could instead focus upon loss of earnings and the effects of acquired disability, rather than trying to make a case for treatment(s).

2. Does the independent sector domination of some areas of specialist care, such as residential brain injury rehabilitation or specialist nursing homes, for example, need to be more closely scrutinised. When providers are generating profits or “excess” well above 20 per cent for their shareholders or owners, could a different model of commissioning, perhaps using the not-for-profit charitable sector, provide better outcomes. For example, either in terms of lower charges or through more of the resources available being deployed to the actual service provision?

3. Could community services make better use of the charitable sector? Could families and relatives of people already involved in supporting individuals with neurodisability be better supported and trained, so that statutory services are needed less? Is there a pool of volunteers that can be developed to deliver some components of care/rehabilitation?

I am sure that this is not an exhaustive list regarding how improvement in the availability of resources might be achieved. What do you think?

Neurological services organisation

How are services for people with neurodisability organised in your area? Are there several different “teams” dealing with specific neurological needs, for example, stroke, acquired brain injury, dementia, MS and so on. Given the overlaps that can occur as regards some aspects of the support required from professionals and carers, there are likely to be ways that services sharing resources and cooperating better may be able to improve on the patient and family experience. Also, where possible it may be that the charitable service providers can make their facilities available to similar groups. For example, at Headway East Northants, we are already offering access to our centre for a dementia support group and a brain tumour support group, and developing links with the Stroke Association. In the “Age of Austerity” working better together is another way to maximise coping.

Forthcoming events/announcements

27-31 January 2014, London. SMART Sensory Modality and Rehabilitation Technique (SMART) Five-Day Accredited Assessors Course, Royal Hospital for Neurodisability, E-mail mailto:smart@rhn.org.uk

March 31-1 April 2014, Lille. The Third European Conference on Clinical Neuroimaging, www.euroccn.com/

5-9 July 2014, Milan, Italy. 9th Federation of European Neuroscience Societies (FENS) Forum of Neuroscience, http://fens2014.neurosciences.asso.fr/

For even more event details, see this World Federation for NeuroRehabilitation site: http://wfnr.co.uk/en/events/

Brain Injury Social Work Group (BISWG) bursaries

Each financial year BISWG Ltd will be offering two exceptional bursaries of £1,000 for international conferences and 16 bursaries of £500 to attend training and conferences in the UK (www.biswg.co.uk/html/bursaries.html).

And finally

If you would like your event(s) featured, send an e-mail with details at least three months before the event to allow for publication lead times.

If you have any questions or opinions that you would like to share with the wider neurodisability community, why not send them in to Forum. I look forward to hearing from you.

Keith G. Jenkins