Health inequalities among older BAME groups in later life

Dr Nayyara TabassumDr Nayyara Tabassum is Evidence Officer in the Centre for Ageing Better. (917 words)

In March of this year when we were still learning about COVID-19 in the UK, I remember listening to a journalist on the telly saying the coronavirus does not discriminate – it infects and kills everyone, rich or poor, young or old. But as more news started filtering in, a pattern of who the virus infected the most began emerging. Even while scientists and public health personnel were grappling with this new virus and how it spreads, one of the earliest news trends of the pandemic is that the virus seemed to affect particular groups, such as older people, those with underlying health conditions, those living in deprived areas, lower-skilled workers, those working in social care, those living in care homes and BAME (Black, Asian and Minority Ethnic) groups more than any other group.

The COVID-19 pandemic has shone a light on health inequalities that disproportionately affect older people and BAME people, something also confirmed by the recent PHE report published in June 2020.

This blog looks at what we know about health inequalities of older BAME groups, what we need to know more about and what are some key recommendations to promote healthy ageing that is inclusive for all. Continue reading

Social care is not an intractable problem

John Burton has been working in and with social care, mostly residential care, since the mid-1960s. He has worked at all levels with all client groups and ages, and is currently consulting to therapeutic children’s homes. His most recent book is Leading Good Care (JKP 2015) and he is now writing a new book on children’s homes. Readers may also be interested in his What’s wrong with CQC? published by The Centre for Welfare Reform. (1003 words)

When designing anything it’s crucial to understand what its purpose is. When redesigning something that isn’t working as well as it should, we must study the operation of what currently exists to identify how it falls short of its purpose. To study effectively, we must get to know it in detail from the inside, look at it as a whole and make no assumptions.

So it is with what we call social care. We start and end life dependent on others, but in between the beginning and end we remain dependent to a greater or lesser extent. We are social beings and we are never fully independent. When we need more support than our family, friends and neighbours can give, we require an organised system of support which will include paid people and is likely to include supplies, buildings, equipment etc. We all need and give support, some more than others and at different times. It’s simply part of being human. Continue reading

Personal budgets in Finland

John WoolhamJohn Woolham is Senior Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. He recently returned from a trip to Helsinki where he discussed the English experience of implementing personal budgets. (1,141 words)

On 31 May of this year, the Social Care Workforce Research Unit at King’s was asked to organise a seminar on the topic of Personal Budgets and Direct Payments for a group of social care practitioners, project managers, academics and civil servants from Finland. They were over here on a ‘fact-finding’ mission. The Finnish Government is proposing to introduce a form of Personal Budgets and Direct Payments in their social care and welfare services, and the group were here to find out what they could about how they had been, and were being, implemented in England. This was a very rapid tour round the landscape. In two hours, Professor Jill Manthorpe, Dr Martin Stevens, Dr Nicole Steils and I told them about the impact of personalisation, personal budgets and direct payments on social care providers, unpaid carers and older people as well as a rapid overview of the research evidence and key issues. Surviving half-baked but well-meaning attempts by me to add Finnish subtitles to my own slides using ‘Google translate’—just don’t, OK?—we even managed to squeeze in a short discussion with questions and answers. Amazingly, after such an intense burst of information sharing, we got some extremely interesting and thoughtful questions. Although Finland was, and remains, at an early stage in the process of transforming part of its welfare services, it was clear that a great deal of thinking was being devoted to how to do this smoothly, and without the ideological rigidity that has characterised some debates around the topic in this country. Continue reading

Finding unity in diversity within China’s long-term care system

csm_Maags_pic_f1915bd14eChristina Maags is a Lecturer in Chinese Politics at the School of Oriental and African Studies (SOAS), London, specializing in the politics of demographic change in China. (1,278 words)

Preparing for the growing ageing population is a huge cause for celebration and yet also a key concern in many countries. Yet, in developing countries, which are experiencing a greater speed of population ageing at a time when they are lacking the financial resources and institutions to provide long-term care (LTC) services, finding policy solutions is becoming ever more urgent.

The People’s Republic of China (PRC) is facing these challenges while the decades of one-child policy are exacerbating these trends, as fewer and fewer younger people are left to provide care to their older relatives. Although in China, as in other East Asian countries, the cultural norm of filial piety has been strong, the stark decline in fertility translates into one younger person, mostly female, sometimes having to care for four to eight older relatives or in-laws. In 2016, 213 million, or 16.7% of the Chinese population, were over 60 years old (Cheng, 2017). Among these older people almost 150 million have long-term health conditions, and more than 40 million are living with deteriorating mental or physical health. As an editorial in The Lancet argues, China’s population ageing is ‘a ticking bomb’ (The Lancet, 2016). Continue reading

Dementia care: the next five years

Mark Ivory, new editor at the Journal of Dementia Care, spoke yesterday at the Margaret Butterworth Care Home Forum. This is a transcript of his talk. (2,712 words)

Good afternoon. So far as they can be separated, this is partly about policy and partly about politics. Where better to start than the Conservative party election manifesto? Pledges:

  • Delivering on the Prime Minister’s Challenge, “making sure that everyone diagnosed with the condition gets a meaningful care plan to support them and their family.”
  • UK will be world leaders in finding a cure for dementia by the target date of 2025.
  • All companies with more than 250 employees would be required to allow them three days of volunteering time each year, something the Alzheimer’s Society welcomed in the context of the Dementia Friends initiative.

It’s the one about volunteering, considered more broadly, that I really want to focus on. In case we were under any illusions that the Tories had dropped the rhetoric of the Big Society, there was a section of the manifesto with the heading “Helping you build the Big Society”. “Volunteering is at a 10-year high,” it boasts, “with 3 million more adults giving their time last year than in 2010.” Continue reading

Data and Debate – reflections on the SSRG Annual Workshop

Caroline Norrie, Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s, was at the Social Services Research Group Annual Workshop this week. (801 words)

This year’s Social Services Research Group (SSRG) Annual Workshop, held at the London School of Economics (LSE) on 15 April was a particularly thought-provoking event. Entitled ‘Evidencing Service Improvement for Vulnerable Children and Adults’, the workshop featured an expertly chosen group of speakers whose presentations stimulated animated discussion from the floor. With the Care Act coming on stream and the increased drive for integration, participants, who were predominantly social care managers with responsibilities for data and organisational performance, enjoyed a great opportunity to discuss service re-figuration and its measurement. Continue reading

New directions in child welfare: good news from the Canadian province of New Brunswick

Geraldine Poirier BaianiDr Joan RapaportGeraldine Poirier Baiani (left) and Joan Rapaport report from New Brunswick. (931 words)

These days, high profile reports of child care tragedies, rising numbers of children being taken into care and social workers struggling with high caseloads are commonplace. Stories of positive developments in children and family services are rare. However, a chance meeting whilst on holiday led to a remarkable discovery: the caseloads of child welfare social workers in the Canadian province of New Brunswick now stand at an incredible seven. Continue reading

Shifting policy attention to the social care workforce

Dr Shereen HusseinDr Shereen Hussein is Principal Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. (956 words)

The year 2014 has seen growing attention given to the social care workforce, with a number of high profile reviews being published, including the Kingsmill Review ‘Taking Care’, the Unison report into home care ‘Time to care’, the Demos review of residential care and, launched today, the Burstow Commission review on the future of the home care workforce, ‘Key to care’.

The question of how to maintain a high quality social care workforce has received academic scrutiny for many years, with research highlighting the lack of career progression, low pay and status, and the inability of the sector to attract young and diverse groups of workers as some of the key issues. There are many reasons why we are in this state of ‘crisis’ but at the core is the assumption that care work is something that can be performed by ‘anyone’—it does not require a vast amount of skills and we can always find a willing worker to do it. While these assumptions go unspoken, they underline how the sector operates and derive from the perception of care work as ‘women’s’ work that comes ‘naturally’; if the family can do it why do we need a skilled professional to do it? Continue reading

The challenges of medical workforce migration between the UK and New Zealand

Prof Robin GauldOn 29 October 2014 the Social Care Workforce Research Unit at King’s hosts a seminar examining workforce migration in health and social care (places still available). Prof Jill Manthorpe, Director of the Unit, is joined by Prof Stephen Bach, Department of Management at King’s: they will be the formal respondents to a presentation given by Professor Robin Gauld who is the 2014 NZ-UK Link Foundation Visiting Professor. Here, Robin Gauld introduces his work, which focuses on health workforce migration between New Zealand and the UK. (531 words)

The week of 6 October saw significant media coverage in the UK of the 2014 State of Medical Education and Practice report by the General Medical Council. This indicated that around half of all migrating doctors are departing for the shores of Australia and New Zealand. One newspaper summed it up as: ‘…They cost us £610,000 to train – but 3,000 a year are leaving us for a life in the sun…‘. Continue reading

An insight into Behavioural Insight – or the evolution of a grudge about nudge

Dr Mary BaginskyMary Baginsky is Visiting Senior Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. (830 words)

When the Department for Education published the Behaviour Insight Team’s (BIT) report on decision-making in intake teams in children’s services earlier this year the sharp intake of breath from many social work academics could be heard across the land, followed by a Twitter tirade. What had led to this?

In another place I have railed against the trend for think tanks and the like to label a shallow dip into a subject as ‘research’ and then to go on to make huge claims that are intended to, and sometimes do, influence policy. But in the past I have also been seduced by the ideas that have emerged from BIT, also known as the ‘nudge unit’. Its stated aim is to apply insights from academic research in behavioural economics and psychology to public policy and services. So when the unit advised the HMRC to change the wording on some of their letters, the result was an extra £200 million collected on time; and when it found that it was clearing the rubbish out of lofts that stood in the way of people insulating them they suggested providing a subsidised loft clearance and the rate at which insulation was happening soared. However, my admiration did not stretch to the findings of the report on social workers’ decision-making. Continue reading