Tag Archives: Care

I survived sepsis eight times. But can care workers spot this deadly illness?

Care staff are increasingly likely to see sepsis, but there is no standard training to make them aware of the symptoms to look out for in clients

Sepsis


There is a golden hour for the treatment of sepsis, when someone can be saved by basic steps known as the ‘sepsis six’. Illustration: Christophe Gowans

I am a survivor of sepsis. Not once, not twice, but eight times.

Sepsis – also known as blood poisoning – kills more people than bowel cancer, breast cancer and prostate cancer combined. It affects more than 260,000 people and claims 44,000 lives every year in the UK. But it is not spoken about in training for social care workers, even though they are increasingly likely to see it.

Sepsis is triggered when the body tries to overcompensate for an underlying infection and too many white blood cells are released into the bloodstream. An example you may see in the social care context is kidney and chest infections. It looks like common flu in the early stages, but it can lead to life-threatening septic shock.

There is a golden hour for the treatment of sepsis, when someone can be saved by basic steps known as the “sepsis six”. Although there is no standard training, there are some symptoms care professionals can look for in a client:

  • Are they sleepy?
  • Is their breathing rapid or shallow?
  • Do they have a raised temperature?
  • Is their complexion mottled?
  • Do they seem confused, distracted or agitated?
  • Have they spoken of feeling the worst they have ever felt?

Taking their temperature at home may be the best indication of whether someone has sepsis until a medical professional is available, but you should try to get the person to a medic as soon as possible after identifying the symptoms.

Most importantly, when you speak to the medic, follow the “just ask” protocol; ask if they think it could be sepsis and give a good, rounded history of the individual. If you are not familiar with the patient, a synopsis of their medical condition should be placed at the front of their care plan.

One of the occasions when I had sepsis offers a pertinent example of why care workers should be aware of the condition’s symptoms. I had been feeling ill for a couple of hours and had told my care workers. They said we should see how it goes – and went back to their mobile phones. This continued until my husband returned from work and, within minutes, he noticed that I was pale and flushed and that my head was nodding. He touched my cheeks and realised I had a temperature – 39.9 degrees at that point. Paul called for an ambulance and asked the paramedics if it could be sepsis; they immediately started to check for the signs using the “sepsis six”.

I spent four weeks in hospital, with a stay in intensive care on high impact antibiotics. I was told that if Paul had not acted so decisively and asked the correct questions, that I may not have received the correct treatment that saved my life. Coincidentally, Paul and I met in hospital when we were both being treated for sepsis.

Please do not underestimate the importance of recognising sepsis and simply asking medics: “Could it be sepsis?” And if you’ve had sepsis before, tell those caring for you about your history – sepsis can and does come back often.

Damian Bridgeman is a social entrepreneur, disability rights activist, and board member of Social Care Wales. He is speaking at an event on this topic in London on 18 January. For more information on sepsis, visit the Sepsis Trust

Join the Social Care Network for comment, analysis and job opportunities, direct to your inbox. Follow us on Twitter (@GdnSocialCare) and like us on Facebook. If you have an idea for a blog, read our guidelines and email your pitch to us at socialcare@theguardian.com

If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs

I survived sepsis eight times. But can care workers spot this deadly illness?

Care staff are increasingly likely to see sepsis, but there is no standard training to make them aware of the symptoms to look out for in clients

Sepsis


There is a golden hour for the treatment of sepsis, when someone can be saved by basic steps known as the ‘sepsis six’. Illustration: Christophe Gowans

I am a survivor of sepsis. Not once, not twice, but eight times.

Sepsis – also known as blood poisoning – kills more people than bowel cancer, breast cancer and prostate cancer combined. It affects more than 260,000 people and claims 44,000 lives every year in the UK. But it is not spoken about in training for social care workers, even though they are increasingly likely to see it.

Sepsis is triggered when the body tries to overcompensate for an underlying infection and too many white blood cells are released into the bloodstream. An example you may see in the social care context is kidney and chest infections. It looks like common flu in the early stages, but it can lead to life-threatening septic shock.

There is a golden hour for the treatment of sepsis, when someone can be saved by basic steps known as the “sepsis six”. Although there is no standard training, there are some symptoms care professionals can look for in a client:

  • Are they sleepy?
  • Is their breathing rapid or shallow?
  • Do they have a raised temperature?
  • Is their complexion mottled?
  • Do they seem confused, distracted or agitated?
  • Have they spoken of feeling the worst they have ever felt?

Taking their temperature at home may be the best indication of whether someone has sepsis until a medical professional is available, but you should try to get the person to a medic as soon as possible after identifying the symptoms.

Most importantly, when you speak to the medic, follow the “just ask” protocol; ask if they think it could be sepsis and give a good, rounded history of the individual. If you are not familiar with the patient, a synopsis of their medical condition should be placed at the front of their care plan.

One of the occasions when I had sepsis offers a pertinent example of why care workers should be aware of the condition’s symptoms. I had been feeling ill for a couple of hours and had told my care workers. They said we should see how it goes – and went back to their mobile phones. This continued until my husband returned from work and, within minutes, he noticed that I was pale and flushed and that my head was nodding. He touched my cheeks and realised I had a temperature – 39.9 degrees at that point. Paul called for an ambulance and asked the paramedics if it could be sepsis; they immediately started to check for the signs using the “sepsis six”.

I spent four weeks in hospital, with a stay in intensive care on high impact antibiotics. I was told that if Paul had not acted so decisively and asked the correct questions, that I may not have received the correct treatment that saved my life. Coincidentally, Paul and I met in hospital when we were both being treated for sepsis.

Please do not underestimate the importance of recognising sepsis and simply asking medics: “Could it be sepsis?” And if you’ve had sepsis before, tell those caring for you about your history – sepsis can and does come back often.

Damian Bridgeman is a social entrepreneur, disability rights activist, and board member of Social Care Wales. He is speaking at an event on this topic in London on 18 January. For more information on sepsis, visit the Sepsis Trust

Join the Social Care Network for comment, analysis and job opportunities, direct to your inbox. Follow us on Twitter (@GdnSocialCare) and like us on Facebook. If you have an idea for a blog, read our guidelines and email your pitch to us at socialcare@theguardian.com

If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs

I survived sepsis eight times. But can care workers spot this deadly illness?

Care staff are increasingly likely to see sepsis, but there is no standard training to make them aware of the symptoms to look out for in clients

Sepsis


There is a golden hour for the treatment of sepsis, when someone can be saved by basic steps known as the ‘sepsis six’. Illustration: Christophe Gowans

I am a survivor of sepsis. Not once, not twice, but eight times.

Sepsis – also known as blood poisoning – kills more people than bowel cancer, breast cancer and prostate cancer combined. It affects more than 260,000 people and claims 44,000 lives every year in the UK. But it is not spoken about in training for social care workers, even though they are increasingly likely to see it.

Sepsis is triggered when the body tries to overcompensate for an underlying infection and too many white blood cells are released into the bloodstream. An example you may see in the social care context is kidney and chest infections. It looks like common flu in the early stages, but it can lead to life-threatening septic shock.

There is a golden hour for the treatment of sepsis, when someone can be saved by basic steps known as the “sepsis six”. Although there is no standard training, there are some symptoms care professionals can look for in a client:

  • Are they sleepy?
  • Is their breathing rapid or shallow?
  • Do they have a raised temperature?
  • Is their complexion mottled?
  • Do they seem confused, distracted or agitated?
  • Have they spoken of feeling the worst they have ever felt?

Taking their temperature at home may be the best indication of whether someone has sepsis until a medical professional is available, but you should try to get the person to a medic as soon as possible after identifying the symptoms.

Most importantly, when you speak to the medic, follow the “just ask” protocol; ask if they think it could be sepsis and give a good, rounded history of the individual. If you are not familiar with the patient, a synopsis of their medical condition should be placed at the front of their care plan.

One of the occasions when I had sepsis offers a pertinent example of why care workers should be aware of the condition’s symptoms. I had been feeling ill for a couple of hours and had told my care workers. They said we should see how it goes – and went back to their mobile phones. This continued until my husband returned from work and, within minutes, he noticed that I was pale and flushed and that my head was nodding. He touched my cheeks and realised I had a temperature – 39.9 degrees at that point. Paul called for an ambulance and asked the paramedics if it could be sepsis; they immediately started to check for the signs using the “sepsis six”.

I spent four weeks in hospital, with a stay in intensive care on high impact antibiotics. I was told that if Paul had not acted so decisively and asked the correct questions, that I may not have received the correct treatment that saved my life. Coincidentally, Paul and I met in hospital when we were both being treated for sepsis.

Please do not underestimate the importance of recognising sepsis and simply asking medics: “Could it be sepsis?” And if you’ve had sepsis before, tell those caring for you about your history – sepsis can and does come back often.

Damian Bridgeman is a social entrepreneur, disability rights activist, and board member of Social Care Wales. He is speaking at an event on this topic in London on 18 January. For more information on sepsis, visit the Sepsis Trust

Join the Social Care Network for comment, analysis and job opportunities, direct to your inbox. Follow us on Twitter (@GdnSocialCare) and like us on Facebook. If you have an idea for a blog, read our guidelines and email your pitch to us at socialcare@theguardian.com

If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs

Shifting care closer to home will ease pressure on hospitals | Ewan King

New year is associated with hope and optimism. But for the NHS, the headlines tell a different story: hospitals at full capacity. As you might expect, these articles focus on what is going wrong: headlines such as “NHS in crisis”, stories of beds in corridors and stressed-out nurses. Clearly these problems are real, but focusing only on hospitals won’t solve the problem. We need to think more broadly if we are to find lasting solutions; we must think about prevention, and how far it is embedded in local systems.

For some time, health and care reforms have been about shifting care closer to home. The programme of vanguards and sustainability and transformation plans was intended to herald a greater focus on prevention and self-care to reduce pressure on hospitals. There is some evidence that these reforms are working: Hertfordshire’s prevention-focused Better Care for Care Home Residents Vanguard, for instance, led to a 45% reduction in hospital admissions and A&E attendances between April 2015 and May last year.

But we are not yet able to see the scale of change necessary to make a significant dent in demand across England and beyond, because of financial pressures, which make it difficult for organisations and commissioners to fund new, innovative services; inward-looking leadership teams focused on short-term goals and local evidence and solutions; a lack of integration across health and social care and housing; and outdated performance management and contracting systems.

A seismic shift – at the level needed – is not straightforward to deliver. As Nesta, Shared Lives and the Social Care Institute for Excellence (Scie) argue in a new report on innovation, we know a lot about what works to support independence in ways that reduce demand for urgent care, but less about how to extend the benefits to more people. As the report concludes: “New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.”

So what can national policymakers and local health and care leaders do differently? First, we need to restate the case for preventive, community-based care and, as part of this, more clearly articulate how it will make a difference to people’s lives. For example, in our report we describe a place in the near future where people are supported to maintain their independence, improving their wellbeing at reduced cost to the NHS. What if you have a long-term condition such as chronic obstructive pulmonary disease; are you able to join a Breathe Easy peer support group to help you manage the condition?

We also talk about North Yorkshire, where an innovation fund has been used to fund initiatives reducing isolation, preventing falls and supporting people to stay at home when they want to. Local care and support providers say this has helped them to build their networks, and they are now working in partnership with more local services.

Second, we need collective local leadership focused on keeping people well and better supported at home, underpinned by a strong commitment to integrated commissioning and to changing funding flows to support more community-based care.

A hospital trust chief executive recently told me that investment away from beds and A&E services would support far better preventive approaches – but there has to be a system-wide strategy for all to lead and support if bed pressures arise.

Third, we need to make better use of the evidence we have, making a stronger case for investment in preventive care. In Scie’s prevention library, we have a mass of evidence-based examples of community-led care and support that helps to reduce demand for hospital care. Age UK’s personalised integration approach in North Kent is a model of holistic support targeted at older people with long-term conditions. It has led to a 26% reduction in non-elective hospital admissions. Commissioners need to use these examples to argue for spending more on preventive models of care and support.

Carrying on as we are is unlikely to succeed; we are firefighting in the face of growing demand in hospitals without always considering what wider changes are needed to prevent this growth. The social care green paper, to be published in the summer, provides a good opportunity for setting out plans for a more preventive, person-centred, health and care system, but there is nothing to stop leaders being more ambitious about prevention right now.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Shifting care closer to home will ease pressure on hospitals | Ewan King

New year is associated with hope and optimism. But for the NHS, the headlines tell a different story: hospitals at full capacity. As you might expect, these articles focus on what is going wrong: headlines such as “NHS in crisis”, stories of beds in corridors and stressed-out nurses. Clearly these problems are real, but focusing only on hospitals won’t solve the problem. We need to think more broadly if we are to find lasting solutions; we must think about prevention, and how far it is embedded in local systems.

For some time, health and care reforms have been about shifting care closer to home. The programme of vanguards and sustainability and transformation plans was intended to herald a greater focus on prevention and self-care to reduce pressure on hospitals. There is some evidence that these reforms are working: Hertfordshire’s prevention-focused Better Care for Care Home Residents Vanguard, for instance, led to a 45% reduction in hospital admissions and A&E attendances between April 2015 and May last year.

But we are not yet able to see the scale of change necessary to make a significant dent in demand across England and beyond, because of financial pressures, which make it difficult for organisations and commissioners to fund new, innovative services; inward-looking leadership teams focused on short-term goals and local evidence and solutions; a lack of integration across health and social care and housing; and outdated performance management and contracting systems.

A seismic shift – at the level needed – is not straightforward to deliver. As Nesta, Shared Lives and the Social Care Institute for Excellence (Scie) argue in a new report on innovation, we know a lot about what works to support independence in ways that reduce demand for urgent care, but less about how to extend the benefits to more people. As the report concludes: “New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.”

So what can national policymakers and local health and care leaders do differently? First, we need to restate the case for preventive, community-based care and, as part of this, more clearly articulate how it will make a difference to people’s lives. For example, in our report we describe a place in the near future where people are supported to maintain their independence, improving their wellbeing at reduced cost to the NHS. What if you have a long-term condition such as chronic obstructive pulmonary disease; are you able to join a Breathe Easy peer support group to help you manage the condition?

We also talk about North Yorkshire, where an innovation fund has been used to fund initiatives reducing isolation, preventing falls and supporting people to stay at home when they want to. Local care and support providers say this has helped them to build their networks, and they are now working in partnership with more local services.

Second, we need collective local leadership focused on keeping people well and better supported at home, underpinned by a strong commitment to integrated commissioning and to changing funding flows to support more community-based care.

A hospital trust chief executive recently told me that investment away from beds and A&E services would support far better preventive approaches – but there has to be a system-wide strategy for all to lead and support if bed pressures arise.

Third, we need to make better use of the evidence we have, making a stronger case for investment in preventive care. In Scie’s prevention library, we have a mass of evidence-based examples of community-led care and support that helps to reduce demand for hospital care. Age UK’s personalised integration approach in North Kent is a model of holistic support targeted at older people with long-term conditions. It has led to a 26% reduction in non-elective hospital admissions. Commissioners need to use these examples to argue for spending more on preventive models of care and support.

Carrying on as we are is unlikely to succeed; we are firefighting in the face of growing demand in hospitals without always considering what wider changes are needed to prevent this growth. The social care green paper, to be published in the summer, provides a good opportunity for setting out plans for a more preventive, person-centred, health and care system, but there is nothing to stop leaders being more ambitious about prevention right now.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Shifting care closer to home will ease pressure on hospitals | Ewan King

New year is associated with hope and optimism. But for the NHS, the headlines tell a different story: hospitals at full capacity. As you might expect, these articles focus on what is going wrong: headlines such as “NHS in crisis”, stories of beds in corridors and stressed-out nurses. Clearly these problems are real, but focusing only on hospitals won’t solve the problem. We need to think more broadly if we are to find lasting solutions; we must think about prevention, and how far it is embedded in local systems.

For some time, health and care reforms have been about shifting care closer to home. The programme of vanguards and sustainability and transformation plans was intended to herald a greater focus on prevention and self-care to reduce pressure on hospitals. There is some evidence that these reforms are working: Hertfordshire’s prevention-focused Better Care for Care Home Residents Vanguard, for instance, led to a 45% reduction in hospital admissions and A&E attendances between April 2015 and May last year.

But we are not yet able to see the scale of change necessary to make a significant dent in demand across England and beyond, because of financial pressures, which make it difficult for organisations and commissioners to fund new, innovative services; inward-looking leadership teams focused on short-term goals and local evidence and solutions; a lack of integration across health and social care and housing; and outdated performance management and contracting systems.

A seismic shift – at the level needed – is not straightforward to deliver. As Nesta, Shared Lives and the Social Care Institute for Excellence (Scie) argue in a new report on innovation, we know a lot about what works to support independence in ways that reduce demand for urgent care, but less about how to extend the benefits to more people. As the report concludes: “New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.”

So what can national policymakers and local health and care leaders do differently? First, we need to restate the case for preventive, community-based care and, as part of this, more clearly articulate how it will make a difference to people’s lives. For example, in our report we describe a place in the near future where people are supported to maintain their independence, improving their wellbeing at reduced cost to the NHS. What if you have a long-term condition such as chronic obstructive pulmonary disease; are you able to join a Breathe Easy peer support group to help you manage the condition?

We also talk about North Yorkshire, where an innovation fund has been used to fund initiatives reducing isolation, preventing falls and supporting people to stay at home when they want to. Local care and support providers say this has helped them to build their networks, and they are now working in partnership with more local services.

Second, we need collective local leadership focused on keeping people well and better supported at home, underpinned by a strong commitment to integrated commissioning and to changing funding flows to support more community-based care.

A hospital trust chief executive recently told me that investment away from beds and A&E services would support far better preventive approaches – but there has to be a system-wide strategy for all to lead and support if bed pressures arise.

Third, we need to make better use of the evidence we have, making a stronger case for investment in preventive care. In Scie’s prevention library, we have a mass of evidence-based examples of community-led care and support that helps to reduce demand for hospital care. Age UK’s personalised integration approach in North Kent is a model of holistic support targeted at older people with long-term conditions. It has led to a 26% reduction in non-elective hospital admissions. Commissioners need to use these examples to argue for spending more on preventive models of care and support.

Carrying on as we are is unlikely to succeed; we are firefighting in the face of growing demand in hospitals without always considering what wider changes are needed to prevent this growth. The social care green paper, to be published in the summer, provides a good opportunity for setting out plans for a more preventive, person-centred, health and care system, but there is nothing to stop leaders being more ambitious about prevention right now.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Shifting care closer to home will ease pressure on hospitals | Ewan King

New year is associated with hope and optimism. But for the NHS, the headlines tell a different story: hospitals at full capacity. As you might expect, these articles focus on what is going wrong: headlines such as “NHS in crisis”, stories of beds in corridors and stressed-out nurses. Clearly these problems are real, but focusing only on hospitals won’t solve the problem. We need to think more broadly if we are to find lasting solutions; we must think about prevention, and how far it is embedded in local systems.

For some time, health and care reforms have been about shifting care closer to home. The programme of vanguards and sustainability and transformation plans was intended to herald a greater focus on prevention and self-care to reduce pressure on hospitals. There is some evidence that these reforms are working: Hertfordshire’s prevention-focused Better Care for Care Home Residents Vanguard, for instance, led to a 45% reduction in hospital admissions and A&E attendances between April 2015 and May last year.

But we are not yet able to see the scale of change necessary to make a significant dent in demand across England and beyond, because of financial pressures, which make it difficult for organisations and commissioners to fund new, innovative services; inward-looking leadership teams focused on short-term goals and local evidence and solutions; a lack of integration across health and social care and housing; and outdated performance management and contracting systems.

A seismic shift – at the level needed – is not straightforward to deliver. As Nesta, Shared Lives and the Social Care Institute for Excellence (Scie) argue in a new report on innovation, we know a lot about what works to support independence in ways that reduce demand for urgent care, but less about how to extend the benefits to more people. As the report concludes: “New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.”

So what can national policymakers and local health and care leaders do differently? First, we need to restate the case for preventive, community-based care and, as part of this, more clearly articulate how it will make a difference to people’s lives. For example, in our report we describe a place in the near future where people are supported to maintain their independence, improving their wellbeing at reduced cost to the NHS. What if you have a long-term condition such as chronic obstructive pulmonary disease; are you able to join a Breathe Easy peer support group to help you manage the condition?

We also talk about North Yorkshire, where an innovation fund has been used to fund initiatives reducing isolation, preventing falls and supporting people to stay at home when they want to. Local care and support providers say this has helped them to build their networks, and they are now working in partnership with more local services.

Second, we need collective local leadership focused on keeping people well and better supported at home, underpinned by a strong commitment to integrated commissioning and to changing funding flows to support more community-based care.

A hospital trust chief executive recently told me that investment away from beds and A&E services would support far better preventive approaches – but there has to be a system-wide strategy for all to lead and support if bed pressures arise.

Third, we need to make better use of the evidence we have, making a stronger case for investment in preventive care. In Scie’s prevention library, we have a mass of evidence-based examples of community-led care and support that helps to reduce demand for hospital care. Age UK’s personalised integration approach in North Kent is a model of holistic support targeted at older people with long-term conditions. It has led to a 26% reduction in non-elective hospital admissions. Commissioners need to use these examples to argue for spending more on preventive models of care and support.

Carrying on as we are is unlikely to succeed; we are firefighting in the face of growing demand in hospitals without always considering what wider changes are needed to prevent this growth. The social care green paper, to be published in the summer, provides a good opportunity for setting out plans for a more preventive, person-centred, health and care system, but there is nothing to stop leaders being more ambitious about prevention right now.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Shifting care closer to home will ease pressure on hospitals | Ewan King

New year is associated with hope and optimism. But for the NHS, the headlines tell a different story: hospitals at full capacity. As you might expect, these articles focus on what is going wrong: headlines such as “NHS in crisis”, stories of beds in corridors and stressed-out nurses. Clearly these problems are real, but focusing only on hospitals won’t solve the problem. We need to think more broadly if we are to find lasting solutions; we must think about prevention, and how far it is embedded in local systems.

For some time, health and care reforms have been about shifting care closer to home. The programme of vanguards and sustainability and transformation plans was intended to herald a greater focus on prevention and self-care to reduce pressure on hospitals. There is some evidence that these reforms are working: Hertfordshire’s prevention-focused Better Care for Care Home Residents Vanguard, for instance, led to a 45% reduction in hospital admissions and A&E attendances between April 2015 and May last year.

But we are not yet able to see the scale of change necessary to make a significant dent in demand across England and beyond, because of financial pressures, which make it difficult for organisations and commissioners to fund new, innovative services; inward-looking leadership teams focused on short-term goals and local evidence and solutions; a lack of integration across health and social care and housing; and outdated performance management and contracting systems.

A seismic shift – at the level needed – is not straightforward to deliver. As Nesta, Shared Lives and the Social Care Institute for Excellence (Scie) argue in a new report on innovation, we know a lot about what works to support independence in ways that reduce demand for urgent care, but less about how to extend the benefits to more people. As the report concludes: “New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.”

So what can national policymakers and local health and care leaders do differently? First, we need to restate the case for preventive, community-based care and, as part of this, more clearly articulate how it will make a difference to people’s lives. For example, in our report we describe a place in the near future where people are supported to maintain their independence, improving their wellbeing at reduced cost to the NHS. What if you have a long-term condition such as chronic obstructive pulmonary disease; are you able to join a Breathe Easy peer support group to help you manage the condition?

We also talk about North Yorkshire, where an innovation fund has been used to fund initiatives reducing isolation, preventing falls and supporting people to stay at home when they want to. Local care and support providers say this has helped them to build their networks, and they are now working in partnership with more local services.

Second, we need collective local leadership focused on keeping people well and better supported at home, underpinned by a strong commitment to integrated commissioning and to changing funding flows to support more community-based care.

A hospital trust chief executive recently told me that investment away from beds and A&E services would support far better preventive approaches – but there has to be a system-wide strategy for all to lead and support if bed pressures arise.

Third, we need to make better use of the evidence we have, making a stronger case for investment in preventive care. In Scie’s prevention library, we have a mass of evidence-based examples of community-led care and support that helps to reduce demand for hospital care. Age UK’s personalised integration approach in North Kent is a model of holistic support targeted at older people with long-term conditions. It has led to a 26% reduction in non-elective hospital admissions. Commissioners need to use these examples to argue for spending more on preventive models of care and support.

Carrying on as we are is unlikely to succeed; we are firefighting in the face of growing demand in hospitals without always considering what wider changes are needed to prevent this growth. The social care green paper, to be published in the summer, provides a good opportunity for setting out plans for a more preventive, person-centred, health and care system, but there is nothing to stop leaders being more ambitious about prevention right now.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

We need to raise taxes to fund our care needs | Letters

The obvious answer to saving the NHS is to train and recruit more care workers in both the NHS and social care – which would not only (alone) meet current crying care needs but provide good professional human-interface jobs in the coming hi-tech age (killing two currently worrying birds with one stone). This does, however, mean raising more public revenue by getting people to pay more taxes.

But to achieve this we must first counter the common idea that providing something that people want, and raising the revenue to provide it by appropriate pricing, is a clear case of “positive wealth creation” if done in the private sector – not only creating wealth for the sector in question (which may be private healthcare, as in the US) but stimulating activity in the rest of the economy – but is simply a “negative burden” if done in the public sector.

Providing separate healthcare budgets, linking specific tax increases to specific public care improvements (disinterring what we need to pay for care from more general taxation), which I think Chris Ham is recommending, may be the best way to get people to focus on the real issues. But until the debilitating myth of private good / public doubtful is scotched, we will not reach square one in solving our current healthcare crisis.
Bernard Cummings
Erith, Kent

It is now time for all opposition parties to combine to bring maximum pressure on the government to end the ever increasing and costly privatisation of the NHS and increase general taxation to pay for it. I think most people would agree to a tax that was hypothecated for the NHS and social care. Part of the problem the NHS is experiencing is due to bed blocking caused by such large cuts to social care.
Valerie Crews
Beckenham, Kent

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

We need to raise taxes to fund our care needs | Letters

The obvious answer to saving the NHS is to train and recruit more care workers in both the NHS and social care – which would not only (alone) meet current crying care needs but provide good professional human-interface jobs in the coming hi-tech age (killing two currently worrying birds with one stone). This does, however, mean raising more public revenue by getting people to pay more taxes.

But to achieve this we must first counter the common idea that providing something that people want, and raising the revenue to provide it by appropriate pricing, is a clear case of “positive wealth creation” if done in the private sector – not only creating wealth for the sector in question (which may be private healthcare, as in the US) but stimulating activity in the rest of the economy – but is simply a “negative burden” if done in the public sector.

Providing separate healthcare budgets, linking specific tax increases to specific public care improvements (disinterring what we need to pay for care from more general taxation), which I think Chris Ham is recommending, may be the best way to get people to focus on the real issues. But until the debilitating myth of private good / public doubtful is scotched, we will not reach square one in solving our current healthcare crisis.
Bernard Cummings
Erith, Kent

It is now time for all opposition parties to combine to bring maximum pressure on the government to end the ever increasing and costly privatisation of the NHS and increase general taxation to pay for it. I think most people would agree to a tax that was hypothecated for the NHS and social care. Part of the problem the NHS is experiencing is due to bed blocking caused by such large cuts to social care.
Valerie Crews
Beckenham, Kent

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