The Sub-Committee noted (i) that Post-Covid syndrome, also known as Long Covid, is multi-system in nature.  Patients often present with clusters of symptoms, often overlapping, which may change over time (ii) there is still uncertainty in what is known about the long-term effects of Covid -19 and only as evidence emerges, will there begin to be a greater understanding about the prevalence and recovery patterns following Covid -19. A summary of the questions and feedback provided is outlined below:

The Sub-Committee:

v  Understood that in recovery, there is an opportunity to create a healthier, more resilient society, by ensuring that patients are provided with the tools to be able manage their long-term conditions better. 

v  Noted that part of the strategy to assist recovery aims to enable Primary Care to stratify patients with long terms conditions in order to help prioritise patients who are at the highest risk of an exacerbation.

v  Was informed that the proposals represent a marked shift away from the focus on competition that underpinned the coalition government’s 2012 reforms, towards a new model of collaboration, partnership, and integration. At the same time, removing some of the competition and procurement rules could give the NHS and its partners greater flexibility to deliver joined-up care to the increasing number of people who rely on multiple services.  However, it is also important to recognise the limitations of what legislation can achieve. It is not possible to legislate for collaboration and co-ordination of local services. This will require changes to the behaviours, attitudes and relationships of staff and leaders right across the health and care system.

v  Commented that whilst adult social care has demonstrated its value throughout the pandemic it is important to recognise the pressures facing social care and welcomed a commitment to reform. However, felt the proposals do not address the urgent need to put social care on a sustainable, long-term financial footing to ensure social care can best support people to live the lives they want to lead.

v  Agreed it was important with regard to social care that there was affordable, high quality, sustainable and joined up care that meets people’s needs.

v  Agreed that self?isolation has caused a negative impact on people's mental health the separation from loved ones, loss of freedom, boredom, and uncertainty can cause a deterioration in an individual's mental health.  As they have been placed in a situation or an environment that may be new and can be potentially damaging to their health.  In addition, Covid has had drastic negative effects on the more vulnerable individuals in the community. Physical isolation at home among family members can put such people at serious mental health risk. It can cause anxiety, distress, and induce a traumatic situation for them. vulnerable people can be dependent on others for their daily needs, and self?isolation can critically damage a family system. Those people living in nursing homes can face extreme mental health issues.

v  Agreed that this Impacts on people's physical and mental well-being, which can manifest to impact on their needs for care and support. And of course we know that carers have also been adversely impacted during the pandemic in a number of ways and therefore the support that they may have offered may not always be as actively available during significant periods of time during the pandemic and including rest by. Therefore, for a number of reasons people’s needs are more complex as a result.

v  Understood that with regard to social care funding a funding shake-up has been long-awaited by older and disabled people and their families, who know how difficult navigating the current system can be. As unlike NHS healthcare, social care is not free at the point of use and Council funding is only available to those with the lowest means.  Whilst the details of what the Government intends are awaited it has indicated that it intends to tackle the 'persistent unfairness' in the social care system by ensuring that self-funders are able to ask their local authority to arrange care on their behalf, so they can get a better deal. Currently, people who fund their own care usually pay higher fees than people who are funded by their local council.

v  Noted in regard to the changes in social care funding there will be an £86,000 cap on care costs across an individual's lifetime.  This cap is not proportional to a person’s assets – it is a fixed amount, not a sliding scale depending on what you own/have.  Therefore from April 2023 it appears that no-one will have to pay more than £86,000 for care costs.

v  Commented that the reforms will lead to increased pressure on areas with higher levels of deprivation: As the plans will not generate money to address the anticipated increase in demand for care in future.

v  Noted that the Government expects demographic and unit cost pressures to be met through Council Tax, the social care precept, and long-term efficiencies.   However, it is estimated that a significant portion of funding nationally will go into funding the new cap on care costs. Furthermore, the administrative costs of implementation of changes in practice required, including changes in policies and procedures e.g. current charging and financial assessment policies and practice will all need to be evaluated and the costs of implementing these changes will need to be appraised and met within the additional funding.  However, the additional funding announced does not represent the significant financial pressures that will be faced, on top of the additional costs of increased care costs and complexities of care due to the pandemic for vulnerable people.

v  Noted that as mentioned social care is not a free, universal service; local authorities have always been able to charge for services. This means that service users are sometimes exposed to potentially very high and unpredictable care costs.  Therefore, it is very important for LBTH to make sure that as part of its financial assessment process that they determine how much, if any, people are able to afford to contribute towards the cost of their care and in doing so to take into consideration disability related expenditure so that LBTH can be assured that (i) additional expenditure that the individual may experience as a result arising from their disability; (ii) people to fully understand the circumstances associated with their charges e.g. what that means for them, and indeed if they need to seek independent financial advice.

v  Whilst welcoming the intention by LBTH to ensure that there is a fair and equitable process including that the users voice is clearly heard and understood (e.g. a process that is co-produced in partnership with our residents), it was agreed that this issue needs to be the subject of further discussions involving service users and providers at a future meeting.