National Schizophrenia Fellowship
Report based on a survey of 2,300 mental health service users, carers and professionals. Results show support for rights-based legislation (i.e. a legal right to adequate care and treatment). Respondents were worried about the dangers of compulsion: that people might be deterred from seeking help, that a Compulsory Treatment Order (CTO) could lead to excessive compulsion, and that treatment administered compulsorily might be substandard. However there was acceptance that CTOs should be made available for a small number of individuals as a last resort and not as a substitute for adequate services. The report also calls for greater rights for carers and for the creation of an inspectorate with real powers to monitor and inform on standards of care and the implementation of the new Act.
(For comment see Community Care, no. 1268, 1999, p. 8-9).
London: TSO, 1999 (Cm 4051)
Outlines proposals for the reform of social services in Wales including:
Community Living, vol. 12, no. 3, 1999, p. 4-5
Report of a conference organised by Scottish Human Services and
Birmingham Social Services on the impact of inclusion and Best
Value on the organisation of day services for disabled people.
Learning disabled people want work, community involvement, further
education, choice, and, above all, greater control over their
lives. There are moves away from formal day centre provision towards
use of direct payments to enable people with learning difficulties
to employ support to follow their chosen activities.
Community Care, no. 1269, 1999, p. 1
Summarises draft proposals issued for consultation by the Mental Health Act Review expert committee. The committee recommends greater rights for users to assessments, access to information, legal advice, an authorised representative to replace the nearest relative and an adequate level of services. It also calls for an independent body to approve compulsory treatment powers, for a person's capacity to consent to treatment to be taken into account, and for compulsory treatment to be the least restrictive alternative to deliver safe and effective care when used outside hospital. Under its recommendations the Mental Health Act Commission would be replaced by an independent body reporting directly to Parliament, advanced directives outlining a patient's wishes would be given statutory recognition and hospital managers' discharge powers would be scrapped.
Community Care, no. 1269, 1999, p. 4-5.
The Campaign for Fair Contracts at its inaugural meeting threatened to name and shame local authorities which refuse to negotiate fair contacts with service providers. Lack of funding for social services departments was blamed for local authorities imposing contracts and refusing to negotiate.
Community Care, no. 1269, p. 22-23.
Useful summary of the current plethora of policy initiatives in social care covering proposals on children in care, elderly people, carers, health improvement programmes, mental health care reform, performance measurement, national priorities guidance and national service frameworks.
Volunteering, no. 47, April 1999, p. 4-5.
Report of a seminar which explored the advantages and disadvantages of citizenship credits. These have been put forward as a possible solution to the problem of providing support and recognition for volunteers, and would be earned by anyone undertaking unpaid work.
Health Service Journal, vol. 109, April 22nd 1999, p. 6-7.
Responses to an initial report by the government's Mental Health Act review team suggest that opposition to compulsory treatment in the community may be crumbling.
F. Hasler and others.
London: Policy Studies Institute, 1999.
Describes way of introducing direct payments for disabled people that are effective for local authorities and enabling for their users. Covers planning, support systems, equal opportunities, eligibility and assessment.
W. N. Leutz
The Milbank Quarterly, vol. 77, 1999, p. 77-110.
Because persons with disabilities use health and social services extensively, both the US and the UK have begun to integrate care across systems. Initiatives in these two countries are examined within the context of the reality that personal needs and use of systems differ by age and by type and severity of disability. The lessons derived from this scrutiny are presented in the form of five "laws" of integration.
Scope, April 1999, p. 16-17.
Voluntary and community organisations in their role as service providers are now routinely involved in contracts with purchasers. Contracts involve a requirement to take account of service users' wishes. Article looks at the voluntary sector's response to user involvement, both in relation to its role as a provider in a mixed economy of care, and in terms of its own organisational structures.
Community Care, no. 1269, p. 8-9.
A new set of Audit Commission performance indicators show across-the-board improvements in the quality of social care. However these encouraging global figures mask discrepancies between the performance of individual councils that are hard to explain.
Abingdon: Audit Commission Publications, 1999.
Latest performance indicators show that social services departments have improved their services. Despite overall improvement, substantial variation in performance between councils was found. A few councils are performing below average, with some performing poorly in areas where the majority are doing well. Indicators used to gauge social services performance are: children in care who are moved more than 3 times in one year; respite care; the provision of small aids; statements of needs; and residential homes inspection.
C. Farrell, J. Robinson and P. Fletcher
London: Kings Fund, 1999.
Research shows that health, housing and social services often fail to help older and disabled people live independently, and do not give them enough information. They also provide services that do not fulfil the needs of elderly and disabled people. The government's forthcoming charter for long term care should include staff guidance on involving users and planning services; ensuring users and carers have access to information on service standards, and a clear complaints procedure.
Registered Homes and Services, vol. 3, 1999, p. 151-154.
Looks at the role of the proposed Commissions for Care Standards in the regulation of long term care. Argues that CCSs as standards regulators will need to go well beyond the traditional role of regulation and inspection which has focused on provider adequacy and has had very little influence on purchasers. The CCSs should act as channels for feeding back service results to influence the way in which people are assessed and the quality of the assessment.
Scope, April 1999, p. 10-11.
Partnership allows two or more organisations from different sectors, geographic areas or spheres of interest to pursue particular objectives jointly. This enables them to deliver more together than any of them could alone. Article looks at Age Concern Northern Ireland's recent health promotion work as a case study on how partnership can operate.
Community Living, vol. 12, no. 3, 1999, p. 18-20.
The 1998 Data Protection and Human Rights Acts, along with government proposals for a Freedom of Information Bill, will dramatically affect the rights of people receiving medical treatment and community care services to see their own personal files. However, the new legislation overlooks the position of carers, one of the areas of the current law most in need of reform.
Department of Health
London: TSO, 1999 (Cm 4320)
Government welcomes the Committee's report and its thorough consideration of the issues affecting the relationship between health and social services. The Government believes that the end of the internal market will herald a new era of partnership working. It is confident that its proposals will make such working easier and enable to needs of patients and users to be placed at the heart of service delivery.
Community Care, no. 1267, 1999, p. 14-15.
Article looks at how charities like Mencap and Change are finding ways to include the views and opinions of their service users at all levels of policy and decision-making procedures. User involvement is the current buzzword, especially as practically every government policy seems to require recognition of the fact that the services clients receive should be those they actually want.