This week’s spending review contained few surprises. As far as the care of older people is concerned the Chancellor has detailed his plans to theoretically redistribute/recycle £2bn from the National Health Service to a new £3.8bn joint budget which the Health Service will share with the local councils that organise care homes and home help. The plan is that this new fund will ease pressure on Accident & Emergency units and save the NHS money with a view to helping older people being pushed from pillar to post. This however must be seen within the context of the government’s plans for implementation of the Dilnot Recommendations and specifically the so-called “cap” on any individual’s lifetime expenditure on residential or nursing care. It must be noted that the cost of these Dilnot Recommendations will be significant. Many people that had previously not fallen within the financial criteria for local authority support will now do so at some point, ie when they reach the so-called “cap” which is currently being proposed to be pegged at £75,000. In other words, many people who are currently private funders will become local authority supported clients. This is bad news for care providers who will therefore receive less income; but it is also bad news for local authorities who will incur very substantial additional costs.

It is not crystal clear from the Spending Review whether the newly recycled NHS money is intended to cover this as well as its primary purpose of reducing the number of people blocking A&E departments and indeed blocking hospital beds. The government’s implementation/transformation group relating to the Dilnot Recommendations is going to have its work cut out to explain to the public and the care sector how this system is going to work and to figure out exactly how it is going to be funded.

The Dilnot Recommendations are widely welcomed as was the news that at long last the government is to adopt some of its principal recommendations. But a year after Dilnot has reported, we are none the wiser as to exactly how this is going to work in practice.

As it is, Dilnot’s recommended cap is not being adopted but rather to the level of £35,000. But still it would appear there is going to be a massive funding gap .
One struggles not to be sceptical but what we have here is another “smoke-and-mirrors” scenario for it is effectively incomprehensible to many of us as to what exactly is going to happen. We are 10 months on from his report and presumably 10 months nearer implementation.

Our Charity this week saw a 1st Anniversary celebration at Hammerson House following the merger of Hammerson House and Nightingale House. Some 50 staff came together and were given an update by our chairman Harvey Rosenblatt and myself on how well the integration has gone and also on our exciting new plans for the future.