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MPs say over-40s should pay extra tax to fund social care

Proposed payments of the extra tax would start at the age of 40 and extend beyond 65 with those earning more making bigger contributions. 

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A new tax for the over-40s in England should be introduced to help pay for social care.

A report published on Wednesday by Parliament’s select committees warns the current funding system is “unsustainable” and has called for the introduction of a 

The primary aim of the proposed system would be to ensure the personal element of social care is eventually available free at the point of delivery to everyone who needs it.

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The committee proposed that money raised would be held in a dedicated and audited fund to reassure the public it would only be used to provide social care.

Proposed payments of the extra tax would start at the age of 40 and extend beyond 65 with those earning more making bigger contributions.

The news comes only days after Theresa May announced £20 billion in extra funding for the health service.

The current system is in critical condition.

Clive Betts MP, Chair of the Housing, Communities and Local Government Committee, said: “The social care system is in a critical condition and there is an urgent need for more funding both now and in the future to ensure people are properly looked after. While we have set out steps to ease the financial pressure on local authorities delivering the service, reforms at a local level will not be enough if we are to rise to the challenge of providing high-quality care for all those that need it.

“We heard during the inquiry that people would be willing to pay more if there was an absolute guarantee that the extra money would go on social care. Given the huge funding gulf, the Government should now take the opportunity to build both a political and public consensus around the need for a new Social Care Premium to secure a fair and sustainable system in the long-term.

“The Government must also consider social care in its wider context and ensure a proper joined-up approach with other services such as public health and housing.”

Too many people are left without the care they need.

Sarah Wollaston, chair of the Health and Social Care Committee, said: “We can no longer delay finding a fair and sustainable settlement for social care. Too many people are being left without the care and support they need and it is time for decisions to be made about how the costs are shared.

This report from MPs across the political spectrum also draws on the informed views of a Citizens’ Assembly in setting out our recommendations to Government. Doing nothing cannot be an option.”

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Hourly rounding ‘may not be the best way for nurses to deliver care’, finds study

Hourly rounding places an emphasis on ‘tick box’ care.

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Hourly rounding made a minor contribution, if at all, to the way nurses engage with patients.

A new report by researchers at King’s College London has found that the widespread practice of hourly or intentional rounding, may not be the best way for nurses to deliver care to patients.

The report also found that rounding makes a minor contribution, if at all, to the way nurses engage with patients.

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Hourly or intentional rounding involves standardised regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013, with 97% of NHS acute Trusts in England implementing it in some way.

The majority of NHS trusts adopted the ‘4Ps’ (Position, Pain, Personal needs, Placement of items) model of rounding.

The research was commissioned and funded by the National Institute for Health Research (NIHR) and was led by Professor Ruth Harris in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care.

Hourly rounding places an emphasis on ‘tick box’ care.

The NIHR report – Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation – is the first study of its kind in the world.

The study found that rounding placed an emphasis on transactional ‘tick box’ care delivery, rather than individualised care. However, patients were found to value their interactions with nursing staff, which the study argues could be delivered during other care activities and rather than through intentional rounding.

The report also found that rounding was implemented without consultation, careful planning and piloting in the interests of political expediency following the Francis Inquiry Report into care failures in the NHS.

Ruth Harris, Professor of Health Care for Older Adults at King’s College London, said; “Checking patients regularly to make sure that they are OK is really important but intentional rounding tends to prompt nurses to focus on completion of the rounding documentation rather than on the relational aspects of care delivery.

“Few frontline nursing staff or senior nursing staff felt intentional rounding improved either the quality or the frequency of their interactions with patients and their family.”

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Nurses’ ‘worry’ better than most early warning scores, finds study

Nurses were asked to grade patients between ‘no concern’ and ‘extreme concern’. 

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Observations

A sense of worry can provide important information for the detection of acute physiological deterioration.

Nurses’ worry has a “higher accuracy” than most published early warning scores (EWS) at predicting if a patient is becoming more unwell, according to a recent study.

The study looked at 31,159 patient-shifts for 3185 patients during 3551 hospitalisations across two surgical and two medical wards. Researchers compared if the nurses were worried about a patients potential for deterioration using ‘the Worry Factor’ with early warning score indicators.

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Nurses were asked to grade each patient between “no concern” and “extreme concern”.

The Worry Score

Out of 492 potential deterioration events identified, researchers found that when nurses had an increasing worry factor the patient was more likely to require emergency medical treatment – 7 cardiac arrest calls, 86 medical emergency calls and 76 transfers to the intensive care unit.

The study also revealed that accuracy rates were significantly higher in nurses with over a year of experience.

The researchers concluded that “nurses’ pattern recognition and sense of worry can provide important information for the detection of acute physiological deterioration” and was often more reliable than traditional early warning systems.

They also noted that the worry score could be used alone or easily incorporated into existing EWS to potentially improve their performance.

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