Social care spending falling below £554 minimum in most areas

Local authorities across the country are spending well below the £554 per week minimum amount recommended for the residential care of older people, new figures have revealed.

Statistics released by 90 councils across the country show that the vast majority fall well below a “floor price” cited by the Local Government Association (LGA) and reveal a worrying postcode lottery.

A number of councils, including Dartford, Wolverhampton, Leicester, Liverpool, Lancashire, Hampshire and North Lincolnshire, pay providers a local weekly rate well below £400, while others are above £600.

The figures come as the government prepares this week to allow local authorities to bring forward increases to council tax to help pay for social care, after warnings about a spiralling crisis.

The LGA called on ministers to use the autumn statement to plug a £1.3bn black hole in a system that they claimed was in a perilous situation, but Philip Hammond, the chancellor, failed to offer additional funding.

Ministers are preparing to respond to the resulting outcry by reforming an existing policy that allows local authorities to charge a precept of up to 2% a year on council tax to help fund social care.

The communities secretary, Sajid Javid, is expected on Thursday to allow councils to pull forward any increases that might have been made in subsequent years to help fill the current spending gap.

Hammond told MPs that the government felt it had offered a “substantial increase” in funding for social care, but acknowledged fears that this money was “back-end loaded” during the parliament, which had posed a challenge to local authorities.

“Local authorities will have to look at how they manage the situation to get from here to the very substantial increase in funding that will be available to them later in the parliament,” he said.

But he added that councils and the NHS had to play their part as well. “Money alone is not the issue. It is about effective cooperation and collaboration between the NHS and social services,” he said.

Others expressed frustration, with one minister telling the Guardian that there was a view that councils had “cried wolf” too many times with claims of crises over a lack of funding.

They suggested that some colleagues feared that too much extra money from central government would reduce local incentives for the NHS and social care systems to be better integrated.

Theresa May’s official spokeswoman argued that more needed to be done by local authorities among which there was a “significant variation” in performance.

“We know money alone is not the solution,” she said. “Many councils are providing high quality social care services within existing budgets.”

The figures on weekly rates came from a freedom of information request submitted by Labour MP Jess Phillips, who told parliament that Buckinghamshire paid £615 a week, while her local council in Birmingham had a rate of £436, with people being asked for top ups.

“Are nans and grandads in Buckinghamshire worth more than they are in Yardley?” she asked.

The MP was speaking after an urgent question was tabled by the shadow social care minister, Barbara Keeley, who blamed the Tories for the crisis and said raising council tax would not fix the postcode lottery.

“Labour has called for this vital service to be properly funded; the Tories should heed those calls but they’ve offered nothing, instead blaming everyone from councils to professionals for the mess of their own making. It will fall to a Labour government to rescue social care.”

Others in government suggested that there was a feeling that the NHS ought to take more responsibility for supporting social care as a means of preventing hospital admissions.

Cllr Isobel Seccombe, the LGA lead on social care, told the Guardian that councils had been praised for being innovative in delivering services but simply needed more money following years of cuts.

Social care spending falling below £554 minimum in most areas

Global health leaders failing women in Zika-hit areas, experts warn

Public health experts are warning that the failure of global health agencies to challenge political and religious resistance to contraception in Zika-affected countries in Latin America and the Caribbean is leading to a humanitarian crisis for women .

The World Health Organisation (WHO) and US Centre for Disease Control (CDC) recommended women in the region delay pregnancy or not have sex well before the Zika virus was definitively linked in April to the birth defect microcephaly. But family planning experts say that women are merely being told to avoid pregnancy without being given the means to do so and that such advice is insufficient in the face of a global epidemic.

“This is in a region where rates of violence against women are high and women do not always have the power or ability to say no to sex,” says Giselle Carino, director of the International Planned Parenthood Foundation’s western hemisphere region, which covers Zika-affected areas.

“Asking women not to get pregnant without ensuring they have the means to prevent unintended pregnancies puts them in an impossible catch-22 situation.”

Most Zika-affected countries in Latin America and the Caribbean are predominantly Catholic and have strong political and cultural barriers to women accessing and using contraception. In Haiti, only 34% of women have access to contraception, while in El Salvador, almost 90% of pregnancies are unplanned. Terminating pregnancies is another minefield: more than 97% of women of child-bearing age in Latin America and the Caribbean live in countries where abortion is restricted or illegal.

Although the Pope suggested earlier this year that contraception could be used – in a departure from Catholic teaching – to prevent infection with Zika, he tempered the advice by calling it a lesser evil. Abortion, he stressed, was still “an absolute evil”.

But international funding to provide contraception in the region has all but dried up, say family planning experts. In the US territory of Puerto Rico, where a Zika epidemic is raging, two-thirds of pregnancies are currently unintended [pdf] and nearly 140,000 women are estimated to not use contraception, according to the CDC. Yet Congress stalled for months to push through an emergency funding bill to combat Zika in the US and its territories, thanks to a provision that would have banned funding to a Puerto Rican Planned Parenthood affiliate that provides sexual health services, including contraception and abortion. Under US law, federal funds cannot be allocated for abortion.

As a result of such political in-fighting, countries most in need of family planning are at crisis point, says Carino: “The unfinished sexual and reproductive health and rights agenda has now become a humanitarian crisis in Latin America.”

Asking women not to get pregnant without ensuring they [can] prevent pregnancies puts them in an impossible situation

Giselle Carino, International Planned Parenthood Foundation

Perhaps as a result of the delicate balance in the region, the WHO, CDC and Pan American Health Organisation (which works in the Americas) have been seemingly loth to stress the significance of contraception in relation to the Zika virus. The CDC, tellingly, refers instead to the timing of a woman’s pregnancy as a “deeply personal and very complex decision” that should be taken with her partner and healthcare provider.

Such tempered language points to the fine line that global health agencies walk, says James Hodge Jr, professor of public health law and ethics at Arizona State University.

“These issues are deeply political and at times legally contested in some countries where access to contraceptives and abortions is greatly restricted, if not prohibited,” he told the Guardian. In Latin America, for example, “public health organisations can be reticent to engage in policies that directly contravene national laws or politics”. As a result, recommendations remain recommendations, not global health policy.

While the WHO has developed a Zika strategic response plan that would also include family planning and education, the $ 122m required to put it into practice is “drastically underfunded”, says Dr Babatunde Osotimehin, executive director of the UN population fund, UNFPA, and under-secretary general of the UN.

“Women of childbearing age and their partners in Zika-prone or affected areas [must] have full access to sexual and reproductive health supplies and services,” he says. “We already know that voluntary family planning is one of the most cost-effective investments in our futures, with some estimated benefits as high as $ 120 for every dollar invested. The Zika outbreak means that, for affected countries, that return on investment could be even higher.”

But Dr Vincent DeGennaro of the University of Florida, who runs a clinic supporting women’s health in Haiti, told the Guardian that the failure to put family planning at the heart of the response to Zika is contributing to a growing crisis.

“When we are in clinic and we offer women access to birth control they accept it like a hungry man eating food,” says DeGennaro. “The current policy on Zika is short-sighted and narrow. There are millions of women of reproductive age without access to contraception and the majority of pregnancies are unintended. We are failing women, and with the low cost of contraception, it’s hard to say it’s not deliberate.

“Why are we talking about Zika? Microcephaly. How do you prevent microcephaly? Prevent pregnancies,” DeGennaro adds. “I struggle to find a more urgent public health issue.”

Global health leaders failing women in Zika-hit areas, experts warn

300 million children live in areas with extreme air pollution, data reveals

Three hundred million of the world’s children live in areas with extreme air pollution, where toxic fumes are more than six times international guidelines, according to new research by Unicef.

The study, using satellite data, is the fist to make a global estimate of exposure and indicates that almost 90% of the world’s children – two billion – live in places where outdoor air pollution exceeds World Health Organisation (WHO) limits.

Unicef warned the levels of global air pollution contributed to 600,000 child deaths a year – more than are caused by malaria and HIV/Aids combined. Children are far more vulnerable to air pollution, Unicef warned, pointing to enduring damage to health and the development of children’s brain and urging nations attending a global climate summit next month to cut fossil fuel burning rapidly.

“The magnitude of the danger air pollution poses is enormous,” said Anthony Lake, Unicef’s executive director. “No society can afford to ignore air pollution. We protect our children when we protect the quality of our air. Both are central to our future.”

Deaths of under-fives linked to air pollution

Air pollution is world’s single biggest environmental health risk, according to the WHO, and is getting worse, with levels of toxic air rising 8% in the last five years. Over three million people a year die as a result of outdoor air pollution – six every minute on average – and this is set to double by 2050 as fast growing cities expand. Indoor air pollution, mainly from wood or dung stoves, causes another three million deaths a year.

Children are especially at risk, the Unicef report says, because they breathe more rapidly than adults and the cell layer in their lungs is more permeable to pollutant particles. The tiny particles can also cross the blood-brain barrier, which is less resistant in children, permanently harming cognitive development and their future prospects. Even the unborn are affected, as the particles inhaled by pregnant women can cross the placental barrier, injuring fetuses.

Prof Jos Lelieveld, at the Max Planck Institute in Mainz, Germany, said the report was excellent: “Air pollution is typically a problem in developing countries, where infants have little resistance due to poor nutrition and where health care is insufficient.”

The Unicef study combined particle pollution data from a range of satellites with ground-level monitors to estimate the number of children in polluted areas. Of the 300 million exposed to levels of pollution six times over WHO limits, 220 million live in south Asia, where India hosts many of the world’s most polluted cities.

Another 70 million children living with very toxic air live in east Asia, mainly in China. But more children are exposed to air pollution levels above the WHO limit in Africa – 520 million – than in east Asia.

The air pollution crisis is worst in low and middle income nations, where 98% of cities do not meet WHO guidelines, but over half the cities in rich countries also fail to meet the guidelines. In Europe, 120 million children live in areas where outdoor air pollution exceeds international limits, and 20 million suffer levels over double the limit.

Dr Penny Woods, chief executive of the British Lung Foundation, said: “In the UK, we know that children’s health is being put at risk every day by unsafe levels of pollution in many of our towns and cities. At least 3,000 schools are located within illegal levels of pollution. Yet very few of these schools have monitors around them. It’s time for the government to enact a new clean air act to tackle this modern pollution problem and protect all our health.”

In the report, Unicef urges all countries to cut air pollution by reducing fossil fuel burning in power plants and vehicles, which also helps tackle climate change. This double benefit has led to significant action in China in recent years. Tackling air pollution is also cost-effective: the World Bank estimates that the welfare losses from air pollution are more than $ 5tn a year.

Unicef also recommends minimising children’s exposure by ensuring sources of pollution such as busy roads and factories are not sited near schools and playgrounds and by the roll-out of cleaner cooking stoves.

300 million children live in areas with extreme air pollution, data reveals

Areas of NHS will implode this winter, expert warns

Parts of the NHS “will implode” this winter, an expert has warned, as new figures show falling A&E performance over the past few months.

Dr Mark Holland, the president of the Society for Acute Medicine, said the days when summer used to provide a respite for busy emergency departments had gone, and instead the NHS faced an “eternal winter”.

The NHS was “on its knees” and a major increase in hospital admissions due to flu or the sickness bug norovirus could lead to collapse, he added.

Holland spoke out as new figures show that waiting times in A&E units in England this summer have been worse than for most winters stretching back more than a decade.

One in 10 patients waited more than four hours in A&E during June, July and August – worse than any winter in the past 12 years bar one, analysis by the BBC showed. Only last winter marked a worse performance since the target was launched in 2004.

Data from NHS England for the summer also showed hospitals are missing key targets for cancer cases, routine operations and ambulance response times. Delayed discharges – where patients are stuck in hospital despite being medically fit to leave – continued to rise, with a record high during August.

The Local Government Association has said a funding gap of at least £2.6bn is opening up for providing social care in the community. This affects discharges because care packages are not always in place for those leaving hospital.

Holland said: “The NHS is on its knees and, this winter, areas will implode around the country. There is no reserve left. We coined the phrase ‘eternal winter’ months ago in relation to increasingly poor performance and this data is clear evidence that is what we are now dealing with.

“Over the coming weeks and months, if we see a major increase in admissions due to flu or bed closures due to norovirus, we will collapse.

“The government has failed to acknowledge or address the scale of the crisis in social care and delayed discharges and, at present, I see no plan of action in place to prevent it derailing the health service. If we are unable to discharge patients and release pressure on our emergency departments and acute medical units at the front door, the system grinds to a halt.”

The Nuffield Trust chief executive, Nigel Edwards, said only a small handful of hospitals now hit the A&E target.

“We need to look at the underlying causes,” he said. “Our analysis of hospitals suggests that after years of squeezed bed numbers, there is not enough space left to move patients through at the rate we want. The practice of counting bed use at midnight misses the real crunch points during the day.

“On the frontline, leaders should work on better monitoring and control of patient flow minute by minute. Helping the longest staying patients to leave hospital sooner should be a priority, although it will be difficult with the social care system on its knees. Nationally, we should be realistic about what hospitals can do when they are this full, and how hard it will be to free up space again.”

The shadow health secretary, Jonathan Ashworth, said: “’The figures expose the Tories’ record of failure on the NHS.

“On Jeremy Hunt’s watch hospitals are now bursting at the seams with thousands of people waiting hours in overcrowded A&E departments and on hospital trolleys.

“These pressures are a direct consequence of the decisions Jeremy Hunt has taken. This government’s cuts to social care over the last six years have left councils struggling to provide basic support for older people in the community and the growing crisis in general practice is forcing many people to travel to A&E because they can’t get an appointment with their family doctor.”

Matthew Swindells, NHS England’s national director for operations and information, said: “While hospitals are continuing to look after more than nine out of 10 A&E patients within four hours, and A&E performance improved this month, today’s CQC [Care Quality Commission] report highlights the impact of rising social care pressures on emergency admissions and delays in people leaving hospital.

“As the CQC argues, if we are to solve these pressures, the transformation work kicking off this autumn led by local health and care organisations, is essential.”

A Department of Health spokeswoman said hospitals continued to perform well, seeing nine out of 10 people within four hours. “In the last 12 months, 175,000 more people were seen within this standard compared to the previous year,” she said.

“We are committed to delivering a safer seven-day NHS which is why we have invested £10bn to fund the NHS’s own plan to transform services for the future and crucially ensuring that the amount of money available to local authorities for social care is rising in future years of the parliament, reaching up to £3.5bn extra by 2020.”

Areas of NHS will implode this winter, expert warns

FDA Areas Clinical Hold On Phase 3 Trial Of Novel Anticoagulant

A extremely promising novel anticoagulant method now appears to be in serious issues. Regado Biosciences announced these days that the FDA had positioned a “clinical hold” on patient enrollment and dosing in the REGULATE-PCI trial, which is testing the Revolixys anticoagulation technique. Revolixys consists of the Factor IX inhibitor pegnivacogin and an agent, anivamersen, which reverses its anticoagulant result.

REGULATE-PCI is a phase 3 trial evaluating Revolixys to bivalirudin (Angiomax, The Medicines Firm) in 13,000 patients undergoing PCI. The principal investigators of the trial are A. Michael Lincoff (Cleveland Clinic), Roxana Mehran (Mount Sinai), and John Alexander (Duke Clinical Investigation Institute).

The FDA action is not fully unexpected. On July 2 the company announced that patient enrollment in the trial had been paused when the Data Safety Monitoring Board (DSMB) initiated an unplanned assessment of trial data. The company explained the DSMB would “conduct a full evaluation of security and treatment advantage-danger ratio of all individuals enrolled to date (3234) with a emphasis on significant adverse occasions connected to allergic reactions.”

Regado mentioned the clinical hold was taken by the FDA “to formalize the involvement of the FDA in any selection to re-initiate enrollment and dosing in the trial in the future.” The organization CEO stated that “any recommendation to re-initiate patient enrollment in REGULATE-PCI will be based mostly on the DSMB’s conclusions and would constantly be implemented in agreement with FDA.” The two the firm and the trial’s principal investigators stay blinded to the examine benefits.

FDA Areas Clinical Hold On Phase 3 Trial Of Novel Anticoagulant

The 135 areas in Britain exactly where 1 in seven boys will not reside to retirement

Stress to increase the pension age since of main enhancements in life expectancy are referred to as into question by official figures exhibiting a sizeable minority of babies born these days will even now not dwell to reach retirement.

According to estimates presented by the Office for National Statistics, all around one particular in four newborn boys in Glasgow, Blackpool and Dundee and one particular in five from Belfast, Burnley and Liverpool will not survive to the age of 65.

All round there are much more than 130 nearby authority locations in the United kingdom in which at far more than a single in seven baby boys will not live long enough to draw their pension.

It indicates that in almost a third of all locations there are groups of underprivileged families whose lifestyle expectancy is effectively lagging decades behind the rest of the country.

Charities stated the figures exposed a “shocking” and little-reported divide emerging in Britain above existence expectancy.

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A examine published by the ONS final week underlined the pace at which daily life expectancy projections are becoming revised to get account of the results of the ageing population.

Women are now anticipated to reside 82.7 years on common – a complete 12 months longer than they were only 4 many years earlier.

Males are quickly narrowing the gap, with regular existence expectancy now at 78.9 many years – an enhance of 17 months in just 4 many years.

But the figures also present how a significant minority of men and women, concentrated in poorer regions, are in danger of being left behind.

The ONS has supplied nearby lifestyle expectancy estimates for far more than 400 nearby authority locations in the United kingdom displaying broad variations.

Concentrating on male lifestyle expectancy, the estimates present that 93 per cent of child boys born in South Cambridgeshire or Hart in Hampshire need to survive until finally at least the age of 65 but that only 75 per cent in Glasgow and 76 per cent in Blackpool would.

General there are 135 neighborhood authority places in which much less than 85 per cent of boys born today will reach the age of 65.

Chris Goulden, Head of Poverty at the Joseph Rowntree Basis mentioned: “These surprising figures demonstrate the hefty toll that poverty and deprivation extracts from people’s lives across the Uk.

“One in 4 boys born in Glasgow or Blackpool are probably to die just before they can start off collecting their pension – even if they have been able to earn sufficient to save for an sufficient 1.

“The identical is accurate for one particular in five boys born in Belfast or Blaenau Gwent.

“The figure falls to about one in ten for people born in the far more prosperous parts of Southern England such as Wokingham or Cambridge.

“Raising the retirement age for men and ladies is most likely inevitable since of our ageing society and the charges of state provision in later lifestyle.

“But these figures present how essential it is to address the leads to of early death amongst men and women from poverty-stricken parts of the nation.”

The 135 areas in Britain exactly where 1 in seven boys will not reside to retirement

Men in most deprived areas of England far more than twice as probably to smoke

Men in the most deprived locations of England are far more than twice as very likely to smoke in contrast with men in the least deprived regions, while smoking rates amongst women had been highest in the most deprived areas than the least deprived regions, according to new evaluation by the Workplace for National Statistics (ONS).

The examination looked at the existing smoking prices for grownups more than 18 many years previous from the 2012 Integrated Family Survey (IHS) alongside the 2010 Index of Numerous Deprivation (IMD) and found that males and ladies had been more most likely to smoke if living in the most deprived regions of England.

In accordance to the IHS, 1 in five adults in England report that the currently smoke. The ONS analysis released right now on No Smoking Day – an annual campaign run by the British Heart Basis to inspire men and women to quit smoking – also found that men and ladies in the least deprived areas were more most likely to have quit smoking.

The ONS discovered that of all these who had ever smoked (recent and ex-smokers), males and ladies in the most deprived fifth of areas were much less most likely to have given up smoking (46.five% and 48.five% respectively) than those in the least deprived fifth (74.% and 76.% respectively).

Searching at the smoking costs by age, the analysis highlights these aged 25-34 which it states are the ages that ‘appear essential for determining to quit smoking’. The charts under display how each males and females residing in the two most deprived quintiles have been most likely to continue smoking than people in quintiles three-five. The ONS conclude that this ‘suggests far more action is needed to help smokers in the most disadvantaged locations to give up smoking.’

The analysis also discovered that the the greatest smoking inequality in between the most and least deprived places occurred at middle age (45-54). A 22.seven percentage point big difference was recorded for guys and a twenty.six percentage level big difference for women.

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Men in most deprived areas of England far more than twice as probably to smoke