How we can start a social care revolution in seven easy steps | Katie Johnson

The government’s commitment to provide an additional £2bn for social care in the spring budget was presented as a solution to help ease pressure on the NHS and councils over the next three years. While the measure has addressed the immediate funding crisis, there is concern that this is no more than a short-term fix. The announcement risks masking the true scale of the challenges ahead and the radical surgery required to reform social care.

In all likelihood, the extra money will be used by local authority and NHS commissioners to block purchase places in residential care homes. This is not the answer.

Spending money in this way will do little to tackle the fundamental problem: we are admitting too many older people to hospital, keeping them there for too long and failing to give them the care they need in their own homes.

While cheaper than a hospital bed, a place in a residential care home is still more expensive and, crucially, less effective than care and support in the community.

There needs to be a transformation in the way that social care is commissioned and provided, to improve the quality of care, but also to make services financially sustainable, without the need to raid other budgets for extra funding.

A strategy for reform would have seven key elements:

1. Champion independent living

We need to engineer a dramatic shift away from residential care towards the kind of support elderly people actually want and need. That means better support for people to live independently in their own homes, with a skilled, professional workforce to provide the advice and assistance they need. We need to invest in a model of care that involves greater collaboration between the person being supported and those providing support.

2. Support families and carers

There needs to be stronger provision of advice and assistance for families and other carers, and more effective liaison with voluntary and community organisations that are skilled in providing support to older people. This means creating partnerships that can empower volunteers and deliver more professionalised community care.

3. Shift the funding focus to community-based care

Local authorities need to switch their focus away from expensive residential provision to support family, carer and community-based services. This funding shift is necessary if we are to create a fundamentally new system that offers holistic care in the home and keeps older people, wherever possible, out of hospital and residential care.

4. Incentivise local authorities

Local authorities should be incentivised to purchase individually tailored packages of care. Why are we so afraid of asking people, and their relatives and carers, what they really want and need? Many councils want to do this, but their options are limited by what the market can provide or by a lack of imagination. They should be rewarded when they invest in transforming the way providers think about services.

5. Prevention rather than cure

Transforming the social care system, rather than simply shoring it up, would address the problem of delayed discharges from hospital, but also reduce the flow of older people into hospital in the first place. It would prioritise prevention, rather than waiting for problems to arise and then attempting an inadequate cure. The best local authorities are already using their resources creatively, such as looking at predictive analytics to anticipate demand.

6. A better alternative to ‘integration’

There is plenty of talk about the need for an integrated health and social care system, or even a “National Care Service”. There is a much simpler solution. NHS providers and local government need to co-operate better to find the right kind of care for elderly people.

Liaison between hospitals and local authorities will never be truly effective if it is just one more item on the to-do list of hard-pressed nurses and social care workers. It requires dedicated resources – well qualified people whose full-time job it is to ensure that the hand-offs between hospital and community care are speedy, efficient and driven by the individual needs of the patient. Creating these vital liaison roles should be only the first step in a programme to transform the skills and role of the social care workforce.

7. Pool resources

Just as the NHS and local authorities should look to share resources, there is a key role to be played by combined authorities and other city and county partnerships. They should be encouraged to pool their money to fund the transformation of social care.

The budget has already seen one U-turn. It is not too late to redirect the £2bn and make a real difference to health and social care in the UK.

Katie Johnston is director at KPMG

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How we can start a social care revolution in seven easy steps | Katie Johnson

Why have four children when you could have seven? Family planning in Niger

Roukaya Hamani has an in-law problem. Her husband’s parents want more grandbabies, but she doesn’t want any more children right now. She’s already given birth four times; one of the babies died, and so now she has three, ages seven, five, and 16 months. She’s 18 years old.

“I just pray to God to bless those three babies I have,” she says. The local health centre in her village of Darey Maliki offered her free contraception, which they get partly from the NGO Pathfinder, but Hamani declined. “Maybe [my in-laws] would tell my husband to marry another woman to have more babies,” she says. “If they want me to have another pregnancy, I can do it just for them to feel happy.”

Hamani, a smiley, gap-toothed girl in a long orangey-brown headscarf worn in the popular style here – tight around her face and then flowing down to the knee, over a bright printed dress – never went to school, and got married when she was 10 and her husband was 20. He works in the fields and she keeps the home, waking up at dawn every day. “Why don’t I want to have another?” she says. “Because being a mother is not easy work.”

Hamani’s life is in many ways illustrative for women in rural Niger, where she lives in a small village of mud-brick houses lining sand-dust roads. Girls here get married young, usually as teenagers, and have their first child at 18. Polygamy is legal and commonplace, especially in the rural areas where about 80% of the population resides. More than half of girls don’t complete primary school, and fewer than one in 10 attend secondary school – as a result, less than a quarter of women here are literate. Women have an average of more than seven children apiece, the highest in the world. And they face a one-in-23 chance of dying from pregnancy or childbirth.

But Hamani is unusual in that three babies are enough for her. Despite having the highest fertility rate in the world, women and men alike in Niger say they want more children than they actually have – women want an average of nine, while men say they want 11.

When you have a huge number of young people who are jobless, they have no choice but to emigrate

Hassane Atamo, ministry of health

Birth rates as high as Niger’s contribute to rapid population growth. The country’s population exploded from 3.5 million people in 1960 to nearly 20 million today, with half of the current population under the age of 15. The overwhelming majority – 80% of Nigeriens – live in poverty. The landlocked nation is largely desert, less than 20% of the land is arable, and that number is shrinking due to climate change. At current growth rates, the population is set to double in 17 years. This, experts say, drives poverty, famine, political instability, and violence.

“When you have a huge number of young people who are jobless, they have no choice but to emigrate,” says Hassane Atamo, the division chief for family planning at the Niger ministry of health, noting that large numbers of young men go to nearby Ghana, Nigeria or Ivory Coast seeking work. “They may also fall into crime, or integrate into terrorism. The country is facing this problem as well, with the Boko Haram issue – they are recruiting jobless young people.”

To combat the health issues that come with high birth rates as well as the burden many young and out-of-work people place on a fragile economy and vulnerable security situation, the Nigerien government has turned to the solution: modern contraception. What they haven’t figured out, though, is how to get women to use it.

“This is a time bomb, because all the Sahel is in this situation, and especially with climate change, the food supply will be less abundant than before,” says John May, a visiting scholar at the Population Reference Bureau. “It’s a huge crisis.”

In a jam-packed room at a health clinic in Magama, a town in Niger’s Tillaberi region, 60-odd women cram side by side, each with a baby or two in tow, to hear Aboubacar Gousmane talk about family planning. Gousmane, an expressive, charismatic employee of Marie Stopes International, a global reproductive health organisation that does family planning work at this clinic, stands in front of a desk with a “choice kit” packed full of sample contraceptives.

“Family planning is about making space between your children,” Gousmane tells the group as babies cry. “We know our communities are poor. If we have many babies, we make it harder for ourselves. That’s why we say you should space pregnancies.” Contraceptives at this clinic, he tells the women, are free.

Currently, Marie Stopes International’s family planning work at this clinic is funded by USAid. Last year, they served nearly 30,000 clients. But since it is an international organisation that supports liberalising abortion laws and provides elective abortions in other countries where the procedure is legally allowed (in Niger, abortion is largely outlawed) it is going to lose its US funding thanks the “global gag rule” put into place by President Trump. Leaders from the organisation say they are hopeful that private donors and more sympathetic governments will fill the gap, but that it will be a substantial blow.

Marie Stopes International healthcare workers counsel women about contraceptive options. Photograph: Jill Filipovic

In front of an attentive all-female audience, Gousmane goes through each contraceptive method, holding up samples – a T-shaped IUD, a needle with a little bottle of Depo-Provera, two white matchstick-sized implants, a slinky female condom – and explains how they’re used and how long they last. “It’s not for you to stop pregnancies or stop delivering babies,” he says. “It’s so you can deliver healthy babies and your body can make another baby.”

Many working in development say that to prevent a series of catastrophes – environmental, economic, security – women in Niger need to have smaller families. But unless women want their families to be smaller, there’s no reason to think the fertility rate will decrease anytime soon.

In Niamey, Niger’s capital city, the global health organisation PSI sends outreach workers to meet with women and talk about family planning. This is how 30-year-old Hadiza Idrissa ended up in the front yard of Mohammadou Rabi, a 39-year-old mother of four, her hair tucked under a gold scarf, a month-old infant in her lap.

Idrissa is helping Rabi figure out what kind of contraceptive to use, showing her samples and explaining the benefits of each one. Rabi asks if the IUD might fall out, or if the implant might break in her arm. Idrissa answers patiently (no and no); when Rabi says she isn’t sure what to pick and just asks Idrissa to choose for her, Idrissa says: “It’s up to you to choose a method. We just explain how the methods work.” She asks Rabi if she wants to come back in a few days, “so you can have a little time to reflect on what you want”. What Rabi wants is a break before having more children, ideally two or three more. “I like to make the Muslim community grow,” she says.

Niger’s population challenges are compounded by the prevalence of a conservative strain of Islam, which encourages followers to have as many children as possible. Any organisation working to put contraceptives into the hands of women has the dilemma of doing so in a way that doesn’t provoke religious backlash. Political leaders, too, have elections to worry about, and don’t want to cross influential clerics by pushing the population issue.

Women gather below a neem tree in a village outside of Dongondoutchi to hear Moundadou Magagi, a health agent with PSI, explain family planning options. Photograph: Jill Filipovic

Some women feel that having more babies gives them a break in their difficult lives. In the villages the days are an endless cycle of hard physical labour from the time you’re an adolescent (or younger) until you become too old to work.

The thing I like in motherhood … is giving my baby his bath and playing with him

Hamsatou Issaka, 15

“I really don’t have time for amusement,” says Hamsatou Issaka, a pretty 15-year-old who lives in a village several hours from the nearest city of Dosso. “I just work all day. Then you sleep.” She nurses her one-year-old son, Habibou. “The thing I like in motherhood,” she says, a big smile breaking across her face, “is giving my baby his bath and playing with him.” A new baby also means a 40-day break from the usual demanding physical labour – and another few years of baby baths and giggles breaking up the monotony of tilling the earth and pounding the millet.

Issaka met her husband, a lanky young man with a wide smile and easy laugh, when she was 12 and he was 15; they got married soon thereafter. All of her friends are married with children and she can’t imagine going into her 20s without a husband and children. Having lots of children is the norm because they bring wealth (“they come with two hands to work but only one mouth to feed”). So why have four when you could have seven? Seven, one of Issaka’s neighbours says pointedly, is a bigger number than four.

“A large family size is a cultural ideal in Niger in a similar way that in the US or UK, a romantic relationship is a cultural ideal,” says Hope Neighbor, a partner at consulting firm the Camber Collective, which has researched increasing contraceptive use in the country. “We need to be more thoughtful in how we communicate family size and desires,” she says. “This doesn’t mean you tell people they need to have smaller families. It means reframing how they think about families, because it creates tremendous risk to the mother, and tremendous risk to the fragile environment in Niger.”

This is why, many experts say, Niger needs a strong campaign for girls education. “If we want to bring change, we must bring young girls to school,” says Laouali Assiatou, the deputy secretary general of the ministry of population, promotion of women, and protection of children.

Most of the time the girl is in school but the parents pull her out. She can’t speak for herself

Laouali Assiatou, ministry of population

Child marriage, Assiatou notes, “happens to vulnerable families. Most of the time the girl is in school but the parents pull her out. She is going to be violated. She can’t speak for herself. She will be pregnant early. She’s in her husband’s house, she has no money. She’s not mature enough to deliver and health services are not very developed in our country. She’s going to have a difficult pregnancy. She can die, or she can deliver a stillborn, or she can end up with a fistula and be rejected by society.” The end result, she said, is that keeping girls out of school “keeps the community in a cycle of poverty”.

Despite assumptions, studies haven’t demonstrated a correlation between polygamy and family size. Nigerien women in polygamous marriages have about the same number of children as women in monogamous ones. But some women’s health advocates argue that polygamy contributes to the norm-setting of large families and consolidation of male power in the household, with a potential second wife wielded as a threat to a married woman who doesn’t want more babies.

Mariama Hassan, who has lived in Darey Maliki village her whole life, got married at 18, late by village standards. As she breastfeeds her daughter, Ramatou, she says she wants to see her baby girl finish school, and eventually get married as well – but not until she’s 25. “I want her to be a doctor,” Hassan says. “I say 25 because I want her to be mature before getting married, and I want her to finish her studies.”

Her hopes for her own life are different. “In my lifetime, I want to have what God decides for me,” she says. What does that mean in terms of children? She smiles and laughs. “I hope God gives me 12.”

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Why have four children when you could have seven? Family planning in Niger

Why do one in seven US citizens still have to fight to vote? | Mary O’Hara

The spectacle of Donald Trump repeatedly demeaning and insulting just about every minority group in the US during his campaign for the presidency has been toxic and unprecedented. High up on the long list of ignominious behaviour was the contempt he displayed for people with disabilities in his mocking of a disabled reporter, captured on video.

As with the battles disabled people have fought in Britain against austerity policies from the bedroom tax to the work programme, Trump’s casual disdain is a potent reminder of how fragile inclusion and hard-fought-for disability rights can be.

Beyond the media focus on the race for the White House a new report explores evidence that, regardless of political rhetoric, people with disabilities in the US routinely encounter barriers within the broader electoral process. There are at least 35 million voting-age people [pdf] with disabilities in the US – one in seven of the electorate. According to the study, co-authored by Norman Ornstein of the American Enterprise Institute for Public Policy Research, many are treated like “second-class citizens” as a result of obstacles to voting. The wide-ranging paper points out how “despite a patchwork of legislation” to ensure access to voting serious problems persist.

Donald Trump mocks reporter with disability – November 2015

Pulling on an array of research and interviews it details the scope of the issue, including how in parts of the US people with disabilities are unable to reach polling stations because of a lack of public or adapted transport and inaccessible buildings. Alternative options such as absentee ballots or assistance with casting a vote aren’t adequate substitutes for a fully accessible, inclusive system it argues because, among other things, these can impede a voter’s right to choice and privacy.

Other hurdles it lists involve election materials and online voter registration (for example for people with visual impairments), poll workers who are poorly trained in disability access and limited resources to improve services. In 2013, the US Government Accountability Office [pdf] estimated that in 2008 73% of polling stations had “a potential impediment”, something this latest report rightly concludes is “stunning and troubling”. Almost three-quarters translates as millions of disabled voters possibly being denied their vote.

The report also says stigma is a huge problem, especially for people with learning and mental disabilities. According to research, in 27 US states large numbers of people in these groups are barred from or have restrictions placed on voting.

It might be tempting to think of voting access for people with disabilities as a predominantly US problem but as the last UK general election showed, it is far from alone. During that election activists including Operation Disabled Vote, which campaigned on voter registration, highlighted the obstacles in place across Britain. Meanwhile a report from the charity Scope, found two-thirds of polling stations had at least one significant barrier to access. Research published in 2014 by Mencap revealed that 60% of people with a learning disability reported difficulties registering to vote.

When it comes to mental health, charities including Mind and Rethink Mental Illness have argued for years that vulnerable people such as those who are homeless with mental health problems can face multiple barriers to voting. None of these problems, be they in Britain or the US, are universal or irreversible. During the 2016 presidential campaign it has been encouraging to see positive perspectives on disability. Hillary Clinton has repeatedly highlighted disabled people’s employment rights and other areas where exclusion and underrepresentation are common.

And in the run-up to next week’s election, activists in the US have been mobilising and political engagement is high. The American Association of People With Disabilities launched a successful campaign in the summer promoting voting accessibility and registration among the millions of people with disabilities who are eligible to vote. Grassroots activism has also been spurred into action with networks such as SignVote, for people who are deaf and hard of hearing, and Crip the Vote, an online campaign encouraging disabled people to participate in local and state elections as well as voting for president.

The right to vote, and not being precluded from exercising that right, is fundamental to citizens in any society wishing to call itself democratic or inclusive. It is intolerable that people continue to face barriers to voting because of their disability.

Why do one in seven US citizens still have to fight to vote? | Mary O’Hara

Do you spend a lot on fitness? Seven people reveal their exercise budget

The latest sportswear, healthy cookbooks, Fitbits, apps and after-work classes – exercise and wellbeing is big business these days. Consumer spending on UK gym membership soared by 44% in 2015 and sales of sportswear grew by by 9.5% in 2014. So how much do you spend staying in shape?

We asked readers about their monthly fitness (including sportswear, health food etc) and weekly exercise spend, calling for people to reveal how much they were willing to pay. We also asked for stories of people who manage to exercise on next to nothing. We received 473 responses. Here are some excerpts from the comments we received, condensed and edited for clarity.

Sian Melonie, 32, from London: ‘I spent more than £1,000 on a juice retreat’

Spend on exercise a week: £37.50
Spend on fitness per month: £25
Hours spent exercising: 15

Sian Melonie: ‘Most pressure to be fit comes from my parents – my mum, sister and step-mum all worry about their looks’

I have a Classpass which lets me access a variety of fitness classes around London. So with this pass you pay £110 a month and you get access to lots of different fitness sessions – you can attend three a month at each studio and it’s a rolling contract so I set myself a goal of doing 20 to 25 a month. It ends up being better value than wasted gym membership. The most I have ever spent on exercise was more than £1,000 for a week at a juice retreat.

I used to go for cheaper alternatives, such as running and going to cheaper gyms, but it didn’t seem to really work. ClassPass allows me to mix it up and do different exercises to challenge my body. I’ve never struggled with my finances because of the cost of exercise but I have spent a lot in the past.

In terms of other fitness spending I buy good quality food as I prefer to put unprocessed foods in my body. I also spend lots on clothes. Most pressure to be fit comes from my parents – they may not appreciate that but my mum, sister and stepmum all worry about their looks. However, the rise of Instagram and Facebook also adds to this. Knowing that l am doing something about it and getting stronger with each class that l do takes the pressure off me feeling bad about myself – knowing I am working towards a goal makes me feel better about myself. I have lost inches from my waist and I am more focused on toning up than losing weight. I am also much stronger and can do planks, burpees and press-ups.

Kelly, 50, from London: ‘The fact I know I will lose money if I don’t see my personal trainer helps to motivate me’

Spend on exercise a week: £200
Spend on fitness a month: £1,000
Hours spent exercising: eight

I have a personal trainer twice a week , a tennis class once a week and I go to group lessons too. I am also a member of a tennis and golf country club, which is about £200 a month. The combination of playing tennis and going to the gym has been good for my body. I have always been into fitness but recently I’ve got better at doing exercises that specifically help me as a tennis player.

Having someone there helps to motivate me and pushes me more

Kelly

If I could pay less on exercise then that would be great. I guess if I didn’t go to such an expensive club I could save. I could also maybe not have a personal trainer twice a week, but have it once instead. I just find it hard on my own. I always think next month I will do just one personal training session a week, but that never quite happens. Having someone there helps to motivate me and pushes me more. It depends on your personality but, for me, having someone there waiting for me and the fact that I will lose money if I don’t go means I can’t create excuses for not going.I feel fitter and look leaner and that has an impact on how I feel about myself. There’s also the endorphin release aspect that helps as I tend to have slumps in my mood and working out helps with that.

‘There’s also the endorphin release aspect that helps as I tend to have slumps in my mood.’

Cearon O’Flynn, 34, from Kent: ‘Cycling to work saves me money in petrol each week’

Spend on exercise a week: £15
Spend on fitness a month: £15
Hours spent exercising: 10

Cearon O’Flynn: ‘Exercising saves me money as I don’t have to drive to work.’

My biggest expense is my bike, it was £800, although through the cycle-to-work scheme I’ve paid for it now. I cycle to work; this keeps me fit and saves me about £20 a week on petrol. I then use that bike to cycle more over the weekend. I love cycling because it keeps me healthy, makes me feel comfortable and allows me to run around with my kids. Exercising saves me money as I don’t have to drive to work. This eases my financial burdens.

Tania, 49, from High Wycombe: ‘I spend a significant portion of my household budget on exercise’

Spend on exercise a week: £50 (minimum)
Spend on fitness a month: £300
Hours spent exercising: 12

Tania: ‘My biggest expense is probably on running shoes, but you can’t compromise on quality.’

I pay for quality exercise classes, as well as doing free stuff such as running. My biggest expense is probably on running shoes, but you can’t compromise on quality – I spend about £120 every six months. Physiotherapy is also expensive and I usually get a few sessions when something goes wrong. I do Taekwondo with an excellent instructor; it costs £55 a month but I can train as often as I like. It’s excellent for the body, mind and soul, and great value for money.

I’ve tried doing classes at my gym, which cost £6 a session, but they are usually packed so I don’t get the same level of attention from the instructors. It’s important to do certain exercises, such as pilates, in small groups so you can make the most out of it. I spend a significant portion of my household budget on exercise but I see it as an investment. I spend the money to be healthy and set a good example to my kids. It’s also a great way to socialise too.

Sam Thompson, 24, from York: ‘It’s very enjoyable to cycle everywhere, and it’s cheap’

Spend on exercise a week: £0
Spend on fitness a month: £0
Hours spent exercising: eight

My biggest exercise expense is probably bike maintenance; I’ll spend on average a few hundred pounds a year on tyres, chains, cassettes, brake pads, new cables, etc. I think I’m about as cheap as it’s possible to be – if I were to spend the same time running, I’d probably get through the same cash on shoes.

Cycling. My bike doesn’t tell me how many calories I’ve burned, but humans have managed for millennia without knowing whether they’ve burnt off that extra slice of cake (though admittedly, we’ve spent millennia without the option of an extra slice of cake). Seeing the English countryside and fresh air is far more enjoyable than labouring in the identikit gym down the road with all the other sweaty people. It’s very enjoyable to cycle everywhere, and it has the positive side-effect that it keeps me healthy.

Not owning a car makes using a bike for everything sound a lot better value. Cycling everywhere costs about half what I’d spend on insurance each year.

Daniel Coleman, 41, from Bracknell: ‘I hired a personal trainer when I was 40 and going through mid-life stuff’

Spend on exercise a week: £5
Spend on fitness a month: £50
Hours spent exercising: five

Daniel Coleman: ‘I got the running bug after doing an obstacle course and have really got into it this year.’

I generally run to keep fit – I run about 5km every day after work and have a budget gym membership. I have set a little challenge for myself this month to run every day but I used to run three times a week. It’s something I’ve discovered this year and before that I had a personal trainer and cycled to work. I hired a personal trainer when I hit 40; I was going through some mid-life stuff, but after having him for a year I gained the confidence to train on my own.

I got the running bug after doing an obstacle course and have really got into it this year. I like how quick and easy running is, and it doesn’t take up much of my day doing it. I am very motivated by goals, so I set myself the target of running 5km in under 24 minutes this year. I mix cheaper activities (eg running in the woods) and more expensive stuff (eg a personal training session) depending on mood. I don’t spend much else on fitness, except I occasionally treat myself to a brand of top.

Clare Riley, 56, from London: ‘I should probably just cancel my gym membership but I keep it as a safety net’

Spend on exercise a week: £75
Spend on fitness a month: £25
Hours spent exercising: three

I do an hour with a personal trainer a week and two bootcamp classes that I pay extra for. I do them locally in London and they are about £12 to £13 each. I haven’t always been into fitness, but when I reached 50 I concentrated on it more as your metabolism slows down, etc. I do spend a lot compared to some people, but it works for me.

I also have gym membership, which costs me £25 a month. I don’t go to the classes at the gym as much though as the standard of tuition isn’t great. I should probably just cancel my gym membership altogether but I keep it as a safety net and sometimes go to pilates there.

What I spend is fair in terms of the market rate and my trainer is very good. The boot camp also gives me a good level of cardio fitness, so it really does make a difference. As you get older, it gets more important to stay healthy. I don’t want to go into old age not being mobile and getting out of breath easily. I want to stay in shape for as long as possible.

Dan, 44, from Bristol: ‘It’s not always easy to pay for it all, but what bigger priority is there than health?’

Spend on exercise a week: £100
Spend on fitness a month: £400
Hours spent exercising: four

I have a personal trainer and gym membership. I also spend monthly on clothes, healthy food and race entry fees. Surely the reason why people spend so much on exercise is because there isn’t an alternative. Lots of us would spend two hours a day running or cycling if we could, but we are all in offices for most of the day. I mean, for six months of the year it’s dark when you leave work so going to the gym is the easy option. On weekends it’s also hard to find the time to exercise outdoors because I want to spend time with my family. I’d rather spend Saturday morning with my four-year-old than training. It’s not always easy to pay for it all, but what bigger priority is there than health? We all come alive when we make a hard physical effort, it’s in our genes.

Do you spend a lot on fitness? Seven people reveal their exercise budget

Seven in 10 nurses say young people"s mental healthcare is inadequate

Seven out of 10 specialist nurses caring for the growing number of young people struggling with mental health problems believe that NHS services are insufficient.

Half of all mental health nurses working with troubled young people say child and adolescent mental health services (Camhs) are inadequate and another 20% say they are highly inadequate, according to a poll undertaken by the Royal College of Nursing (RCN) for the Guardian. Only 13% believe they are good or very good, while the rest say they are adequate.

Young people’s mental healthcare survey

The survey found serious concern among frontline nurses that the rationing of access to care and shortage of beds are so acute that young people risk harming or killing themselves.

Of the 631 mental health nurses working in Camhs, 43% said services were getting worse, despite government promises of extra investment and assurances that more young people would be able to receive care.

Young people’s mental healthcare survey

“This vital service has been totally underfunded for years. The pressure on the service is not only appalling for children, young people and their families, but staff morale and mental health too,” one nurse said.

Another nurse said: “Children and their families are suffering due to poor Camhs, support and availability. The criteria for referral means children are having to attempt or threaten to take their own lives before receiving support.”

Asked to list what they saw as the main problems with Camhs, 73% of respondents cited too few nurses, 72% said delays in patients getting appointments, 69% pointed to young people being sent “out of area” to get inpatient care, because of bed shortages in their area, and 59% cited the inability of staff to give patients as many appointments or as much care as they need.

Young people’s mental healthcare survey

Fiona Smith, the RCN’s professional lead for children and young people’s nursing, said the survey showed that services for seriously troubled young people are “completely overstretched” in the face of growing demand for care.

“These results tell us that things are seriously poor. Mental health nurses working in children’s services tell me that they have never known it so bad,” she said.

Young people’s mental healthcare survey

“We are failing young people with mental health problems by not providing services and interventions in a timely manner. It’s foolish of the NHS and the government not to really focus on meeting these young people’s needs, because we know that with [the] three out of four adults with mental health problems, their symptoms began in childhood.”

The Liberal Democrat MP and former health minister Norman Lamb said the findings showed that NHS services for troubled young people “are buckling under the pressure. The truth is that we are letting down a whole generation of young people by failing to invest in essential support.

“We have to end the historic underinvestment in children’s mental health. It makes no sense to spend just 6% of the total mental health budget on children and young people when we know that 75% of adult mental ill health starts before the age of 18.”

Sarah Brennan, the chief executive of the charity Young Minds, said lengthening waiting lists for care and higher thresholds for troubled children to qualify for treatment were likely to exacerbate their suffering.

“Without treatment, problems are very likely to escalate and children are more likely to self-harm or become suicidal, to be violent and aggressive, or to drop out of school, which can ruin their prospects for the future.

“Delays can also have a disastrous effect on families, with parents forced to leave their jobs to look after their children.”

The Conservative-Liberal Democrat coalition government promised to invest an extra £1.4bn in children’s mental health services by 2020. But frontline staff, the Royal College of Psychiatrists and mental health charities are sceptical about whether this funding is being delivered. “Too much of that money has been diverted elsewhere and is not getting through to where it is desperately needed,” Lamb said.

Official NHS workforce figures provided to the Lib Dem MP by the House of Commons library show that the number of consultant psychiatrists working with children in England has only gone up slightly over the past six years, despite the far greater recognition of young people’s psychological and psychiatric issues.

The number of full-time equivalent consultant psychiatrists rose from 622 in May 2010 to 649 in May this year.

The number of non-consultant doctors working in Camhs fell over the same period, from 367 full-time equivalents in May 2010 to 314 in May 2016.

The number of specialist mental health nurses working in NHS hospitals went down by 10% between 2011 and 2016.

Seven in 10 nurses say young people"s mental healthcare is inadequate

seven Baking Soda Well being Treatments that Could Shock You

Baking soda wellness treatments are remarkable for the a lot of ailments that can be cured or relieved by this most basic, all-natural compound. Its usefulness can make sodium bicarbonate one of the all-essential equipment to keep in your natural house health kit.

Baking soda is derived from the all-natural mineral natron and has been utilised because ancient occasions for many purposes. Baking soda in its current form became popular more than 150 years when it was created in America by the Arm &amp Hammer company. Today, the several cleansing and cooking makes use of for baking soda are extensively acknowledged.

But, are you conscious of the wonderful medicinal employs for baking soda?

7 Baking Soda Health Remedies that are Remarkably Successful

one. Stuffy Nose Relief

If you just cannot breathe due to the fact of a stuffy nose, you can clear your sinuses with just a minor bit of baking soda. Not only will this remedy clear your nasal passages, but it can soothe inflamed sinus membranes as properly.

Instructions:
Combine one/4 teaspoon of baking soda with 1 tablespoon of water. Use a dropper and drop a single or two drops in each nostril. You need to come to feel relief shortly.

You can also add 1 teaspoon of baking soda to water in your humidifier to support alleviate congestion in your chest. (Baking soda provides the additional advantage of helping hold your humidifier clean.)

2. Help You Stop Smoking

If you’re making an attempt to quit smoking, but want aid in curbing the nicotine cravings, the Mayo Clinic states that baking soda may be powerful. This can be helpful for brief phrase use in minimizing nicotine withdrawal signs and symptoms.

Instructions:
When you come to feel the cravings, add two teaspoons of sodium bicarbonate to eight ounces of water. Drink the cocktail to assist relieve the urge to have a smoke. (Don’t in excess of-do, because as well significantly sodium bicarbonate can result in above-alkalinity that can contribute to health difficulties. If you have queries, just check with your medical professional.)

three. Bug Bites and Stings

For fast relief of unpleasant bee stings or insect bites, baking soda can come to the rescue. You will want a little box for this application. It is a excellent idea to have a box or two on hand when you camp or get pleasure from prolonged outside activities.

Directions:
Mix about half a little box of baking soda with just enough water to make a paste that can be smoothed on the affected location. Allow it dry. You can re-apply if required. (As an additional bonus, this paste is exceptionally very good for treating poison ivy and can dry up the blisters speedily whilst also relieving itching.)

four. Acid Indigestion and Ulcer Ache

This is probably the most well recognized overall health use for baking soda, and is still really an efficient organic treatment for calming upset abdomen.

But, did you know that it can also relieve ulcer discomfort and discomfort? Baking soda can support to neutralize hydrochloric acid in the abdomen which permits the stomach to calm and heal.

Instructions:
Make your very own normal antacid by mixing one-2 teaspons of baking soda with an eight ounce glass of water and drink. This resolution is confirmed to neutralize stomach acid and is advisable by many overall health professionals as a quick remedy for discomfort.

Yet again, really do not overdo. You shouldn’t drink this more than two or 3 instances a day at most, unless of course you wish to half the recipe and spread it out more than the day.

5. Urinary Infections

If you typically expertise bladder infections, it could be that you want to alter your body’s pH levels. You can aid to get rid of the infection by reducing acid in the urine. Treating a bladder infection with baking soda has supplied relief for a lot of sufferers of urinary tract infections.

You can very easily test your pH amounts by acquiring litmus pH paper at your neighborhood drug keep to measure your saliva and urine. Urine pH ranges in the morning need to normally be between 6. and seven.4 before drinking something. Urine ought to be about 6. to seven..

Test yourself for a few days to see outcomes. If your pH levels are decrease than these, just take the following suggestions to increase them to appropriate amounts, then test yet again. This can go a extended way in normalizing the urinary tract and keeping away from infections.

Directions:
Combine 1/two teaspoon of baking soda in four ounces of water and drink four occasions a day for 2 or three days. You can more boost this remedy by consuming lots of organic cranberry juice and an added 8-10 glasses of water a day.

five. Enhances Athletic Performance

Bet you didn’t know that drinking baking soda water is a common practice among elite athletes!

There have been at least thirty different scientific studies carried out on the benefits of consuming a baking soda beverage prior to workout. These have shown that the normal properties in sodium biocarbonate support to curb the buildup of lactic acid for the duration of competition.

For sports that demand maximum endurance and best pace, this kind of as cycling or running, delaying accumulation of lactic acid makes it possible for for best overall performance. Even if you are NOT an athlete, you can advantage from this soon after activities that lead to sore muscles and tiredness.

Directions:
Research have concluded that the total greatest use of baking soda water is a concoction of in between .3 to .four grams per kilogram of physique weight. For illustration, if you weigh close to 155 lbs., the suitable amount to use is about three tablespoons (21 to 28 grams) per 33.81 fl oz (one liter) of water. For much better flavor, you include a minor natural juice.

You must drink this about 60 to 90 minutes ahead of operating out or engaging in an athletic competition. It’s ideal to drink it gradually above this time time period to stay away from negative side effects. Some individuals could expertise an upset abdomen or diarrhea, so be confident to check out with your trainer or healthcare specialist about its use.

six. Deal with Widespread Burns

A great way to alleviate the sting of burns and lessen blistering is by using this baking soda remedy quickly following damage.

Instructions:
Moist a clean cloth in ice water mixed with baking soda. Apply continuosly until the heat diminshes. Blistering is significantly less very likely to arise if this remedy is utilized as soon as achievable. For larger location burns, like sunburn, you can include one/4 cup of baking soda to luke warm bath water and soak in it till the water cools (or at least for 15 minutes).

7. Sore Throat

You can alleviate your sore throat by gargling a soothing mixture of baking soda, aspirin and scorching water.

Instructions:
Combine one teaspoon baking soda with one/2 cup scorching water. Stir in 1 aspirin presently melted in two teaspoons sizzling water. Gargle as frequently as you need to have to alleviate painful sore throat.

These are just some of the ideal in the huge array of baking soda house treatments that have been employed for years to provide far better health, conserve income and dwell naturally.

Remember, when using baking soda for health makes use of, be sure to pick only pure sodium bicarbonate, and really don’t overdo its use, specifically if ingested. As with any healing compound, usually use widespread sense and check with your healthcare professional if you have any worries.

Allow the relief begin!

For far more information, go to www.wiselygreen.com, a trusted resource for Toxic Totally free, Organic, Green Living data, local community and private support. Follow us on Twitter, Pinterest and Facebook.

References:

A Short History of Baking Soda

Q &amp A of Using Bicarbonate to Buffer Lactic Acid in Athletes

Drinking Baking Soda for Your Health

seven Baking Soda Well being Treatments that Could Shock You

seven Personal Improvement Tips to Increase the High quality of Your Daily life

How do you boost your daily life? You can emphasis on external issues if you want. Perhaps your existence will be better if you moved into a various apartment. Possibly a new job is your crucial to a better life. There is no shortage of folks who have tried to boost the quality of their life by way of pursuing relationships. However, there is a issue with all of this. Any time you concentrate on changing the external, at least a portion of what you are shifting is beyond your control. You may not find an apartment to rent that you can afford. A new job may not be offered to you, and there is no way of knowing of guaranteeing that the feelings of another particular person match yours, let alone no matter whether or not your life will be much better. Ultimately, the only factor that you can do that is assured to increase the high quality of your existence is to function on your very own private advancement.

1. Dedicate an Hour of Productive Time Each Day to Oneself

What do you feel when you read through the phrase ‘me time?’. Do you consider of time on the sofa binge viewing your favorite television demonstrates, or time you invest in some other form of self-indulgence? Pampering by yourself is definitely great. It can enhance your state of thoughts and increase your outlook. If you are performing this, there is no reason to end, but have you deemed working in an hour of time every day that you dedicate to doing productive issues to improve oneself? You can use that time to read, set ambitions, or merely organize your life.

2. Compose Down One Goal to Focus on Each Month

At the end of each and every month, make setting a aim for the following month a priority. Then, decide what it is that you will do every single day to operate towards that aim. For instance, if you want to read far more, focus on getting through ten pages each and every day. If you want to organize your home, give yourself the goal of focusing on one living room each and every week. This will give you a positive accomplishment to focus on at the end of the month, and give you the energy to find something else to do for the next month.

3. Overlook About Resolutions. Focus on A single Constructive Notion For The Year

Odds are, you’ve burned through hundreds of resolutions every 12 months, and for the most part, none of them have truly resulted in any optimistic modify in your lifestyle. Worse, you may even feel worse since you haven’t reached the objectives that you set at the beginning of the yr. So, what would happen if you eschewed the notion of resolutions altogether? What if you replace resolutions with a positive idea that you could focus on throughout the 12 months. For example, you could focus on getting of services to other individuals or creating my spirituality. If this sounds like this would function for you, attempt discovering a relevant quote that you can use as your affirmation.

4. Prioritize Finding out

You might not be sure of what you need to do to increase oneself as a person and increase your high quality of lifestyle. Need to you operate on your physical wellness and brain exercise, try out to earn that up coming promotion, or concentrate on your spirituality? It can be challenging to tell. However, there is one particular location on which you will never regret focusing. If you make studying a priority, your results can only be positive. You can make learning a priority by going back to college, or just turning out to be a more curious person.

5. Move a Minor Much more

Treating your entire body a little much better, incorporating some motion to your daily life, and focusing on your bodily wellness are great techniques to boost your lifestyle. Some folks attain this by setting objectives to shed a specific sum of bodyweight or by reaching some objective, this kind of as operating a 5k, or currently being able to trek up a mountain. The only problem with this is that it can really feel like failure if you really don’t reach your aim. What if you enhanced your life by merely turning into more and a lot more active each and every day, every week, and each month? You could incrementally edge yourself in direction of bodily well being with out dealing with the chance of setbacks due to disappointment and failure.

6. Commence a Journal

“Write.” If you’ve ever read the novel Push by Sapphire, or watched the movie based mostly on that guide ‘Precious’, you know that this basic instruction provided to the title character represented some thing existence modifying. Yes, precious is a fictional character, but the book represents what the electrical power of literacy and creating can do for anyone, no matter exactly where they are. Now, think about what trying to keep a journal can do for you on your spiritual and emotional journey.

7. Pursue Some thing That Has Usually Interested You

Everyone ought to have interests. Following all, it is our hobbies, interests, and passions that really make us special. However, these are the things that can also assist us find our tribe and then relate to that tribe in methods that we considered have been unattainable. Produce your interests, and you will always be your very best companion.

Personalized growth will take a great deal of effort, and you might not be ready to apply all of these suggestions to your existence correct away. In fact, you might not want to apply these ideas at this point. Hopefully, you are ready to focus on at least one or two as a way to increase the quality of your life, and increase oneself along the way.

seven Personal Improvement Tips to Increase the High quality of Your Daily life

seven Very good Food items for Pancreatic Well being

The pancreas plays several crucial roles in keeping you healthier:

• It produces numerous enzymes which are essential for you to digest protein and fats in the meals you intake


• The enzymes it creating are important for your entire body to decrease inflammation that induced by harmful toxins and infections


• It manufactures some hormones, this kind of as insulin, which maintains your blood sugar at a wholesome level.

A healthful pancreas program is essential for your overall wellness, and an unhealthy pancreas program can be discerned by some standard signs:

• Spots on Pancreas


• Bloating


• Back soreness


• Reduction of appetite


• Vomiting


• Nausea


• Diarrhea


• Ache in the upper abdomen


• Yellowing of the skin and eyes

For maintaing a healthful pancreas, retaining a healthier eating habit is one of the most valuable ways. Some varieties of foods groups can protect against pancreas problems and even pancreas cancer, including:

• Fish that substantial in omega-three fatty acids


• Nuts and Beans


• Veggies(all varieties of veggies, leafy greens, tubers and cruciferous)


• Fruits(limit the consumption of substantial excess fat material fruits such as avocado and coconut)


• Spices(great choices are cayenne, garlic, ginger, black pepper and turmeric)

Eat raw and unprocessed food items, limit meat consumption and pick foods reduced in fat, contain the following advisable meals in your diet regime to heal your pancreas system:

One- Garlic

A research shows consuming garlic assists avert pancreatic cancer. This is mainly thanks to the sulfur, arginine, selenium, oligosaccharides, and flavonoids it includes. Other members of the allium species vegetable this kind of as leeks, onions and chives are also with this potential.

Two- Turmeric

The anti-inflammatory properties of turmeric could benefit a number of conditions like arthritis, inflammatory bowel ailment, uveitis and including pancreatitis. Also, curcumin, the active ingredient in turmeric is mentioned to have powerful anti-oxidant properties, and oxidative stress is one of the aspects for pancreatitis. Food items that contain antioxidants like turmeric could fight free of charge radicals and prevent oxidative anxiety thus avoiding the pancreas problems.

3- Spinach

Health professionals at the German Institute of Human Nutrition Potsdam-Rehbruecke advised B nutritional vitamins and iron are crucial for preserving a healthier pancreas program, spinach is a very good supply of the two and can be consumed in a selection of ways, stir-fry with garlic or just include it to your salad. Other leafy greens such as swiss chard and mustard are also excellent meals for pancreatic well being.

4- Kale

Just like spinach, kale is also one of the pancreas-pleasant meals. It is a good source of kaempferol, a dietary flavonoid that has been verified to reducing the danger of pancreatic cancer as effectively as other pancreas issues.

5- Oatmeal

Individuals who’re suffering from pancreatitis may expertise reduction of excess weight as there are not ample enzymes created by the pancreas to help in digestion. Oatmeal is a very good source of dietary fiber, consume it along with lean proteins can stop fat loss and diabetes. Other total grains such as brown rice, buckwheat and barley are also excellent picks.

Six- Blueberries

Blueberries also with robust anti-oxidant properties, which assist get rid of cost-free radicals in the entire body accountable for several chronic illnesses as nicely as cancer. Standard consumption of blueberries aid to maintain good pancreatic overall health.

Seven- Reishi Mushrooms

A report from The American Journal of Chinese Medicine in 2011 showed the reishi mushroom has ability to inhibit the growth of cancer cells, and it has been recommended for the use of pancreatitis remedy.

Sources:

nativeremedies.com

turmericforhealth.com

101healthyrecipes.com

Much more Posts By Writer.

seven Very good Food items for Pancreatic Well being

seven Techniques To Get Probiotics Without A Pill

Now that individuals are waking up to the advantages of probiotics, the retailer shelves have become lined with different pill popping techniques to satisfy your want to try out this “new” trend. Nonetheless, what handful of folks realize is that in several situations, appropriately fermented meals and drinks can give a wide array of strains and high counts of helpful bacteria, and provide more than just probiotics.

Right here are seven methods you can get probiotics, without popping a pill.

Sauerkraut

Sauerkraut is designed by means of the approach of lacto-fermentation, which is essentially offering an surroundings for bacteria to break down cabbage so that it is teeming with hugely bioavailable probiotics, enzymes, and nutrients. Current investigation has indicated that a four ounce serving of homemade sauerkraut can yield up to 10 trillion bacteria!

One particular requirements to be mindful nonetheless to pick raw or unpasteurized sauerkraut when in keep, as the pasteurized pickled sauerkraut you frequently discover on shelves has ruined individuals delicate enzymes and probiotics, and very likely consists of non-natural white vinegar (GMO alert).

To get a recipe, go right here.

Kimchi

Typically referred to as “Korean sauerkraut”, this fermented deal with is usually produced of napa cabbage and daikon radish, with a variety of spices like red chili peppers and ginger to boot. Feel of it as a spicy sauerkraut, which aids supply an additional potent punch to your gut and tastebuds.

When in shop, the same warning goes for kimchi. Decide on raw or unpasteurized, and remain away from the pasteurized and pickled versions.

Miso

Generally made from fermented soybeans (the only form of soybean you want to consume), miso usually comes in a paste with other grains such as rice or barley. It is teeming with enzymes, probiotics, and minerals (such as zinc), and can be used in soups, sauces, and salad dressings,

Kombucha

Kombucha is a fermented beverage generally produced from black or green teas, sugar, and a SCOBY. This refreshing drink not only contains useful enzymes and bacteria, but it is also wealthy in antioxidants, glucoronic acid, glucosamine, and B-vitamins.

There is however, some disadvantages to kombucha so to realize the pros and cons of it, please visit this revealing article.

Kefir

Typically produced from fermenting cows or goats milk with yeast and lactic acid bacteria, kefir can be fairly compared to consuming yogurt, only with a much more varied population of bacteria. It can used in smoothies, soups, and even cereal, or simply blended with fruit to make a good tangy however sweet beverage.

Kefir is not limited to just dairy even so. An even more potent and healing beverage than dairy kefir is coconut kefir, which you can learn more about and learn how to make, right here.

Apple Cider Vinegar

Apple cider vinegar is a type of vinegar produced from fermented apples and can be substituted in numerous foods preparations for white vinegar (like salad dressing), with exponentially a lot more wellness advantages.

Consuming apple cider vinegar will introduce advantageous enzymes, probiotics, and amino acids that will enhance digestion, relieve heartburn, stimulate the lymphatic program, help get rid of Candida, and aid strengthen the immune system.

Natto

This Asian delicacy is made from fermented soybeans and has a very pungent aroma that a lot of might evaluate to previous socks. Apart from getting wealthy in enzymes and probiotics, it is one of nature’s richest kinds of vitamin K and Bacillus subtilis bacteria.

Natto functions effectively in prepare rice dishes, mayo, and specific noodle dishes.

Now that you know all these various forms of probiotics, why would you want to get them? Effectively, the core of your extremely well being depends on it but if you need far more information than that and what distinct situations they can assist ameliorate, pay a visit to this informative write-up.

Sources for this write-up consist of:

http://www.healingthebody.ca/four-strong-probiotic-foods-that-produce-a-sturdy-immune-program/
http://www.healingthebody.ca/the-genuinely-superior-source-of-probiotics/
http://www.healingthebody.ca/the-advantages-and-drawbacks-of-consuming-kombucha/

About the Author:

Derek Henry took a deadly wellness challenge that traditional medicine couldn’t fix and self-directed a 1-in-a-million overall health journey that discovered him happier and more healthy than he had been in his entire existence. As a end result of this rewarding journey, he produced Healing the Body and became a properly revered holistic well being coach who now spends his time creating, coaching, and educating thousands of people each and every month who want to get pleasure from equivalent benefits.

His Wellness Transformation E-Manual and THRIVE On the internet Wellness Program are two vital assets for anyone who wishes to have the intelligence and solutions to grow to be really properly.

seven Techniques To Get Probiotics Without A Pill

Discomfort Management- seven Potent and Natural Painkillers To Use Rather Of Opiates Drugs

Lot of us use opiates for soreness relief. These drugs operate properly for awhile, but sooner or later the body adapts to them and develops a tolerance. These medicines are doing more harm than great to your physique. Natural painkillers are plentiful and varied during the world.

7 Potent and Normal Painkillers To Use Instead Of Opiates Drugs

White Willow

The bark of white willow is employed as a all-natural painkiller. The properties identified in it are more like that of aspirin. It is used to cure headache, muscle contraction, lower back discomfort, and arthritis. Chewing the bark and swallowing its juice will also assist. You can also brew this herb as tea.

Cloves

Toothache and ache in the gums can be immediately treated with cloves. The very best way to use cloves for toothache is to chew it simply because in that way a powerful ingredient with analgesic effect, referred to as eugenol is launched. If you are not capable to manage the powerful and unique clove flavor, make a robust cloves tea.

Turmeric

Turmeric aids in fighting a variety of varieties of irritation, chronic pain, back and muscle pain, toothache and arthritis. Also, this spice aids in successful recover of tissues and it is excellent for detoxification and strengthening total health. You can add turmeric to different dishes as nicely as teas and juices. Turmeric is best combined with black pepper simply because it is most productive used in this way.

Ginger

A root that is indigenous to southern China, ginger has phytochemicals called gingerols, which are structurally comparable to the COX-two inhibitors in Advil and other NSAIDs. In two clinical studies involving patients who responded to standard drugs and those who didn’t, physicians located that 75% of arthritis patients and 100% of sufferers with muscular discomfort experienced relief of discomfort and/or swelling.

Vitamin C

Also known as ascorbic acid, Vitamin C has also been linked with soreness relief. A Dutch review of a lot more than 400 men and women discovered that day-to-day doses of Vitamin C helped decrease ache in men and women with wrist fractures. My preferred supplement is Genuinely All-natural Vitamin C.

Coconut oil

Consists of organic anti-inflammatory and anti-microbial properties. It can be employed internally or externally for boosting your immune technique and decreasing back and joint soreness. It is also fantastic skin moisturizer as effectively as a hair conditioner for dry and frizzy hair.

Kratom

One particular of the strongest normal painkillers is kratom, a tropical deciduous and evergreen tree in the coffee loved ones native to Southeast Asia. Kratom has organic painkiller positive aspects simply because it is an opioid agonist. This means that it mimics the results of medication like oxycodone, hydrocodone, and other opioid painkillers.

Sources and Reference:

opiateaddictionsupport.com

healthwyze.org

lewrockwell.com

Read:

Discomfort Management- seven Potent and Natural Painkillers To Use Rather Of Opiates Drugs