Wrinkes are where the smiles were

A happy sentiment for older people, from the Facebook page: I speak female. Link to the page.

Grandparents are important carers

This verse (from the Facebook page 'Just Feelin' Good') expresses (sentimentally but what the hell) why grandparents are important carers.

Link to the Face book Just Feelin' Good page.

Health and social care records about older people: are they too casual?

The Information Commissioner’s Office (ICO) website is always a fascinating read. He is the guy who you complain to if someone misuses your personal information. He also deals with appeals to get information, when some organisation has information about you but won’t tell you what it is. He also fines organisations quite big money if they lose your data. There's little mention recently specifically of data on older people, but that doesn't comfort me. 

Link to the Information Commissioner's website.

The regular flow of fines of health and social care authorities suggests that nobody much in health and social care has bothered much to set up good data systems about vulnerable people. There are regular disclosures of information about children in care (as it used to be called - being 'looked after' or safeguarded is the current jargon) and medical records, so I don't suppose people in health and social care have good systems for the confidentiality of older people's data either. I suspect there may be it's another form of age discrimination: they're only old - there's nothing much important to keep confidential. I don't suppose it's evil intent, it's more being casual because you;re used to dealing with loads of this stuff every day.

This month, the ICO fined Torbay Care Trust £175,000 because they published confidential details about their staff on their website, details like the sexual orientation (that means whether they were gay or lesbian or something else), religion, ethnicity (race to most people but ethnicity is the technical word) and disability. They did this for 19 weeks, would you believe, until someone noticed.

But you don’t get fined just for doing something crass like this. To get fined you have to have really not bothered. Like Torbay. They had no procedures  to check for releases of information, no initial or update training for your staff and so on. Lots of health trusts and social services authorities do things like this, because they have so much of our data in their records that it all seems sameish. But to us, it could be really important.

One breach that probably will affect older people is the Central London Community Healthcare (CLCH) NHS Trust which was fined £90,000 earlier this year for faxing medical information from its palliative care unit (which deals with dying people) to the wrong number.

Last year, Powys County Council sent details about a child protection case to the wrong person. It seems reports were sent from a computer to a printer that was shared by several people and the reports on this child got mixed up with someone else’s report and sent to the wrong person. You can be see it would be easy to do. But, this was the second time Powys social services had done this, so, even after a warning, they’re obviously not working at it.

It really needs constant attention to detail: the detail about how our records are kept.

Earlier this year, Belfast Health and Social Care Trust was fined £225,000 for keeping old records about patients and staff in a disused hospital, with poor security, and not destroying records in accordance with the rules for getting rid of records when they are no longer needed. And Brighton and Sussex University Hospitals NHS Trust was fined £325,000 for allowing hard drives with data about patients HIV and genito-urinary condition to be sold off on the internet.

There are several other reports about health trusts and local social care services. None are specifically about information about older people going missing or being wrongly used. This fact does not give me a sense that everything’s alright with older people’s records, though.

Just to show that keeping our data secret is not rocket science, the Information Commissioner has recently published five tips for charities like Age UK who are handling our data. The advice is stunningly obvious, and the fact that they bothered to publish it at all suggests that we all ought to worry more about how organisations that are supposed to help and care for us are using our information. Here is the ICO's five top tips for keeping information confidential:

1   Tell people what you are doing with their data. People should know what you are doing with their information and who it will be shared with. This is a legal requirement (as well as established best practice) so it is important you are open and honest with people about how their data will be used.

2   Make sure your staff are adequately trained. New employees must receive data protection training to explain how they should store and handle personal information. Refresher training should be provided at regular intervals for existing staff.

3   Use strong passwords. There is no point protecting the personal information you hold with a password if that password is easy to guess. All passwords should contain upper and lower case letters, a number and ideally a symbol. This will help to keep your information secure from would-be thieves.

4   Encrypt all portable devices. Make sure all portable devices – such as memory sticks and laptops – used to store personal information are encrypted.

5   Only keep people’s information for as long as necessary. Make sure your organisation has established retention periods in place and set up a process for deleting personal information once it is no longer required.

Link to information about the guidance of charities and voluntary organisations.

Link to information about Torbay Health Trust’s silly mistake. 

Link to information about Powys County Council’s silly mistake. 

Link to information about the Central London Community Health Trust's silly mistake.

Link to information about Belfast Health and Social CareTrusts’ silly mistakes.

Link to information about the Brighton and Sussex University Hospitals Trust.

Pre-retirement downshifting: seize opportunities and create work flexibilities

And another of my musings on retirement.

People who know me have commented that I have planned my retirement rather well by downshifting over the last ten years: this notice comes from the International Downshifting Week website - links to downshifting below.

In my mid-fifties, I left my fairly high-powered job as professor and head of a university department to work in a hospice. After five years, one of my pensions became due and I went part-time in a less managerial job. Several academic contracts and other bits of work in fact came along to maintain the two days a week of income that I lost. Finally, I retired fully a month or two ago, when my state pension and other pensions fall due. And I still have some writing contracts and other occasional jobs to bring in some extra money for a while. A series of downshifts to increasingly less pressurised roles; just the right thing to do as you come to retirement – take it in easy stages.

People tend to think of academic jobs as a life in a holiday camp, anyway. Unfairly I rather think, but they are flexible, so you’re not going to be dying young because you don’t have control over your work life. The research says that the less control you have over your work life, the more stressed you will be and the younger you will die.

It’s all a bit of a misconstruction of my motivations; my planning leaves a lot to be desired. I actually left the university job when my wife moved to London to take up a new job. I have been doing it for too long and was feeling jaded, so took the chance of a change back to management and practice. The experience gave me a lot of new material for my writing. Then the downshift to part-time came really because the chief executive needed to find a job for someone who was ready to move up, so it was a chance for a bit of organisational succession planning, fortuitously available. Also, I suspect, when she realised I was going to do consultancies and writing about our field of work, she took the Lyndon Baines Johnson option.  He was an American vice-president of the 1960s, of whom a famous comment was made. The implication is that there’s a bit more control for a manager having me inside the tent excreting in an external direction than outside…you know the rest.

So rather than plan, I’ve seized opportunities when I could. But I suppose you could say that’s a form of planning. And it’s also important to have bits of work that you can do flexibly – that’s not an opportunity that many people have.

Link to International Downshifting Week.

Link to the Downshifter UK website - lots of good advice.

Link to Notes from the Frugal Trenches blog - interesting blog on downshifting in all sorts of ways, not just reducing your work, but reducing your demands on the environment.

Private hospital group aims to delay care for NHS patinets to get them to pay more for private care

The Independent reported in July that an executive director of BMI hospitals (this is Bernie Creaven, just so that the face and name become as widely known as possible) told its consultants to delay NHS patients' admission for treatment on the NHS contracts to encourage them to go private (and make BMI more money).

Apparently the poor diddums are not making enough money because NHS waiting lists are too low, so they're keen to get back to the position during the last Conservative government in which waiting lists were so long that people were forced to spend their money on private care. It's another way in which the government hopes to cut the cost of the NHS by co-payment (the jargon for making people pay some of the costs), just as all government have been doing over the past thirty years by transferring as much care as possible into social care.

And all this, of course, affects older people most, because they are more likely to need routine 'elective' healthcare. It's not elective if you are can't carry on with your life because you are in pain; that's something that the government hopes younger people won't think about when they vote because they don't have to live with 'multiple co-morbidities' (the jargon for  having a lot of minor disabilities wrong with you that make your life miserable but don't actually kill you).

The government is going to tell BMI healthcare not to do this. I suspect they are going to have to get their regulators to do a lot of chasing round to put a stop to this sot of thing as the new NHS emerges. In my blog on 'big society' policy, I have pointed out that big companies take over government projects because true community organisations work have locally, and can't and don't want to 'scale up' to run a giant programme.  Examples are A4e, the company that are making a lot of money out of the work programme for unemployed people, and Serco, the profit-makers who are bidding to take over the National Citizen Service, the volunteer programme for young people which is being piloted at the moment (and aims to find unemployed youngsters something to do). These big organisations are interested in their profits. I'm calling them the 'big privates'.

As Ms Creaven has clearly demonstrated, the profits are more important than the best service for patients. The private healthcare providers have big privates, too, it seems.

Link to The Independent report.

Valuing older people

Ageing is important for cheeses

I rather liked this picture about attitudes to ageing on the International Federation on Ageing Facebook page; link to the page.

Staff cuts at DWP will end an important indicator of how well they do their job

One of the big worries about older people's use of social security benefits is the concern that they do not take up the benefits they are entitled to. Information about lack of take-up comes from a regular government survey.

The government is consulting about stopping publication of their regular reports on the take-up of benefits. This is because they want to have more research done on things they think are important, because they've cut their statistics staff, so they want to reduce their workload and because the sample size of the study is being reduced so the reports will be less accurate. They're also less accurate than we would all like, anyway.

My view is that there can be no higher priority than making sure older people (and others) get the pensions and benefits they are entitled to - people in older agegroups who get benefits are often seriously afflicted by poverty. What they should do is increase the sample size and look for other ways of making the reports more accurate, not get rid of them. You can't help feeling that they want to do away with an important indicator of how well they're doing their job. But as I've said before, the main purpose of the DWP under the current administration is saving money on social security, so it's no surprise. I'm starting to call them the Department of Wilting Protection.

Link to the consultation document