20 Public spending and vulnerable adults

Resolution submitted by the RCN Research Society

That this meeting of RCN Congress urges Council to monitor the disproportionate effects that reductions in public spending may have on those adults who are most vulnerable to abuse and neglect

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Progress reports

Submitted by: Research Society
Council lead and committee assigned: Hamish Kemp, Nursing Practice and Policy Committee
Committee decision: New work
Members involved: Professor Ruth Northway, Rhondda and Taff Ely Branch and RCN Research Society

Final summary update at May 2012

In light of Government changes in health care delivery, vulnerable adults remain in need of RCN focus and attention. Following Congress 2011 a number of initiatives were undertaken by the RCN.

A portal was developed on the RCN website to organise resources on safeguarding and many RCN forums have provided information for it. Additional links to new resources on whistleblowing (by Mencap and the Care Quality Commission (CQC) are now available to members.

The RCN has worked with the Department of Health in England to produce guidance to safeguard those who have autism. This was published by the RCN Publishing Company Ltd.

In Wales, the RCN has contributed to a Cross Party Group on the Welsh Assembly Government’s new law to protect vulnerable adults, and will be consulting with Age Concern about this new law.

The RCN Learning Disability Nursing Forum has strengthened its priorities around the workforce, leadership and education of learning disability nursing, to help safeguard the needs of people with learning disabilities.

In 2011 RCN Events hosted a number of conferences which related to safeguarding at which speakers discussed policy, practice and the nursing contribution.

Update at November 2011

In light of Government changes in health care delivery, vulnerable adults remain in need of RCN focus and attention. The RCN Learning Disability Forum committee has already embarked upon work to support vulnerable adults who have learning disabilities, and this work will continue.

Simultaneously, RCN Adviser for Older People Nicky Hayes is to review the RCN resources that exist in support of vulnerable people.  Current RCN publications are being reviewed, gaps identified and a safeguarding web page/portal is being explored.

Early contact has been established with the submitting entity, Professor Ruth Northway from the RCN Research Society by the Nursing Department, and Nicky Hayes has led a safeguarding task and finish group which has met in April 2011.  

RCN forums have been approached to prepare a short text in relation to their own forums’ perspectives which will be published to illustrate the differing aspects of practice and how the needs of vulnerable adults can be met.

The Safeguarding group met at RCN headquarters on 1 September 2011 and was chaired by Nicky Hayes. At this meeting Professor Ruth Northway joined a group of key RCN staff.

The group has made progress in gathering forum perspectives on safeguarding. Nicky Hayes is making progress on updating RCN Direct advice on safeguarding, and a proposal has been made to set up a dedicated web resource.

During September RCN Events hosted a number of conferences which related to safeguarding (Independent care homes, LD, forensics) at which a variety of speakers discussed policy, practice and the nursing contributions:

Debate report

This resolution called on RCN Council to monitor the impact of cuts on the most vulnerable adults in society. It was proposed by Ruth Norway of the RCN Research Society who warned that older people, those with disabilities, learning difficulties and mental health problems were already being adversely affected by public sector spending cuts.

She implored the hall to understand the seriousness of the issue and warned of an “impending crisis” if vulnerable people fail to receive social care support. “This will impact massively on the NHS in terms of increased hospital admissions and dependency on the service,” she said.

Ian Mansell of the Learning Disabilities Forum was among many who supported the resolution. He said: “We cannot allow ourselves to go back to the bad old days. We cannot take a backwards step in caring for the most vulnerable people in society.” 

The resolution was passed with a huge majority of the vote.

Result

The resolution was passed.
For:  99.31% (433)
Against: 0.69% (3)
Abstain: 3 

The global financial crisis has placed unprecedented pressure on public expenditure. As a result the situation for vulnerable groups – which include ethnic minority groups, older people, people who have a learning disability or poor mental health - and those who rely on public sector support, is likely to become grave as they struggle in the face of rising inflation and reduced future benefit payments.

All countries in the UK face similar pressures in terms of meeting needs from limited funds.  In Wales, the Welsh Assembly Government’s In safe hands (Welsh Assembly Government, 2009) guidance is in place and the inspection of adult protection is undertaken by the Care and Social Services Inspectorate Wales, while in Scotland there are a number of safeguarding resources relating to incapacity, learning difficulties and mental health. Meanwhile in Northern Ireland the Department of Health, Social Services and Public Safety and the Department of Justice are currently formulating a policy framework to safeguard vulnerable adults, and the Health and Social Care Board - in liaison with the five HSC Trusts - has responsibility for the implementation of the new Northern Ireland Adult Safeguarding Partnership (NIASP) and five Local Adult Safeguarding Partnerships (LASPs).

Alongside its highly successful Dignity campaign, the RCN has participated in a variety of stakeholder working groups on this issue. For example, based on member feedback relating to health care cuts gathered from the RCN Frontline First campaign, the RCN in Scotland has asked the Scottish Parliament to take into account the full range of funding required to support the most vulnerable and called for an audit of the socio-economic impact of spending decisions and service reconfigurations.  It is not yet clear whether the Scottish Government will independently take forward legislation on a statutory socio-economic duty now that the Coalition Government has decided not to implement this part of the UK Equalities Act.

References and further reading

Age UK (2011) Age UK, London; Age UK. Available at: http://www.ageuk.org.uk/  (Accessed 07/02/11) (Web)

Department of Health, Social Services and Public Safety (2010) Adult safeguarding in Northern Ireland: new regional and local partnership agreements, Belfast: DHSSPS. Available at: http://www.dhsspsni.gov.uk/index/hss/safeguarding_vulnerable_adults/safeguarding_vulnerable_adults-resourcelibrary.htm (Accessed 07/02/11) (Web)

Royal College of Nursing (2010) Managing money better...through supporting vulnerable communities. Edinburgh; RCN. Available at http://scottishelections.rcn.org.uk/page/-/uploads/vulnerable_communities.pdf (Accessed 07/02/11( (Web)

Welsh Assembly Government (2009) In safe hands: the protection of vulnerable adults from financial abuse in their homes: update 2009,Cardiff: Welsh Assembly Government, Available at: http://wales.gov.uk/topics/health/publications/socialcare/reports/safehands09/;jsessionid=gJZdMn1c102WX5fS7g1DbTGJGvGnpBDGSF1xL8nLTDzQj7XDsXTG!320120316?lang=en
(Accessed 07/02/11) (Web)