Mayor of Liverpool calls for a Royal Commission ahead of UK Budget

AHEAD of Monday's Budget, on 29 October 2018, Joe Anderson, the Mayor of Liverpool, has suggested a Royal Commission to ensure a:- "fair funding formula for local Council Services."

Mayor Anderson said:- "Councils have borne the brunt of a decade of austerity, with many losing ½ their funding, crippling their ability to perform their roles and deliver vital services. We need to create a system that responds to local need and properly funds the key services we provide. As the 4th poorest borough in the country, it is manifestly unfair that we have seen ⅔ of our Government funding; some ₤444 million; slashed from our budget since 2010. I'm calling on the Chancellor to look at establishing a Royal Commission so that can create a fair and transparent system of financing Local Government for the long term, ending an approach that is currently too short termist and opaque about how allocations are made. We also need to future proof the system to take into account the rising demand for adult services and supports those Councils, like my own, dealing with ingrained social and economic problems. I've long campaigned for a fairer funding regime, but the cumulative effects of austerity, the botched implementation of Universal Credit and the looming threat of Brexit mean the issue is now urgent. We desperately need a system that focuses on need and helps us strengthen and grow our local economies so that Councils is better able to generate new forms of income and become more self reliant."

What Liverpool needs from the Budget...

► Fair funding:-

A clear end to austerity; as promised by the Prime Minister in her recent Conservative Conference speech. Liverpool City Council has seen a ⅔ cut to our budget ₤444 million; since 2010. Like other Councils, we also need clarity on funding settlements beyond 2019/2020 and urgent confirmation around the future operation of business rates. Also, the Chancellor should commit to a Royal Commission on financing local public services, creating a fair and transparent regime based on service need; as well as bolstering local economies to drive inclusive economic growth.

► Brexit resilience:-

Clarity is also needed about how monies repatriated from the EU will be redistributed via the Shared Prosperity Fund. Local authorities are set to lose ₤8.5 billion in funding and we need guarantees that this 'lost' EU funding will be recovered through the SPF. Again, we need to see a fair share, reflective of the Government's own leaked analysis showing areas of the country, like Liverpool, will be much harder hit by a 'no deal' Brexit than the Sout East of England. We need to see further efforts to boost regional economies and help build in resilience to Brexit shocks.

► Adult Social Care:-

We need to see a consistent funding settlement that properly addresses increasing demand and is futureproof for at least 3 years ahead; in order to avoid the constant brinkmanship and uncertainty around social care funding. The King's Fund calculates a national funding shortfall of ₤1.5 billion by 2021, rising to ₤6 billion by 2030.

► Children's Services:-

The Chancellor also needs to close the yawning gap in children's funding. Liverpool City Council has a ₤7 million overspend this year on vital services to vulnerable children and young adults because of Whitehall cuts. Children's services must not become a 'bridesmaid issue.' The Association of Directors of Children's Services calculates that the number of statutory responsibilities has increased by 50% since 2011, without the extra investment to pay for them. We need an urgent review of the financing of statutory services to ensure they are adequately resourced. Also, Government needs to better regulate the activities of private fostering providers, who are gazumping local Councils by paying more to foster carers and driving up costs for local authorities.

► A proper pause and rethink on Universal Credit:-

The current model; with its ideological penalties (such as the 35 day wait for new claims) is entirely unfair and punitive and must be scrapped. Ministers are guilty of a sleight of hand, as new claimants and those who have their benefits modified; are still being transferred to UC, despite the Secretary of State's announcement that the rollout will be paused. Also, the Chancellor should make some concessions on the reduced benefit levels for in work households on Universal Credit. A 5th of our working age Council Tax Support / Housing Benefit claimants, within Liverpool are in work; 10,000 households; yet still struggling to:- 'make work pay.'

► Landlord licensing:-

The number of households in the Private Rented Sector (PRS) rose by 106% between 2001 and 2011; with regulation failing to keep pace; leading to a nationwide problem of rogue landlords. The Chancellor should restore the ability of local authorities to apply for borough-wide landlord licensing schemes; as we have in Liverpool; so they can take concerted action to raise standards in the PRS sector, improving health and safety and repairing a broken private rented market.

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New Zonal Engagement and Observations for Patients with Dementia

HEALTH professionals from Lancashire Care NHS Foundation Trust have successfully implemented a new observation system for patients with dementia in order to enhance patient experience.

Dementia patients at the Trust can now benefit from a new and improved observation system which will reduce levels of challenging behaviour, patient boredom and enable staff to provide safe patient care that is tailored to their needs. Patients who intermittently present an increased level of risk to themselves and others, were placed on continuous:- 'Safe and Supportive Observations' facilitated by one or more members of the nursing team. Staff working on dementia wards across the Trust identified that the current system was not always effective for patients with dementia and often resulted in increased challenging behaviours and at times could not always be adapted to suit the individual patient's needs. Staff feedback identified that morale was reduced due to the high levels of acuity and frequency the staff were facilitating safe and supportive observations. Staff also noted that the use safe and supportive observations increased the Trust's need for bank staff, which also brought challenges.

In order to reduce the level of risk and ensure positive clinical outcomes for patients and staff it was decided to introduce a new system known as:- 'Zonal Engagement and Observations,' which aimed to ensure appropriate observation of individual patients without the need to assign particular nurse to be in close proximity to the patient for long periods of time. Zonal observations and engagement aims to provide patients with increased activity and therapeutic engagement and to assess patient's mental and physical health and document this in real time. Staff worked together with patients, carers and relatives to co-design and plan exactly how the new system would look for patients. This included the paperwork that would need completing, the resources staff would need, the activities that would take place and the layout of the ward. During the pilot, the ward team held daily sessions with staff and opened feedback for relatives and other professionals to discuss how the project was progressing so that they could adapt and improve the process as per the challenges and experiences they faced along the way.

Dr Olufunso Aribisala from Lancashire Care NHS Foundation Trust said:- "We are really pleased with how successfully the new observation system has been introduced across the Dementia Wards at the Harbour and an advanced care ward in Blackburn and most importantly what this means for the patients that are receiving our care. The new system means that we have regular, experienced and skilled staff to care for patients and a process where staff are able to build positive, therapeutic relationships with patients and know them as individuals. We have received some fantastic feedback from staff and relatives. Patients who pose as a risk to themselves or others are still receiving the same level of observation, but in the least restrictive manner, resulting in less boredom and an improved experience for the patients, their carers and relatives."

Following 12 months of the zonal observations and engagement approach we have evidence that incidents have reduced, there has been significant reduction in use and cost of additional temporary staff, quality of care and the level of patient engagement in activities has improved and staff morale and wellbeing has also increased.

For more information about dementia care and services at Lancashire Care please visit:- LancashireCare.NHS.UK/Dementia.