As we approach the Yomim Noraim, the Days of Awe which mark the spiritual culmination of the year, our thoughts turn to our families, and our loved ones and the challenges we all face.
Social care has been a big area of discussion and a major feature of our work over the summer.
There has been a particular debate about the extent to which the community is already and should further be enhancing the state’s provision in the field of youth mental health. One of the reoccurring messages that my Chairman, Jonathan Goldstein and I had picked up over the summer months, was from senior members of the community who are concerned about the service provision to deal with youth mental health issues. There have been in recent years a number of tragic cases of young people taking their own lives, which has given greater visibility and enhanced urgency to the subject.
The first thing we did was try to understand what provision is already there within the community. We convened a meeting of community organisations providing services that touched on youth mental health.
Each of the organisations which we invited to the meeting gave a presentation on the services they were providing in the area. Different organisations address youth mental health from differing levels of priority. Other organisations than those within the JLC also provide mental health services to young people.
It was clear from the meeting that there is already significant work being done within the community and material resource being used, and that the work needs coordinating. It was also important to know where there might be overlap, inconsistency and gaps in provision. None of the organisations provide clinical therapy, but rather therapeutic relief. The problem for families is that the thresholds in CAMHS (the NHS Youth Mental Health Service) are getting higher, with lengthening waiting lists for assessments and then for treatment.
It was agreed that we will commission research to enable us to understand what needs are not currently being met and how those needs could be met on a sustainable basis. I would hope that this research could be available by the end of November, which will allow us to make some recommendations to the community.
This type of long term, strategic planning for community provision is a main element of the work that the JLC will be focussing on under the leadership of our Chairman, Jonathan Goldstein. Social care is a particular focus.
Since early in 2017, we have been mapping current and expected supply and demand in elderly care. We believe that elderly care represents one of the most pressing strategic challenges for the community, as the demographics of the community shift, as regional communities struggle to be able to support their elderly care provision, and as the statutory and philanthropic environment becomes more challenging.
In the wider UK market, social care has been under sustained public funding pressures as government limits access to a sector which is 50% privately funded and 50% publicly funded. Public funding kicks in as a social safety net once people have exhausted personal assets. Providers are facing sustained price pressure from government, increases in living wage rates, loss of immigrant workers due to Brexit, and wider competition due to low unemployment rates.
Increasing rates of very elderly people and high dementia rates make it harder for people to manage in their own homes as they age which increases requirements for support. In general, residential care becomes the default once people are high dependency, and particularly once they are the sole surviving member of a couple.
The concern that JLC is seeking to focus on is on the sustainability of residential care across the country. Residential care homes and all (with the possible exception of those in Manchester and London) are facing severe threats in the next 5 years:
- Rising dependency of an aging group of relatively isolated individuals
- Significant reductions in scale of the regional working age communities which can provide both financial and time based support
- Relatively constant total charitable donations to social care, meaning that unplanned collapses of residential homes risk diverting funds from other uses
- Pressure on revenues and costs of residential care as is occurring across the UK
What we aim to undertake is a piece of work which will enable us to
- understand demand
- understand supply
- understand likely/ possible government policy directions
- understand evolving economics of Jewish elderly care sector
- develop options and recommendations
You can see that we have two pieces of significant long term planning that we are undertaking in the field of social care. The time is right and the JLC is the right type of organisation, for this planning and collaborating with organisations to take any decisions which are necessary.
May I take this opportunity to wish our members, our colleagues and the community a Shana Tova. G’mar V’Chatima Tova.