Julie Morgan AM

Direct Payments and NHS Continuing Health Care #SaveWILG

The following article was taken from the Luke Clements site and was written by Ann James. 

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The Deputy Minister’s update statement on the Welsh Independent Living Grant[1] (WILG) is particularly welcome because it acknowledges the risk to the independence,choice and control of disabled people in Wales unless the Welsh Government enables people in receipt of either a Joint Package of care funded by the Local Authority and Local Health Board or NHS Continuing Health Care to receive a Direct Payment.

This risk to independence has been known to Welsh Government for some considerable time,[2] has been identified in a ‘direct payment note’ on Rhydian Social Welfare Law in Wales and highlighted as a risk in a paper on the Closure of the Welsh Living Grant that was offered as evidence to the Petitions Committee dealing with the Save WILG.

While it is heartening that the Deputy Minister ‘has instructed her officials to undertake a review of the Direct Payments and CHC interface’ one could argue that this is very late in the day. It would be hard to convince disabled people and their carers that setting up a system that enables them to have meaningful and personal control over key elements of their care package will compromise the principles of a public service NHS. The time is ripe to redress this lacuna which has this potential to derail Welsh Government commitments and aspirations for disabled people in Wales.

Recipients of the WILG require immediately the confidence that they can continue to retain the right to have personal assistants of their choosing irrespective of whether the funding from the LHB is a proportion of the cost of the care and support package or whether it is a NHS CHC funding arrangement.

There are those people who are not previous recipients of the WILG but who are fearful that their future is in the hands of local government and local health board officers who erroneously believe that Direct Payments cannnot be facilitated.They require an unambiguous statement from Wesh Government that all Local Authorities in Wales and all Local Health Boards are required to facilitate a joint package of care through a Direct Payment as set out in Continuing NHS Healthcare: The National Framework for Implementation in Wales[3].

In the absence of legislative change Independent User Trusts (IUTs) should be offered to disabled people and facilitated by the Local Health Board, to enable a person who has become eligible for NHS CHC to consider this option and its suitability for his/ her circumstances.

While we await a successful conclusion of the review set up by the Minister, there needs to be measures in place to enable disabled people in Wales to achieve their personal outcomes and maintain their independence. Welsh Government commitments and aspirations to Social Model of Disability is currently being shown to be hollow when the level of physical impairment and health related needs determine whether a disabled person in Wales can have control of their care and support arrangements through a Direct Payment.

Local Authorities and Local Health Boards need practice directions from Government and training in this matter if we are to avoid further human rights infringements in Wales.

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[1] Julie Morgan AM, Deputy Minister for Health and Social Services Written Statement: Welsh Independent Living Grant (WILG) – Update on Independent Care Assessments (Welsh Government 13 February 2020)
[2] See for example letter Welsh Government Director of Social Services and Integration dated 10 February 2016.
[3] Welsh Government Continuing NHS Healthcare: The National Framework for Implementation in Wales (2014).

PeterRabbitmeme

WRITTEN STATEMENT BY THE WELSH GOVERNMENT #SaveWILG

TITLE: Welsh Independent Living Grant (WILG) – Update on Independent Care Assessments

DATE: 13 February 2020

BY: Julie Morgan AM, Deputy Minister for Health and Social Services

It is paramount that people’s ability to live independently is not compromised by changes to the way their care and support is arranged and provided. Last July, and following close working with the #SaveTheWILG campaign, I updated Members on the new arrangements I had introduced to provide independent care assessments for people who used to receive payments from the Welsh Independent Living Grant (WILG). These new arrangements were to aid any former WILG recipient who was unhappy with the outcome of their local authority care assessment. This statement is an update on those independent assessments.

Following my last update, ICS Assessment Services were appointed, through a competitive process, to organise and undertake the independent assessments for those who requested these, and 46 former recipients of payments from the WILG took up this opportunity. ICS has now undertaken all of these assessments.

All of the independent assessments completed have now been quality assured by ICS and passed to the respective local authority to consider. This was prior to a discussion between a social worker from ICS and a social worker from the respective local authority about the outcome of the independent assessment, and any effect its findings may have on the person’s current care package. Subsequent to this, a joint meeting is held with the person to discuss the outcome of that discussion, talk through the implications for their care package and agree the future care and support they will receive as a result.

In around half of the independent assessments completed, the discussion between the ICS and local authority social workers has now taken place, with the remaining discussions taking place over the next few weeks. Following these, meetings with care recipients have begun, with outcomes for those people being agreed and starting to be put in place. While it is too soon to comment on the overall outcomes from these independent assessments, some important issues are coming to light.

In a number of cases ICS has found that individuals are currently receiving larger care packages than expected, potentially because those individuals are at the transition point for NHS Continuing Healthcare (CHC). This interface between CHC and direct payments, and the challenges this can cause for care recipients, are issues that have also been highlighted to me at the National Social Care Partnership Board

Having reflected on this, I have instructed my officials to undertake a review of the direct payments and CHC interface. This is with a view to determining whether there are other mechanisms, for example independent users’ trusts, that could be used to ensure people that need more support from the NHS are not put in a position of losing the team of personal assistants they have funded through direct payments and built up over a number of years. If a better more equitable way can be found, this would remove the apparent fear that some people feel about the prospect of CHC.

It is a complex area and I will not compromise the principle of an NHS that is in the public sector rather than in the hands of private individuals, but I want us to see if there is a better way and to do that work quickly.

The United Nations Convention on the Rights of Persons with Disabilities, Article 19, is clear that States must ensure disabled people have access to a range of home / residential and other community support services, including the personal assistance necessary to support living independently and inclusively within their community. The key principle regarding this human right is the ability to choose how you are supported in your everyday personal care.

As the outcomes across the span of independent assessments are confirmed, I would remind Members that the cost of the independent care assessments, and any additional social care that might be identified from them, will be met by the Welsh Government. This is so that there can be no question of changes being made to people’s care and support as a cost cutting measure. The under-pinning principle of my approach is to ensure that outcomes reached are fair and consistent with supporting people’s agreed wellbeing outcomes.

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Birthday Musings… #SaveWILG

Many thanks to everyone for all the birthday wishes – it means a lot and is much appreciated.

I can’t believe twelve months have passed so quickly. I am proud to have published Dancing on Thin Ice – a selection of Tanka and Haiku poems in the last year. It was a year that began with a visit from Julie Morgan AM, who works as the Deputy Minister for Health and Social Services in the Welsh Government. She attended my house to inform #SaveWILG campaigners that she had decided to give those who were unhappy with local authority assessments, the chance to have an independent assessment with extra funds provided by the Welsh Government to pay for any extra support needed.

This seemed like a victory for #SaveWILG campaigners. Indeed, the support given by the Welsh Government has been encouraging and comforting. They appointed ICS to undertake the independent assessments and the vast majority of these were completed by the end of October 2019.

However, WILG recipients are still stuck in limbo almost six months later. This is not due to any failing by the Welsh Government or ICS, but local authorities are still keeping us waiting, as they rubber-stamp the independent assessments.

I am really not knowing which way to turn at the moment. Life remains very insecure until I find out what the reassessment says about what support I can expect in the future. I am subsequently unable to decide where to put my energies. Do I write a new book, create some new poems or take a well deserved holiday before deciding on my next venture? I can’t make a decision on this until I know how much my independent assessment has been coloured by their meetings with WCBC.

I was told last week, that I could expect to hear back from Adult Social Care at the beginning of this week. At close of play today (Wednesday), I have still not heard anything. I believe a verdict is imminent, as I know a decision has already been made, but being kept in the dark about this is seriously damaging my physical and mental health.

The anxiety all this has caused me and other WILG recipients, is appalling. We should all be claiming compensation for the way we have had to wait, but I am sure we all agree that we just want it over and done with – as long as we end up with the support we need, to live on a level playing field with the rest of society.

Once again, many thanks for my birthday wishes and I hope that by this time next year, I am looking forward to the future with some degree of certainty.

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#SaveWILG Tweets

We have not forgotten…

Disability News Service: Welsh government ignores social care funding crisis… in independent living action plan #SaveWILG

The following is an article written by John Pring on his excellent Disability News Service website. This can be accessed by clicking here. 

I have been put in a difficult position following the publication of the Welsh Government’s new framework on independent living – Action On Disability – The Right to Independent Living.

I have been extremely critical of this new legislation, but I want to make it very clear that this is a separate issue to my WILG campaign. I will be forever grateful to the Welsh Government for listening to campaigners and acting decisively. Our new First Minister and the Deputy Minister for Health and Social Services deserve particular praise for their hard work and determination to protect a vulnerable section of society.

However, I hope both Mark Drakeford and Julie Morgan can appreciate why I  have to speak out against the new framework due to the lack of consideration of social care. I am a proud member of the Labour Party and fully support the vast majority of the party’s policies, but I reserve the right to be critical of specific programmes and will campaign to improve them.

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The Welsh government has completely ignored the social care funding crisis in a new action plan aimed at ensuring disabled people’s right to independent living.

A public consultation process with disabled people and disability organisations led to “multiple calls” for increased social care funding.

But the final version of the Labour government’s framework and action plan on the right to independent living – which includes 55 actions – says nothing about the funding crisis or the need for more spending on adult social care.

This contrasts with its 2013 framework, which it replaces and which included lengthy sections on access to social care, direct payments and personalised support.

In discussing the engagement process, which took place in 2017, with further engagement late last year on a draft version of the framework, the document says: “We heard that cuts to social care provision have led to lower allocations for Direct Payments which means disabled adults and young people are becoming increasingly isolated and impact to their well-being compromised.”

It also admits that there were “multiple calls for increased funding for health and social care” during that process.

But despite those calls, not one of the 55 actions in the plan mentions social care funding, or the need to address the cuts.

Instead, the action plan details wider measures around independent living, including: barriers to employment; recruitment of disabled apprentices; a review of funding for housing adaptations; collecting evidence on disability poverty; and improving access to health services.

It also includes a planned review of the disabled students’ allowance system; a pledge to improve understanding of the social model of disability across the Welsh government; and action on access to public transport.

There is also a pledge to introduce a scheme in Wales to provide financial support for the extra costs of disabled people seeking election to local councils, to match schemes in Scotland and England.

Nathan Lee Davies, a leading disabled campaigner who has helped secure concessions from the Welsh government on the impact of the closure of the Independent Living Fund (ILF), said the omission was “bemusing” and appeared to be a “major step backwards”.

A spokesperson for the Welsh government refused to comment on the failure to mention cuts to social care funding in the action plan.

But Jane Hutt, the Welsh government’s deputy minister and chief whip, who has responsibility for equality issues, said in announcing the new framework that “supporting people to live their lives in the way they choose is the right thing to do”.

She said the framework sets out how the government was fulfilling its obligations under the UN Convention on the Rights of Persons with Disabilities (UNCRPD).

But the failure of the action plan to suggest any measures to address the funding crisis and cuts to support suggests the Welsh government could be in breach of the convention’s article 19.

Article 19 says that governments signed up to the convention should take “effective and appropriate measures” to enable disabled people to live in the community with “full inclusion and participation”.

Despite this omission, the framework pledges to “work for continuous improvement in how Wales fulfils its obligations with regard to [UNCRPD] and the Rights of the Child”.

There is also no mention in the document of ILF, and the Welsh government’s decision to close its interim Welsh Independent Living Grant (WILG) scheme, which it had been running as a stopgap with UK government transition funding since ILF closed in June 2015.

WILG closed on 31 March 2018, when the £27 million a year funding provided by the UK government to maintain support to former ILF recipients transferred to local authorities in Wales.

Because of the WILG closure, Welsh local authorities are now solely responsible for meeting the support needs of all former ILF-recipients.

More than 1,200 former ILF recipients will now have their needs met through council funding, while 50 of them have requested an independent assessment of their new support package, a process being funded by the Welsh government following a campaign led by Davies over concerns about post-WILG support.

A Welsh government spokesperson said: “The Welsh Independent Living Grant was introduced as an interim measure to support people who received payments from the UK government’s Independent Living Fund which closed in 2015.

“Our new framework focuses on the future of independent living in Wales, and what Welsh government can do to support disabled people going forward.”

Davies said: “On the face of it the new framework that has been introduced by the Welsh government, following a lengthy consultation process, is as bemusing as it was when [the draft version] was originally launched last year.

“It seems as if I wasted my breath at two consultation days as many of the failings of the framework that I highlighted have failed to be addressed in a [document] that does not seem to address the needs of disabled people with high support needs.

“Social care does not seem to be addressed at all. This is an absolutely bizarre situation when discussing a framework supposedly designed to promote independent living for disabled people.

“Not one of the 55 actions in the action plan mentioned social care funding, which is extremely worrying.”

He added: “After achieving success with the #SaveWILG Campaign – where former ILF recipients have been offered the opportunity of an independent assessment if they disagreed with the decision of the local authority, all funded by the Welsh government – it was hoped that this would signal a change in attitude going forward.

“The dynamic brand of 21st century socialism introduced by first minister Mark Drakeford has delivered positive change that deserves to be recognised.”

But he said the new framework and action plan “seems like a major step backwards”.

He added: “It just seems that the socialist values that the Welsh government demonstrated with their reaction to the WILG campaign have not been utilised in the new framework.

“It does not sit well with me to criticise this new [document], but the fact that it seems to blatantly flaunt the UNCRPD article 19 is a major cause for concern.

“It would be very easy for me to ignore this as WILG recipients have now been protected, but as a disabled activist I remain vigilant to the needs of my disabled brothers and sisters across Wales.

“All disabled people with high support needs should be able to access adequate social care and I will not rest until justice prevails for those in need.”

Rhian Davies, chief executive of Disability Wales (DW), who led the national steering group on the framework, welcomed its publication, particularly “the renewed commitment to implementation of the [UNCRPD] and consideration of options to incorporate this and other UN treaties in Welsh law together with a stronger focus on the social model of disability and proposals to tackle the disability employment gap and support disabled people to take up positions in public life.”

But she added: “Some aspects of the action plan are stronger and more developed than others, often in those areas where disabled people have been closely involved in informing and influencing policy.

“With regard to social care, there appear to be relatively few initiatives cited in the action plan compared with other policy areas.

“Key issues raised during the consultation are omitted, including low take-up of direct payments, provision of advocacy services, WILG developments and the impact of austerity on social care as a whole.

“We understand that the action plan is a work in progress so DW will continue to press for these issues to be addressed, including through Welsh government’s Disability Equality Forum which plays a vital role in monitoring implementation of the framework.”

The Final Furlong #SaveWILG

I am up to my neck in negotiations with my local authority over emergency payments for my depleted Direct Payments account. It has taken a beating over the past six months, as I have been using it to fund the 24/7 support that I so desperately need. I had saved quite a sum to be used in such a situation – it was always going to happen, due to the fact that I live with a progressive disability and had not been fully reassessed since 2010.

I am pleased to report that, having met with the Head of Adult Social Care, WCBC have agreed to make the relevant payments to ensure that I can continue to receive the support I need, at least until the end of my forthcoming WILG reassessment.

There is one thing that I would like to make clear to WCBC and all local authorities. One of the meetings I recently had with WCBC, through up the question of where the additional funds that I am now in desperate need of, would come from? I was shocked and disappointed that WCBC and a number of other local authorities, do not seem to grasp the fact that the #SaveWILG campaign that I led, resulted in the Welsh Government agreeing to fund any extra costs incurred. This was clearly outlined in a written statement on the future of WILG payments, made by the Deputy Minister for Health and Social Services, Julie Morgan on the 18th of July:

I would remind Members that the cost of these independent care assessments, and any additional support for people that might be identified from them, will be met by the Welsh Government. This is so that there can be no question of changes being made to people’s care and support as a cost cutting measure. The under-pinning principle of my approach is to ensure that outcomes reached are consistent with supporting people’s agreed well-being outcomes.

It is important that all local authorities realise that Ministers have agreed to fund any increased care costs that may arise from the outcome of an independent assessment.

Even though the #SaveWILG campaign has been extremely critical of local authorities in Wales over the past four years when dealing with WILG recipients, we have actually assisted cash-strapped councils by reducing the amount they are expected to pay to support disabled people with high support needs across Wales.

WILG recipients and their supporters need to remember this fact, and hammer it home when confronted by adult social care professionals who do not keep up with the news, or realise just what an impact the #SaveWILG campaign has had. The Welsh Government has actually done something pretty special and deserve all the credit in the world. They have listened to our fears, read the evidence we collected and acted decisively. Sadly, there is little room for any positive news in the media at the moment, as we are all obsessed with the actions of a Conservative Muppet and the mess he is making of the BREXIT debacle.

All we need to do now, is remind all local authorities of the changes that have been introduced…

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Written Statement by Julie Morgan AM #SaveWILG

I have just received this Written Statement by Julie Morgan AM, Deputy Minister for Health and Social Services. It is an update on the current situation regarding the Independent Care Assessments that the #SaveWILG Campaign insisted upon.

This is another positive step forward and it is encouraging that the end is now in sight…

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TITLE: Welsh Independent Living Grant (WILG) – Update on Independent Care Assessments

DATE: 18 July 2019

BY: Julie Morgan AM, Deputy Minister for Health and Social Services

In February I announced a change of approach in the way that people who used to receive payments under the Welsh Independent Living Grant (WILG) were in future to access their support from their local authority’s social services. This is an update on the arrangements I am introducing.

It is paramount that people’s ability to live independently is not compromised by changes to the way their care and support is arranged and provided. It was for this reason that I decided that those people who used to receive payments under the WILG should have the opportunity of an independent care and support assessment if they are unhappy with the outcome of their local authority care and support assessment. Those assessments are being undertaken to agree with people the wellbeing outcomes they wish to achieve to live independently and to agree how these would be met.

While the majority of people who used to receive WILG payments are content with the care and support they are now receiving, where people are unhappy with the outcome of care assessment the ability to have an independent care assessment would provide for a second opinion. It also restores for them the tripartite decision making arrangement that existed under the Independent Living Fund (ILF) of recipient, independent ILF social worker and local authority social worker. This was something that the “#Save the WILG campaign” was very keen to have restored.

I am pleased to report that we have made good progress in putting in place the arrangements for these independent care assessments. I wrote in April to all former WILG recipients informing them of their ability to have an independent care assessment and explained my reasons for providing this opportunity. If people wanted an independent assessment, I asked them to contact their local authority by 14 June to request this, so we could gauge the level of interest. By that date 55 requests had been made across 14 local authorities. This is out of approaching 1,400 people in Wales who received payments from the WILG. This would seem to confirm our understanding that the vast majority of former WILG recipients are content with the outcome of the care assessment they had and the subsequent care and support they are receiving. However, it does also confirm that I was right to introduce this change of approach

for what is a significant number of people who have concerns about the outcome of their care assessment.

We have in addition completed a procurement exercise to secure an organisation to recruit and manage the independent social workers required to undertake these assessments. These social workers will be suitability qualified and experienced to perform this task, being registered as such on the relevant register maintained by Social Care Wales. They would consequently be well versed in the ethos and requirements of our Social Services and Well-being (Wales) Act 2014 and the regulations and code of practice we have made under this in relation to care assessments and meeting care needs. They would not, however, be employed by a local authority in Wales so as to maintain their independence.

Following evaluation of the bids received for this contract, ICS Assessment Services Ltd. has now been appointed to organise and undertake the independent care and support assessments requested. ICS has significant experience in both social care and undertaking assessments, having worked previously with a range of local authorities across Wales and England. Officials have met with representatives of ICS, the Association of Directors of Social Services Cymru and the Welsh Local Government Association, to agree the process that will be followed to complete the independent assessments and to work through the practicalities associated with this. This is well advanced so that the arrangements to begin to undertake ICS assessments should be in place by the end of this month. I will be writing shortly to those former WILG recipients who have requested an independent care and support assessment be update them in more detail on this and to confirm what they need to do to pursue their assessment.

I would remind Members that the cost of these independent care assessments, and any additional support for people that might be identified from them, will be met by the Welsh Government. This is so that there can be no question of changes being made to people’s care and support as a cost cutting measure. The under-pinning principle of my approach is to ensure that outcomes reached are consistent with supporting people’s agreed wellbeing outcomes.

I appreciate that establishing these arrangements has taken some time. However, it is imperative that we put in place properly considered arrangements. The “#Save the WILG Campaign” has been supportive of the approach I am taking, as we share a common interest in seeing changes implemented properly.

I will update Members as further progress is made.

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