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The Commission on Funding of Care and Support, chaired by Andrew Dilnot, reported its recommendations in 2011 (TSO ISBN 9780108510847). Two key proposals were: (i) the Government should put a cap on the lifetime care costs that people face, and raise the threshold at which people lose means-tested support; and (ii) there should be universal access to deferred payments for people in residential care. The Government agrees that these principles should form the basis for any new funding model, but there remain important questions and trade-offs to be considered about how those principles should be applied in a reformed system: the level of the cap; changes to the cap over time; who benefits and who should pay? However, the Government will introduce a universal system of deferred payments for residential care (from April 2015), and will also introduce a national eligibility threshold for adult care and support in England (also April 2015). The Government is also committed to providing a clear, universal and authoritative source of national information about the care and support system. Chapters in this paper include: the need for funding reform; stakeholder views on reform; the Commission's recommendations and how the Government is responding; the principles of funding reform; the benefits and costs of the Commission's model; conclusions and next steps.
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Care and support affects a large number of people: eight out of 10 people aged 65 will need some care and support in their later years; some people have impairments from birth or develop them during their working life; some 5 million people care for a friend or relative, some for more than 50 hours a week. The current system does not offer enough support until a crisis point is reached, the quality of care is variable and inconsistent, and the growing and ageing population is only going to increase the pressure. Consequently, two core principles lie at the heart of this White Paper. The first is that individuals, communities and Government should do everything possible to prevent, postpone and minimise people's need for formal care and support. The system should be built around the promotion of people's independence and well-being. The second principle is that people should be in control of their own care and support, with personal budgets and direct payments, backed by clear, comparable information and advice that will allow individuals and their carers to make the choices that are right for them. This paper sets out the principles and approach, with sections covering: strengthening support within communities; housing; better information and advice; assessment, eligibility and portability for people who use care services; carers' support; defining high-quality care; improving quality; keeping people safe; a better local care market; workforce; personalised care and support; integration and joined-up care.
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
The report analyses the ways in which unpaid care work is recognised and organised, the extent and quality of care jobs and their impact on the well-being of individuals and society. A key focus of this report is the persistent gender inequalities in households and the labour market, which are inextricably linked with care work. These gender inequalities must be overcome to make care work decent and to ensure a future of decent work for both women and men. The report contains a wealth of original data drawn from over 90 countries and details transformative policy measures in five main areas: care, macroeconomics, labour, social protection and migration. It also presents projections on the potential for decent care job creation offered by remedying current care work deficits and meeting the related targets of the Sustainable Development Goals.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
Farming for Our Future examines the policies and legal reforms necessary to accelerate the adoption of practices that can make agriculture in the United States climate-neutral or better. These proven practices will also make our food system more resilient to the impacts of climate change. Agriculture's contribution to climate change is substantial--much more so than official figures suggest--and we will not be able to achieve our overall mitigation goals unless agricultural emissions sharply decline. Fortunately, farms and ranches can be a major part of the climate solution, while protecting biodiversity, strengthening rural communities, and improving the lives of the workers who cultivate our crops and rear our animals. The importance of agricultural climate solutions can not be underestimated; it is a critical element both in ensuring our food security and limiting climate change. This book provides essential solutions to address the greatest crises of our time.