Helen Ramsbottom / Guest specialist, Older people

This work is an increasingly large part of the role played by local Age Concern Chief Executives, many of whom sit on Local Strategic Partnerships and other strategic groups. It’s vital to be there, but it also makes demands that compete with the running of the organisation. No on gets paid for the time they put in to this work, but it can yield the basis of partnerships for effective future work. Again, it’s the smaller Age Concern organisations who are stretched, like so many others, between operational realities and the need to be represented round the table. One solution some Age Concerns are using is the skilling up of senior or key staff to represent the organisation so that a spread of partners are covered.

Local Age Concerns are very aware that despite older people’s implicit trust in the brand, reliance on the name alone is not sufficient and that robust evidence and impact assessment are key aspects of demonstrating and maintaining good services. Of course there’s a cost to this, but the cost of not doing it is even higher. There are some excellent materials and reports highlighting qualitative and quantitative evidence of Age Concern services that demonstrate their impact and that are shared across the federation. The challenge is developing this so that there is national consistency for an older person using services anywhere in the country.

In the last decade, pensioner incomes have increased, however, current volatility in the stockmarkets have significantly reduced the value of pensions. It is uncertain as to what impact the current economic crisis will have on pensioner income and high levels of poverty amongst pensioners (2.1 million pensioners currently live in poverty) or whether people may be forced to work longer to make up for the decline in their pensions. Current changes to retirement and pensions may seek to address these issues though the downturn may also limit the government's ability to fund any increases to pensions.

In Britain, the largest voting group is already those aged 65 to 74. With an ageing and increasingly healthy population, this trend seems likely to continue. It is possible that this may lead to may be a shift in priorities to some extent away from families, children and young people, towards older people.

This is clearly a very important driver for organisations working with older people. However, older people are also becoming more diverse, see this driver - http://www.3s4.org.uk/drivers/diversity-of-older-people

Increasingly we are seeing a shift in the way people view old age and older people, with a move away from the traditional view of a vulnerable, disempowered group, needing help and support, to views reflecting the increasing power, wealth and value of older people. This is partly due to the blurring of boundaries between age groups, with people of all ages sharing common interests rather than interests defined by particular age groups, for example in music, art, cinema, theatre, TV programmes, radio etc.

Is your organisation ready for social enterprise? It requires a change of mindset in terms of the ‘way we do things round here’. If you have existing staff, it’s quite likely you’ll be paying staff in the social enterprise business a different rate of pay, determined by the statutory or private sector. If you set up a social enterprise inside your existing charity, there may be a culture conflict between the two parts of the charity. For many, it will be easier to set up a separate business in new premises where you can generate a new ethos.

Many Age Concerns have yet to develop effective social enterprises where the business breaks even – but even starting to charge more realistic prices will help to make an organisational shift away from the nominal small fees that cost so much in administration time and don’t reflect the true cost of the service. Have your trustees had a recent debate about charging for services?

What are the prospects for Age Concerns who want to develop successful social enterprises in the current climate? Can you charge realistic market prices ? ‘Heat or eat’ is an option for many older people; will self funders or those with a little more money now chose between an Age Concern service such as tidying up the garden, or go without?

Despite very high government and local council targets (some report targets of 50% of people taking up personal budgets by 2011), take up is still unknown. This makes it difficult for local authorities to plan very effectively for Individual Budgets beyond one or two years ahead. However, organisations can still prepare by costing up all services in units, and be ready for when the specifications come out. Managing the impact on cash flow will be key where lots of small payments come in instead of a block contract.

We will need new strategic alliances with other organisations to deliver services at an effective economic scale.

When day services are no longer block funded how will Age Concerns deliver these services?

Whilst direct payments work successfully for many people with disabilities, many older people do not want to take on an employer role. There are good models around in the co-operative sector than enable participation of users but which take the burden of employment responsibilities off them. On the other hand, families may take on the role of employer – they are competitors for funding too.

There is still a low take up of Individual Budgets by older people, this could give Age Concerns time to create new strategies for delivery in the future – innovating new services and day activities.

Will carers be allocated Individual Budgets? We don’t know yet, but if they are, will Age Concerns be in a position to provide some of the services they might require? Many carers are older people themselves and have specific needs and preferences – Age Concern has a wealth of experience in understanding those needs and might be able to remove the burden of responsibility from those who may find it difficult to cope.

Self funders have needs too – the concept of need (but we’re also talking about ‘aspirations’ now rather than ‘need’ – what is the kind of life I’d like to lead? then organise the things I need to make it happen) doesn’t just apply to those people eligible for state support. Are there good examples of where Age Concerns have uncovered the needs and aspirations of self funders, and marketed successfully to them?

Age Concern Health & Social Care Partnership briefing states that:

“Age Concern should explore how they can become, and be perceived by others as, organisations of older people, not just for older people”

echoing the success of the disability rights movement (and the government mantra of ‘co-production’, i.e. people who help shape their own services). If this becomes the case, service users will need to become in control of the organisation through formal governance. Alzheimer’s Society and Scope have made great strides forward with this by genuinely incorporating users into the governance process. What do Age Concerns do locally and can they do more?

The Darzi report will consider how personal budgets could work in healthcare – there may be opportunities for Age Concerns here, and a pilot in early 2009 might add to these.

The Society of Procurement Officers is well versed in social enterprise and how they can procure social enterprise services, due to effective lobbying on the part of the social enterprise subsector. Does your organisation understand social enterprise and its requirements sufficiently if you are going to enter this market and tender successfully?

‘More for your money’ produced by SOPO is a guide that procurement officers use in order to understand purchasing from social enterprises and building a social enterprise supply base. Although aimed at services provided by local authorities in 2004/5 this publication does set out the mindset of procurement officers in relation to social enterprise, and also offers some care service examples. It also talks about stimulating the market for social enterprise, again offering useful insights.

There is a real challenge for Age Concern organisations (and others that work with older people) that are used to block purchasing and receiving clients by referral in this agenda. The emphasis on individual funding and needing to market to individuals means we need to think about services in a different way, engaging with self funders, delivering differently, and making services sustainable. There will need to be economies of scale for Age Concerns to make the figures stack up, so business models need to be quite different to before.

One of the many issues is the need for advocacy, navigation and representation for users around the system – but who will pay organisations for it?

Age Concerns can start by trying to influence service arrangements in the short to medium term. This is best done by negotiating with local authorities (Las) over an appropriate period of time. Organisations will need to find out the local authority planning schedule to ensure that their negotiations fit in with the LA planning cycle, in order to ensure significant change takes place.