You can't fix the NHS without fixing social care, Streeting warned
Speaking in Commons on Thursday, Edward Argar warned Wes Streeting he risks failing to 'seize the genuine opportunity' presented by the plan if social care is not also reformed.
There were also calls to bring forward the end date of the Casey Commission, which aims to set out a plan to implement a national care service, in order to go 'further and faster' on social care.
Mr Argar said: 'Unless we move faster to adjust the challenges of social care and put it on a sustainable footing, these reforms risk failing to seize the genuine opportunity presented.'
Mr Streeting said: 'We're not waiting for Casey. The Spending Review gave an additional £4 billion to social care, and we're delivering the biggest expansion of carers allowance since the 1970s, significant increase in the disabled facilities grant.
'And the deputy prime minister and I will shortly be setting out how we will deliver the first ever fair pay agreements for the care workforce, building a real social care progression.'
The Casey Commission launched earlier this year, with the first phase expected to report in 2026, although recommendations from the initial probe will be implemented in phases over the course of 10 years.
Social care leaders have raised concerns over the potential timeline of 2036 for some reforms to be introduced.
The second phase of the commission, setting out longer-term reforms, is due to report by 2028.
Mr Streeting said social care 'has to be part' of neighbourhood health, adding: 'In the context of this plan, social care features because it has a role to play on admission avoidance and speeding up delayed discharges.'
Chancellor Rachel Reeves, Prime Minister Sir Keir Starmer and Health Secretary Wes Streeting (Jack Hill/The Times/PA)
Helen Morgan, Liberal Democrat MP for North Shropshire, said a plan for the future of the NHS is 'welcome' but sought reassurance on social care.
'In 143 pages of the 10-year plan, there is only a passing reference to social care,' she said.
'Everyone knows that you can't fix the NHS without fixing social care.
'With so many people unable to return home from hospital to get the care they need, solving the crisis in social care is a huge part of moving care out of hospital and into the community.'
Mr Streeting said: 'I hope the house is reassured by the action we've already taken on social care, that's greater funding, the expansion of carers allowance, increasing the disabled facilities grant, the Fair Pay agreements, and the role and the partnership that we will see with social care to deliver better neighbourhood health services.
'And I should also say, especially in the context of what we've been describing about the importance of data and digital connections and better systems, in some parts of the country the social care system is actually ahead of the NHS, making better use of data, joining up systems in a more effective and efficient way.
'And there's lots that the NHS can learn from social care as well as the other way around.'
The chief executive of Care England, Professor Martin Green, also warned that the NHS 'cannot deliver this vision alone'.
'If adult social care is not put at the centre of delivery – not just as a partner, but as a leader – this plan will falter,' he added.
'The plan speaks to a future we've already been building. But vision alone isn't enough. Providers need clarity, investment, and status.
'Without a clear role for adult social care, this plan will leave a gap between policy and reality.'
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Scottish Sun
40 minutes ago
- Scottish Sun
The truth behind a dramatic rise in autism – and why it could be catastrophic, says Dr Rebecca Ker
Plus, take the 10-question test to discover if you might have it RISING TIDE The truth behind a dramatic rise in autism – and why it could be catastrophic, says Dr Rebecca Ker IF you've spent any time on social media, you'll likely have come across videos titled 'the signs you're autistic' and 'why autism is to blame' for any number of behaviours or personality traits. This content has become so prolific it's pushed thousands of people to seek an official diagnosis. But is autism really becoming more common, and if so, is TikTok the only factor driving the surge? Advertisement 3 Dr Rebecca Ker, a psychologist who specialises in neurodivergent people and their families, reveals why the rise in autism diagnoses could be catastrophic Credit: Dr Rebecca Ker About 700,000 people in the UK are thought to have autism - a lifelong condition that affects how people experience and interact with the world. But influencers might have you assuming that number is far higher. There are now 3.2million posts about autism on TikTok alone. Many of these are inaccurate, but it is true that diagnoses are on the rise. Advertisement Rates are up 787 per cent in England from 1998 to 2018, and experts warn the NHS is 'overwhelmed' by the influx. Here, Dr Rebecca Ker, a psychologist registered with the Health and Care Professions Council and co-founder of Carlton Psychology in Surrey who specialises in supporting neurodivergent people and their families, reveals what's behind the dramatic increase - and why it could prove catastrophic. EARLIER this year, US Health Secretary Robert F Kennedy Jr promised a 'massive' research effort involving hundreds of scientists to get to the bottom of what he calls an autism 'epidemic'. Yet after more than 15 years working with autistic children, adults and families, the only epidemic I can see is one of fear-mongering and stigma. We've not suddenly 'caught' autism. Autism isn't an illness. It doesn't need a cure. It is a term that describes areas of difference - some disabling, some brilliant. Advertisement Yes, autism rates have increased hugely - by 787 per cent in England over the past 20 years. Simple 10-question test that can help determine if you have autism When autism was first discussed in the 1940s, it was thought to affect one in every 2,500 people. Today, research suggests it could be more like one in 30. The reality is, that rise is down to our greater awareness and understanding of the condition and a broadening of the diagnostic criteria we use to define it. For starters, we're better at realising the nuances and subtleties of the condition and the broad spectrum of people who are autistic. That greater understanding has also been informed by the autistic community themselves. Advertisement There are some brilliant brains out there, advocating, educating, and finally being heard in a way they never were in the 1950s. We meet lots of parents bringing their children to clinics who are beginning to realise they might be autistic too. Often they grew up with a very different understanding of what autism is. THE NEW DEFINITION Secondly, when the DSM-5 - the guidebook psychologists use to classify conditions - was updated in 2013, it removed Asperger syndrome as a separate diagnosis and folded it into the wider autism spectrum. Autism spectrum disorder is currently defined as 'persistent difficulties with social communication, social interaction, restricted and repetitive patterns of behaviour (including sensory difficulties), and it has to be present from early childhood to the extent that these limit and impair everyday functioning'. Advertisement The criteria is broad. For example 'restrictive and repetitive behaviours' could look like lots of things, from rocking, hand-flapping and skin-picking to sticking to a strict routine or eating the same food every evening. For one person, difficulties with social communication might look like difficulties with picking up on the social cues of the person they are speaking to. For another person, it might mean being completely non-verbal. Autistic minds often thrive on sameness, predictability and routine. They have a real need for sameness. But here's the problem. While understanding has moved on, support systems are struggling to keep up. The latest NHS England figures, covering the period ending March 2025, show the number of patients waiting at least three months for an initial specialist appointment has jumped by more than a quarter since last year. That figure has also tripled since 2021. Advertisement In total, nearly 124,000 under-18s are on the waiting list for over three months - almost 30,000 more than the year before. 3 The diagnostic guidelines for autism have changed Credit: Getty NHS guidelines say patients should be seen within 13 weeks. But nine in 10 wait much longer. And those who did get assessed last year? They'd already been waiting, on average, a year and a half. And a diagnosis is often just the start… it doesn't automatically unlock the necessary support. Advertisement In my experience in Surrey, it's not unusual for children to wait years. That's years of growing up without support and without understanding. Changing schools. Falling behind. Developing anxiety. And it's not just children. Last year, the Oxfordshire Adult Autism Diagnostic and Support Service stopped taking new referrals altogether. Adults being referred at that time were told they'd have to wait 18 years. If you're one of those families stuck on a waiting list, it can feel impossible. You're worried, your child is struggling, and you're being told to just wait and keep waiting. But even without a diagnosis, there is support out there. Please don't let schools tell you everything's fine just because your child is quiet or well-behaved there. Masking is real and it's exhausting. The children who cope at school often fall apart at home Dr Rebecca Ker While many end up seeking support privately, there are national charities and helplines available too. Advertisement Families need faster access to specialists to provide clarity, tools, and reassurance. Someone who understands neurodivergence can help you notice patterns, validate your concerns, and work with you on practical steps that reduce stress and improve connection. If you are concerned that your child is autistic, keep a journal of behaviours that concern you. Record exactly what triggers meltdowns, how you have noticed your child differs from their peers, how they respond to change, what their social interactions look like. Be as specific as you can. Advertisement Take that evidence to your child's teacher or SENCO. Ask for support plans, even without a diagnosis. Speak to your GP, or if your child's under five, your health visitor. The key characteristics of autism - and why they go unnoticed By Alice Fuller, Health Features Editor MODEL Christine McGuinness was a 'recluse' for eight years and only left the house at 3am. Springwatch presenter Chris Packham says it makes him a 'task-centric workaholic who sees problems in everything he does'. And recently, Bella Ramsey revealed they were diagnosed after struggling to wear thermals on the set of The Last of Us. But what exactly is autism and why does it seem so different in everyone? Leanne Cooper-Brown, neurodevelopmental lead at Clinical Partners, tells Sun Health: 'Autism is considered a spectrum, so not all people share the same traits. 'Whereas we used to think of autism as a linear line, we have come to realise that terms such as 'high' and 'low' functioning or definitions of 'mild', 'moderate' or 'severe' aren't helpful and can be misleading. 'Nowadays, we think of autism in terms of the strengths and needs of the individual, which can change over time depending on their environment and support network.' About 700,000 people in the UK are thought to have autism - that's one in 100. But research by University College London suggests that number could be twice as high, as many people remain undiagnosed. Cases are on the rise though. Figures released last year showed a 175 per cent increase from 2011 to 2022. Dr Selina Warlow, clinical psychologist and owner of The Nook Neurodevelopmental Clinic, says: 'Conversation around neurodiversity is becoming normalised, and that's so positive to see. But more awareness is needed. 'Receiving a diagnosis can open access to expert resources that support autistic people to thrive in society.' Autism has long been associated with social difficulties, like problems maintaining conversations and forming relationships. But research published in the journal Cell Press suggested that repetitive behaviours - like rocking or finger-flicking - and special interests - whether it's TV shows or specific animals - are more indicative of an autism diagnosis. Generally though, experts say the core characteristics include… Sensitivity - autistic people can be much more or less sensitive to sights, sounds, textures, tastes and smells. For example, they find bright lights or crowded spaces overwhelming, Leanne says. They may also stand too close to others or need to move their whole body to look at something. - autistic people can be much more or less sensitive to sights, sounds, textures, tastes and smells. For example, they find bright lights or crowded spaces overwhelming, Leanne says. They may also stand too close to others or need to move their whole body to look at something. Stimming - to manage this sensory overload, some people use repetitive movements or sounds. 'This is called stimming, and includes rocking, tapping and hand-flapping,' Dr Warlow says. 'Though it's something everyone does to some extent, those with autism are likely to engage with it as a form of self-regulation.' - to manage this sensory overload, some people use repetitive movements or sounds. 'This is called stimming, and includes rocking, tapping and hand-flapping,' Dr Warlow says. 'Though it's something everyone does to some extent, those with autism are likely to engage with it as a form of self-regulation.' Masking - this is a strategy used by some autistic people, consciously or not, to match neurotypical people, Dr Warlow says. 'It's a way of hiding your true characteristics, and could involve copying facial expressions, planning conversations in advance, or holding in 'stimming' - swapping hand clapping with playing with a pen, for example,' she adds. - this is a strategy used by some autistic people, consciously or not, to match neurotypical people, Dr Warlow says. 'It's a way of hiding your true characteristics, and could involve copying facial expressions, planning conversations in advance, or holding in 'stimming' - swapping hand clapping with playing with a pen, for example,' she adds. Burnout - this is a state of physical, mental and emotional exhaustion and is a common feature in autism. 'Being extremely tired, both mentally and physically, can be associated with the act of masking for a long period of time, or sensory or social overload,' Dr Warlow says. 'Symptoms of autistic burnout include social withdrawal, reduced performance and increased sensitivity.' - this is a state of physical, mental and emotional exhaustion and is a common feature in autism. 'Being extremely tired, both mentally and physically, can be associated with the act of masking for a long period of time, or sensory or social overload,' Dr Warlow says. 'Symptoms of autistic burnout include social withdrawal, reduced performance and increased sensitivity.' Social struggles - socialising can be confusing or tiring for autistic people. They often find it hard to understand what others are thinking or feeling, making it challenging to make friends. Leanne says: 'In adults, autism may present as difficulties with interpreting social cues such as understanding body language or sarcasm, struggling to express emotions or preferring to be alone. This can impact relationships and work.' - socialising can be confusing or tiring for autistic people. They often find it hard to understand what others are thinking or feeling, making it challenging to make friends. Leanne says: 'In adults, autism may present as difficulties with interpreting social cues such as understanding body language or sarcasm, struggling to express emotions or preferring to be alone. This can impact relationships and work.' Routine - many of us have a fairly regular daily schedule. But for autistic people, this becomes a 'very strong preference for routine', Leanne says. This could be needing a daily timetable to know what is going to happen and when, or having rigid preferences about foods or clothing. - many of us have a fairly regular daily schedule. But for autistic people, this becomes a 'very strong preference for routine', Leanne says. This could be needing a daily timetable to know what is going to happen and when, or having rigid preferences about foods or clothing. Literal thinking - some autistic people have a literal view of language - like believing it's actually 'raining cats and dogs' or that someone really wants you to 'break a leg'. Dr Warlow says: 'This can result in confusion with figures of speech, irony or indirect requests. 'For instance, being told to 'pull your socks up' might be understood literally, not as a motivational phrase.' - some autistic people have a literal view of language - like believing it's actually 'raining cats and dogs' or that someone really wants you to 'break a leg'. Dr Warlow says: 'This can result in confusion with figures of speech, irony or indirect requests. 'For instance, being told to 'pull your socks up' might be understood literally, not as a motivational phrase.' Hyperfocus - often associated with ADHD, hyperfocusing is also common in autistic people. 'It's where you're able to focus intensely on an activity and become absorbed to the point of forgetting about time,' Dr Warlow says. 'This is useful in work or hobbies but can result in neglect of other aspects of life, such as food or rest.' - often associated with ADHD, hyperfocusing is also common in autistic people. 'It's where you're able to focus intensely on an activity and become absorbed to the point of forgetting about time,' Dr Warlow says. 'This is useful in work or hobbies but can result in neglect of other aspects of life, such as food or rest.' Special interests - we all have hobbies and interests, but for autistic people, these are so compelling they often want to spend all their time learning about, thinking about or doing them. 'Special interests could include anything from dinosaurs to superheroes, and gardening to music,' Dr Warlow says. 'These usually begin in childhood, but can also form as an adult. 'Chris Packham is an example of an autistic person who turned his childhood special interest in animals into a successful career, becoming one of the UK's best-loved natural world TV presenters.' Please don't let schools tell you everything's fine just because your child is quiet or well-behaved there. Masking is real and it's exhausting. The children who cope at school often fall apart at home. If you can afford to explore a private assessment, be cautious. Advertisement There are brilliant services out there, but it can be overwhelming choosing a private provider that is offering the best quality in terms of assessment. A good autism assessment is a lot of work. It should involve a multidisciplinary team - not one person sitting with your child for half an hour. The specialists should be Health and Care Professions Council registered. The process should follow National Institute for Health and Care Excellence guidelines. They should draw information from different contexts (observing your child themselves, talking to school, interviewing parents) and produce a detailed report that can stand up when you need it - for school support, Education, Health and Care Plans, or future care. 3 Dr Ker says parents are 'too often dismissed' when they raise concerns about their children Credit: Getty Advertisement Let's stop talking about trying to 'reduce' autism. That's not the goal. Instead, we need to be building a more accessible world, where people can say: 'I'm neurodivergent. I am more comfortable doing it this way.' That means changing how we run our education system and services. Just as we build wheelchair ramps, and would view a lack of ramps to be unacceptable, we should be building sensory-friendly classrooms, alternative timetables, and flexible expectations. We need to train teachers to understand neurodivergent minds. Advertisement We need to provide the funding for more capable systems that can enable all types of brains to reach their potential. Too often, quiet girls or rule-following boys are told they're 'fine' while they suffer silently. Too often, parents are dismissed as 'overly anxious'. But often there are signs - a child who is exhausted after school, struggles with transitions, is inflexible in their play, feels different or confused by peers, complains the dining hall is too loud or smelly to be able to eat. The 10-question autism test TO get an official autism diagnosis, you need to be assessed by a healthcare professional. But if you think your or your child might have the condition, there is a simple quiz called the AQ-10 that you can use to help support your suspicions. The assessment tool — used by NHS doctors — does not confirm whether you are on the spectrum. Instead, it is used to screen people who might be. A version for children is also available. For adults For each question, write down if you 'Definitely Agree', 'Slightly Agree', 'Slightly Disagree' or 'Definitely Agree'. I often notice small sounds when others do not I usually concentrate more on the whole picture, rather than the small details I find it easy to do more than one thing at once If there is an interruption, I can switch back to what I was doing very quickly I find it easy to 'read between the lines' when someone is talking to me I know how to tell if someone listening to me is getting bored When I'm reading a story I find it difficult to work out the characters' intentions I like to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plant etc) I find it easy to work out what someone is thinking or feeling just by looking at their face I find it difficult to work out people's intentions Score 1 point for 'Definitely Agree' or 'Slightly Agree' on each of items 1, 7, 8, and 10. Score 1 point for 'Definitely Disagree' or 'Slightly Disagree' on each of items 2, 3, 4, 5, 6, and 9. If you score more than 6 out of 10, a healthcare professional will consider referring you for a specialist diagnostic assessment. For children For each question, write down if you 'Definitely Agree', 'Slightly Agree', 'Slightly Disagree' or 'Definitely Agree'. S/he often notices small sounds when others do not S/he usually concentrates more on the whole picture, rather than the small details In a social group, s/he can easily keep track of several different people's conversations S/he finds it easy to go back and forth between different activities S/he doesn't know how to keep a conversation going with his/her peers S/he is good at social chit-chat When s/he is read a story, s/he finds it difficult to work out the character's intentions or feelings When s/he was in preschool, s/he used to enjoy playing games involving pretending with other children S/he finds it easy to work out what someone is thinking or feeling just by looking at their face S/he finds it hard to make new friends Only 1 point can be scored for each question. Score 1 point for 'Definitely Agree' or 'Slightly Agree' on each of items 1, 5, 7 and 10. Score 1 point for 'Definitely Disagree' or 'Slightly Disagree' on each of items 2, 3, 4, 6, 8 and 9. If the individual scores more than 6 out of 10, they will be considered for a specialist diagnostic assessment. None of these on their own mean a child is autistic, but we should be sensitive to the clues. Advertisement With adults, the process is more complex. You don't always have parents to describe childhood behaviours. But what we see again and again is this: they've been masking their whole lives. They've been told they're too much, too blunt, too rude. They've often experienced long term difficulties with their mental health or been misdiagnosed with personality disorders, anxiety disorders, eating disorders and so on. Difficulties with mental ill-health are more prevalent in autistic people. These are all signs that it is hard to be autistic in a world that is geared up for neurotypical people. They've made it through work or university by sheer effort - but at a cost. Burnout. Depression. Exhaustion. Advertisement And often, the moment they receive that diagnosis? It's a relief. At last, something makes sense. 'Not everyone is neurodivergent, but everyone is neurodiverse' So yes, autism is a difference. But it's a difference we've punished, misunderstood and ignored for far too long. The DSM-5 still calls it a disorder. But many autistic people find this term offensive and prefer the word 'difference' or 'condition'. And I agree. It isn't an illness. And there are many strengths associated with autism too. We all have different brains. Neurodiversity is a natural part of human variation - just like height or handedness. Advertisement Not everyone is neurodivergent, but everyone is neurodiverse. So when Kennedy Jr says autism is worse than Covid, he isn't just wrong - he's dangerous. His words fuel a climate of panic, shame and disinformation. And for what? To blame vaccines? To stir controversy? There's no medical basis for that claim. But what there is is a growing body of knowledge. Of compassion. And of people - autistic people - finally being seen, heard, and supported.
South Wales Argus
an hour ago
- South Wales Argus
First doctors in UK to graduate through part-time study celebrate
The University of Edinburgh group has completed an 'innovative' five-year programme, known as HCP-Med for Healthcare Professionals, which aims to offer people already working in health the flexibility to become doctors. It is open exclusively to existing healthcare professionals, clinical scientists and veterinary surgeons living and working in Scotland. The course has been designed to address the increasing demand on the healthcare workforce in Scotland and has a strong emphasis on GP placements. Graduate Calum MacDonald with his wife Debbie and daughter Freya (Douglas Robertson/PA) The first three years of the undergraduate course are conducted part-time and mainly online, so that students can study in their own time while balancing work and other commitments. After completing their remote studies, students then join the university's full-time undergraduate medical programme for the final two years and carry out a range of clinical placements in GP practice and hospital wards. Dr Jen Kennedy, programme director HCP-MED, said: 'We have lots of incredibly talented people working within the NHS in Scotland who may have missed the traditional route to become doctors. 'By creating this new pathway and widening access to medical degrees, we are able to nurture their talent and use their valuable experience to enhance the healthcare workforce.' Calum MacDonald, who started his career as a staff nurse in an intensive care unit in Glasgow, is part of the first cohort of students who graduated from the programme on Saturday. His experience working in intensive care and subsequent training to become an advanced critical care practitioner, a role he has held since 2016, led him to consider a career as a doctor. He became a father in his second year of the course and the programme enabled him to stay in Glasgow and balance work with part time study and family life. Now a newly qualified doctor, he has secured a foundation post in Glasgow and will rotate across seven specialties. He said: 'I'm very proud to fly the flag for the HCP-Med programme – it's been a challenging but incredibly rewarding journey. 'Being able to continue working as a nurse while studying medicine was a huge financial incentive. I am delighted to be graduating today and am excited to start my placement as a junior doctor in Glasgow.' He is considering specialising in anaesthetics or general practice. Alongside the part-time study, students receive full funding from the Scottish Funding Council which the university said makes it an attractive route to retrain for those already working within the healthcare industry. Professor David Kluth, head of Edinburgh Medical School, said: 'I am very proud that Edinburgh is the first university in the UK to offer this innovative part-time programme. 'We are committed to doing all we can to empower individuals to reach their full potential and to widen access to medicine for future generations. 'The students on this programme bring with them a rich diversity of backgrounds, experiences and skills – from prior careers to lived experience of the communities they will serve. 'This breadth of talent and perspective is vital in building a more inclusive, adaptable, and effective medical workforce for Scotland.'
Daily Record
2 hours ago
- Daily Record
Man, 102, becomes oldest in Britain to be given Viagra on the NHS
A man of 102 is the oldest in Britain to be given Viagra on the NHS, as figures show a record number of over-80s have been prescribed the drug in the last year. A 102 year old man has become the oldest person in Britain to receive Viagra on the NHS. He stands out in statistics revealing a record-breaking 250,000 prescriptions of the drug were given to those over 80 last year, although this figure could be just the very beginning, with more senior Romeos potentially purchasing the bedroom aid privately. Our scrutiny of figures from 106 clinical commissioning groups across England disclosed the NHS prescribed a staggering 4.71 million courses last year to boost men's performance – costing £16.9 million. Those in their sixties topped the charts for receiving the most number of the renowned "blue pill," used to combat erectile dysfunction. These findings emerge as online dating services and hookup applications are increasingly welcoming to seniors seeking intimate encounters. The most well-known geriatric user of Viagra was Hugh Hefner, the founder of Playboy magazine, who enjoyed legendary get-togethers with his Playmates at opulent residences. Hefner passed away in 2017 at age 91, with his hearing impairment allegedly linked to his use of these pills – other potential adverse effects include colour blindness and vertigo. Sildenafil, the key compound in Viagra, was originally crafted in the 1990s as a medication for pulmonary arterial hypertension, reports the Mirror. The active ingredient was also discovered to block the breakdown of a molecule that increases blood flow in various parts of the body, potentially resulting in arousal that could last up to two hours. The UK has seen the launch of Hezkue, a novel oral spray to battle erectile dysfunction that retails for £60. According to NHS guidance, sildenafil is generally safe for most men over 18 to use, but those who have recently suffered from a heart attack or stroke are cautioned due to heightened risk of adverse effects. Offering his insights on mature users of Viagra, Professor of Sociology at the University of Kent, Frank Furedi, observed: "Contemporary culture sends out the signal that sex is for life. A lot of elderly man feel they must have a full-on sex life by any means necessary. They are fast becoming 'generation Viagra'."
