Atoc said the number of journeys made by passengers with a Disabled Person’s Railcard had more than trebled in the past 15 years to 3.5 million a year.

It claimed the rise could be attributed to the discount card and improvements made by train companies.

But campaign groups said more needed to be done to help disabled travellers.

The Disabled Person’s Card – held by 130,000 people in the UK – reduces the price of most tickets by a third.

Atoc said there had been “significant improvements in facilities and services” on trains and at stations.

They included interactive maps of all 2,500 stations in the UK; passengers being able to book assistance if they bought tickets and reserved seats in advance; and improvements to trains, such as removing slamming doors.

David Sindall, Atoc’s head of disability and inclusion, said: “Accessible public transport plays a key role in allowing disabled people to lead an independent life, so it’s good news that more and more people are taking advantage of the railcard.”

He said “huge progress” had been made in improving rail services for disabled people over the past 30 years but added that train companies were “committed to responding to passengers’ needs and will continue to work closely with disability charities and support groups to improve services even further”.

Charity Leonard Cheshire Disability said “simple and inexpensive changes” could be made, such as working more with disabled people, to ensure more people could travel by train.

“This would not only open up the customer base, but also help to create UK train services that everyone can use,” the charity said.

The charity’s Hannah Hollingworth said: “We hear stories from disabled people of being stepped over in train carriages, trapped in toilets, and having to wait a long time for assistance.”

Campaign group Passenger Focus carried out research into support for disabled passengers, particularly looking at help in reserving seats.

Director David Sidebottom said they found a “mixed bag of service for passengers needing assistance” and more needed to be done to improve the system.

“We found there had been some improvements between 2008 and 2010 but there was still inconsistencies in delivering the service.”

The Age UK report said £7.3bn was being budgeted this year – the same as in 2011 – but it represented a drop of 4.5% once inflation was taken into account.

The charity said the squeeze meant thousands were missing out on care.

But ministers said there should be enough money available to avoid cuts.

The report, based on official data plus Age UK’s own research, comes amid mounting concern about the state of social care, which includes help in the home with activities such as washing and dressing as well as residential care places.

Ministers have promised to publish plans in the spring to reform the system to ensure it is sustainable in the long term.

But following the Spending Review in 2010, they said extra funds would be made available for social care – including money from the NHS budget – to help councils out.

This is because of the wider cuts to local government funding – over the next four years its budget from central government will be reduced by a quarter, leading to cuts in everything from leisure centres to libraries, which are being seen across the country.

The Age UK report argues that despite the extra money social care has not been able to escape unscathed from the cuts programme.

The analysis shows that councils are reducing spending by 4.5% – £341m in monetary terms.

But the report said that if rising demand from the ageing population were taken into account, the drop would be closer to £500m.

And the charity predicted the situation would get even worse in the coming years.

The report said the squeeze on spending had led councils to restrict access to services as well as increasing the fees they charged – only the poorest got their care completely free.

Age UK believes there are 2m people in England with care needs, 800,000 of whom are not getting any formal support.

Michelle Mitchell, charity director of Age UK, said: “Behind these figures are real older people struggling to cope without the support they need, compromising their dignity and safety on a daily basis.

“Social care is not a nice-to-have extra – it is the support that helps older people get out of bed, feed themselves, have a wash and live a life that is more than just an existence.”

Care services minister Paul Burstow said: “We believe councils have enough to maintain the current levels of access and eligibility but they will need to work hard and smart, and invest in things like telecare and re-ablement [helping people regain skills] to free up more money for front-line services.”

But he said he recognised the system needed improving for the future and that was why a White Paper would be published in the spring.

David Rogers, of the Local Government Association, said councils were doing the best they could.

“These figures highlight what we already know – there isn’t enough money in the system and without fundamental reform the situation is only going to get worse.”

Shadow care services minister Liz Kendall said: “This report provides yet more evidence that there is a growing crisis in care for older people.”

Blackfriars Befriending can provide a trained volunteer who will come around have a chat, share a cup of tea and provide help and support.

The befrienders can also help you get out and about and provide information about local groups, services, transport and activities in your area.

If you know of someone who would like to find out about the befriending service please contact Sophia on 020 7928 9521 or sophia.appleby@blackfriars-settlement.org.uk

The Forget Me Not Diary Club is a fun meeting to exercise brains and boost memories; a mixture of memory games, singalongs, storytelling, crosswords and diary filling.

The club is held every Tuesday afternoon from 14:00 to 16:00

If you are interested please call Tina on 0207 928 9521

The Disabled Facilities Grant is worth a total of £200 million this year, and is awarded to pay for adaptations such as grab rails, accessible bathroom or kitchen facilities, wheelchair ramps, etc. The extra funds were announced by Grant Shapps, the Housing Minister, as part of a £51 million programme to support independent living.

He said: “As we get older the last thing we want is for our properties to become our prisons. That’s why today I’m offering a new deal for older people, backed with millions of pounds of Government cash, to ensure elderly residents get the support they need to live independently and comfortably in their own homes for as long as they can, with particular support for those leaving hospital.”

By providing extra funds for Home Improvement Agencies, they want to help ensure that people can access reliable tradespeople to carry out necessary alterations and installations, rather than risk being ripped off by ‘rogue traders’. If you would like to find your local Home Improvement Agency, you can do so on the Foundations website

Local councils will also be obliged to ensure suitable numbers of accessible properties are included in their future housing plans as part of the government’s proposals.

But, as the Department of Health (DH) delighted in pointing out once it had studied the detail of the BMA’s poll, just 7.2% of its membership are ready to actually strike – a miniscule figure by comparison. And only 30.1% believe the coalition’s proposed changes to the NHS pension scheme to be so iniquitous that they should be rejected altogether. And of course the turnout for the BMA’s survey was just 36%, raising obvious questions about how representative it is.

No government ever relishes confrontation with doctors, the most trusted profession. But the DH clearly feels that not just right, but also public opinion, is on its side. It points out: “Doctors and consultants who are among the highest earners in the NHS have benefited hugely from the current final salary scheme arrangements compared to other staff groups. Under the current scheme, a typical consultant retiring at age 60 will receive a pension of over £48,000 a year for life. In addition they will receive a tax free lump sum of around £143,000 – this equates to a pension pot of over £1.7m in the private sector.” Such arrangements are now “unsustainable”, it adds, gambling that defending such lucrative rewards will prove difficult for a well-paid profession, despite the public’s general admiration of doctors’ qualities.

Doctors’ leaders are used to getting their own way when they flex their muscles, whoever is in power. But Labour ignored the profession’s protests to impose patient-friendly longer GP surgery opening times, while Andrew Lansley’s decision to pay almost no heed at all of the BMA’s opposition to his health and social care bill should have ended any lingering BMA belief that it enjoys automatic influence. It is hard to predict where this developing impasse over pensions will end. With a coalition climbdown, or at least sufficient further concessions to persuade medics to back down? Unlikely. Or with the first industrial action by doctors since 1975, when junior doctors took action over their contracts? That now seems unavoidable.

Meldrum says the pension shakeup is “the final straw” for doctors who are about to enter the fourth year of a pay freeze and, in England, are having to contend with a £20bn NHS savings drive and an unpopular restructuring of the system which few think is necessary. Doctors are angry, he says, as they will be “hit hard” because “the amount deducted from their pay for their pensions will go up this April, with further rises in 2013 and 2014″.

“Those at the start of their careers face the prospect of paying over £200,000 in additional lifetime contributions. The normal pension age would increase, with many having to work to the age of 68 before being able to draw a full pension. And the current final salary scheme would be replaced with a new career average scheme, which would leave most doctors with worse overall benefits,” he says. A scheme revised as recently as 2008 should be left well alone, Meldrum adds.

Doctors have a mixed record on getting what they want on the rare occasions they get worked up enough to consider industrial action. In 1990, when Ken Clarke was health secretary, there was much disgruntlement at a proposed new GP contract. But the BMA Council decided not to hold a ballot. In 1975 there was industrial action, by junior doctors angry at their new contracts; agreement on a new deal was reached a month later after ministers decided to resume negotiations. The year before, Barbara Castle tried to stop consultants in the NHS from undertaking private work on top. So consultants took action between January and April that year, suspending goodwill activities and sticking to the letter of their contracts – much medical work relies on doctors performing extra-contractual tasks – which ultimately led to peace breaking out and a deal.

However, the two major health unions which did not ballot their members before the pensions day of action last November – the BMA and the Royal College of Nursing – are now both, very reluctantly, set to do that some time soon. Both say that all the talking so far with ministers and officials has got them nowhere, and that in effect they are being pushed into balloting on industrial action. Nurses have never taken strike action, but that is a growing possibility. That cautious organisations such as the BMA and RCN are now being pushed into the same camp as the more predictable anti-pensions Unison and Unite unions will test doctors’ and nurses’ unity, but could ultimately pose a tougher test for ministers.

The two charities have been in detailed negotiations for the past 18 months and, subject to the remaining formal and regulatory steps, the new charity will be operational from 1 April 2012, with a public launch in the summer.

Crossroads Care and The Princess Royal Trust for Carers have a strong history of working together, with a number of jointly funded posts and a range of successful fundraising and policy campaigns.

The new charity, which is yet to be named, will build on the experience and expertise of its two founder charities to work towards its vision of a world where the role and contribution of unpaid carers is recognised and they have access to the quality support and services they need to live their own lives.

Andrew Cozens, former Vice-Chair at The Princess Royal Trust for Carers, has been appointed as Chair of the new charity. Mark Currie joins the board as Treasurer, a role he has been carrying out at Crossroads Care for the past two years. Recruitment of a Chief Executive for the new charity is now underway.

Her Royal Highness, The Princess Royal, has agreed to be President of the new charity, a role she has held at The Trust since it formed in 1991.

Commenting on the announcement, Andrew Cozens said: “We are delighted that The Princess Royal will be President of the new charity, which continues her long support for carers.

“Both of the founder charities place carers and carers support at their heart and this will be at the core of the new organisation. The work undertaken by Crossroads Care and The Princess Royal Trust for Carers is complementary and they have a well known and respected track record of working together.

“While both are doing great work independently in supporting carers, it became apparent that so much more could be achieved, both now and in the future, if the two came together to create a new charity.

“Doing so will give us a single, stronger voice with which to raise greater awareness of the issues that carers face, as well as the money needed to sustain existing, and develop new, services for carers.”

Both charities’ networks will continue to provide support to carers under their local brands, and are not expected to merge locally as a result of the national merger.

The Prime Minister’s  been saying a lot on domestic policy recently. I wonder if he was saving it all up over the Christmas break, making notes in between his turkey and plum duff. He’s been wading in on a few issues which he normally leaves to others, which have  hit a bit close to home on the caring front.

Over the weekend he made what was apparently an off the cuff quip about Tourette’s syndrome. Maybe some people found it funny, but I bet people with Tourette’s and their families didn’t. Most people with a disability will tell you about the names they’ve been called  or the humiliation they’ve had to put up with, just because they look different, need different things, talk differently, behave differently. Making fun of someone’s disability  to score a couple of laughs just isn’t on, and if you’re the Prime Minister, frankly, you should know better. Zero points, Mr Cameron, for disability awareness.

And  last weekend he was on about health and social care and how they need to be more joined up. He wants to make it a priority, as care in England  is too fragmented .

I’m delighted he’s taking an interest. We desperately need our political leadership to social care right at the top of the list as a major priority to be addressed. He’s absolutely right that the artificial boundaries between health and social care make no sense and act as a barrier. I can’t tell you the number of times I speak to carers who are stuck in the middle, making never ending phone calls to different departments trying to put together all the pieces of the jigsaw puzzle. It’s no wonder carers don’t access support for themselves- by the time they’ve got the essentials in place for the person they care for, they’re exhausted, just can’t face it, or think there’s no blooming point.

But it is a bit odd, all the same. We’ve been talking about joined up care for as long as I can remember. We have pooled budgets which are supposed to mean health and social services plan  together. We have jointly agreed care plans and in some places care trusts which bring all the services together. And whilst there are successes,  they’re there because the local leadership pushes it and people on the ground are fully, root and branch, committed to making it work. In many places it’s still very much  a case of the right hand having no clue what the left hand is doing.

At the same time, the Health and Social Care Bill drives policy in the opposite direction – removing more and more central direction, and removing the need to have the same boundaries for health and care authorities. We lobbied hard on this, including talking to the PM about it directly,  because  where families need to work with multiple services – for example,  adults and children services, health trusts, education services, all at the same time –  creating extra confusion doesn’t  help and people who are the most disadvantaged get missed.  The reorganisation which health services will have to go through following the Health and Social Care Bill is going to make things a lot worse at least in the short term. I’m worried about how we will make sure everyone gets what they need whilst the NHS is trying to figure out who’s in charge and who works for who.

It’s fantastic that the PM  has spoken about the importance of social care, and of integration. If we can find ways of achieving better joined up working, let’s do it. But I’m worried that his comments suggest that if we all try a bit harder to work together then the social care system might turn out not to be quite so broke and therefore not need fixing, meaning we can shelve the difficult decisions for another day. No matter how much integration there is, social care in England needs reform and needs more funding. Let’s keep our focus there.

We currently have spaces in two of these groups and are looking for people to join us.

• The Stroke Club meets every week on Wednesdays between 1.00 – 3.00pm and is for people who have suffered a stroke and their carers.
• The Visually Impaired Group meets on alternate Thursdays from 1.00 – 3.00pm and is aimed at people who have any kind of visual impairment.

Both groups provide a varied programme of activities including informative presentations, chair based exercise, screening of films and trips out to go bowling and to visit local museums and entertainment, as a well as a chance to socialise with people who are facing the same kinds of issues.

Both groups are mixed and are aimed at those over 50. If you would like to come along to either group please contact Mbuyisa Maphalala on 020 7232 5667

mbuyisa.maphala@timeandtalents.org.uk

Chris Linacre says the work capability assessment made her feel as though she was regarded as someone ‘just milking the state’.

A detailed year-long study into the coalition government’s controversial work capability assessments (WCAs) has revealed new evidence of widespread inaccuracies in the medical reports that help to determine whether individuals are eligible for sickness benefits.

The research, conducted by the charity Citizens Advice, identified a group of people about to embark on the process of claiming employment and support allowance (ESA), which replaces incapacity benefit, and followed them throughout the process from the summer of 2010, looking at how their claims were handled and the accuracy of the medical assessments.

The report’s conclusions are stark: of the 37 individual reports examined, 16 (43%) revealed “serious levels of inaccuracy”, and a further 10 contained a “medium level of inaccuracy”, a level still significant enough to have an impact on the claimants’ eligibility for benefits. Only 11 were entirely accurate or had a low level of inaccuracy.

The study, Right First Time?, is the latest in a series of reports highlighting the unreliability of the complex new system, which is meant to determine who is sufficiently fit to work and who is eligible for state benefits. However, the Citizens Advice report is the first attempt to follow a group of claimants through the process, looking in detail at the way they were treated by Atos, the firm contracted to carry out the work capability tests, and analysing how its report matched up with the claimants’ assessment of their medical state.

Fear and loathing

Last summer, the Commons work and pensions select committee said the very mention of Atos Healthcare triggered “fear and loathing” among claimants, and concluded that there had been “failings” in the service provided by the company, which had “often fallen short of what claimants can rightly expect”. One MP on the committee described the process as “disastrous”. Disability charities, meanwhile, have been very critical of the company’s record since the new policy was launched in October 2008. Some terminally ill cancer patients have been told they are fit for work, while other claimants have died from their conditions shortly after being found fit for work (a parliamentary question recently revealed that 31 people had died while awaiting their appeal in the three years to last October).

Chris Linacre, who was not part of the Citizens Advice study, is appealing against a decision not to grant her sickness benefits, based on an Atos assessment last October at which she was awarded zero points and classified as totally fit for work. Problems with her spine since her 20s and arthritis mean she was forced seven years ago to give up a long career in adult education, when the pain made it impossible for her to continue with her job.

“They [Atos] said I could lift my leg 70 degrees above the ground. I can’t do that; even if I lift my leg two inches I’m in excruciating pain,” says Linacre. “It said I appeared to have no difficulty in removing my coat; I should have told them how much pain I was in. The report said I had a normal grip, but I can’t use a tin opener or peel a potato. It said the muscle tone on my left leg was normal, but I haven’t been able to drive a manual car for 12 years because of a weakness in my left leg.”

Linacre says she told the assessor that she did most of her shopping online, although she was able to go the shops in an emergency, but would be in great pain. The report stated that she had no problems going to the shop to buy milk and walking around for 10 minutes.

“I think they expect you to be a Beano cartoon character, with ouch bubbles above your head, but people tend to be stoic. I try not to labour the fact that I’m in pain. I wasn’t going to tell them that some days I can’t even put my knickers on I’m in so much pain,” she says. She had a strong work ethic, but she says her experience with the Atos assessment made her feel as though they saw her “as someone who is just milking the state”.

Vicky Pearlman, Citizens Advice disability benefits policy officer, says: “Inaccurate medical assessment reports risk undermining the government’s welfare reform programme. They create huge difficulties for seriously ill and disabled people who are wrongly found ‘fit for work’ when they are not.”

The low rate of accuracy is worrying disability campaigners because the reports used in deciding who should get ESA are also increasingly used to determine entitlement to disability living allowance (DLA) and other benefits. If the government’s welfare reforms go ahead as planned, next year the award of ESA will become the main route to all future disability related support. The medical assessment report itself will play a much greater role in deciding entitlement to personal independence payment (PIP) – the successor to DLA.

Because so many claimants believe that their medical reports have been inaccurate, there was a 56% rise in ESA and incapacity benefit appeals received by the tribunals service in 2010/11 and there is a long backlog of cases waiting to be heard. The most recent appeal figures show that 39% of appeals against decisions not to award ESA are overturned in the claimant’s favour.

The Citizens Advice study cites an example where the claimant told the assessor that he was unable to get dressed or shower without help; he later received a summary of the medical report, stating that he managed to “dress and undress without help or aids”. In another test, a claimant, who is registered blind, was required to undergo a sight test, and, in a third case, the assessor under-reported the number of times a diabetic person experienced hypoglycaemic episodes, thus making the claimant not eligible for benefit.

Radically improved

A Department for Work and Pensions spokeswoman says the report does not acknowledge the ongoing changes to the assessment system, designed to iron out some of its flaws. “It is in everyone’s interest to get the WCA right, which is why it has been radically improved over the last two years. The system is far better than it was, and we will continue to keep it under review and refine it further.”

An independent and ongoing review of the first five years of the WCA is being conducted – at the request of the government – by Malcolm Harrington, a former professor of occupational health at the University of Birmingham. The government is introducing the improvements he recommended in his first report in 2010. But claimants are still seeking help with similar issues related to inaccurate reports, despite the changes implemented.

The Citizens Advice report recommends that the government should consider imposing financial penalties on Atos for every inaccurate report it produces, and also suggests independent monitoring of the accuracy of the medical assessments.

An Atos spokeswoman says: “Atos Healthcare will be carefully considering Citizens Advice’s report. The second Harrington report [published last year] acknowledged the improvements made since the assessments referenced were undertaken, and we hope to work with Citizens Advice in the year ahead to drive further improvements in how work capability assessments are carried out.”