Care funding cuts could lead to a ‘terminal’ impact on services and hold back health integration, report warns

CCN News 2016 | 08 November 2016

Default Post Feature

Just one in ten adult social care directors believe their budgets are now manageable, as the Government is warned care funding cuts in county areas could soon be ‘terminal.’

Today, the County Councils Network publishes a new report, Delivering Adult Social Care in Challenging Times, outlining the issues and funding pressures facing county authorities in delivering this key frontline service, potentially leaving thousands of vulnerable people without the care and support to maintain their independence.

The results of a survey contained in the report from county directors of adult social care (ASC) reveals that 88% believe their budgets to be either ‘severe’ or ‘critical’, and only 12% say current funding levels are ‘manageable’.

It is yet more evidence ahead of the Autumn Statement on the brittle nature of the social care system in England.

The survey also reveals that just one in five ASC directors believe Sustainability and Transformation Plans (STPs) will fulfil their objective to ensure services are sustainable in the coming years. And they cite insufficient funding, as well as conflicting targets and incentives, as impeding health and social care integration.

The report shows that social care pressures are most acute in county areas – CCN member councils have the oldest and fastest-growing elderly populations, yet funding has proportionately reduced for counties at a higher rate than any other local authority type. As a consequence, overspend in social care means that some county authorities will struggle to deliver a balanced budget before the end of this Parliament.

The impact of this rising demand and falling budgets in county areas has a knock-on effect within the public sector. CCN members have seen a 68% increase in the number of delayed discharges within the month from April 2014 to July 2016, higher than in any other local authority area – costing the NHS millions.

Ahead of the report launch, CCN has written to the Chancellor and Health Secretary on behalf of county authorities to request he brings forward at least £700million of the Better Care Fund to 2017/18, to address the funding crisis now.

The letter ahead of the Autumn Statement, signed by the CCN Chairman Cllr Paul Carter, said:

“It is vital we work together to find a sensible and sustainable way forward. If we proceed on the current trajectory, I fear the impact on frontline social care services in counties will be terminal. This will potentially leave some of the most vulnerable people in our society without the care and support they need to maintain their independence and dignity.”

CCN added if there is scope for reducing deficit reduction targets, any additional funding for public services is targeted towards social care funding to stabilise local services for residents, care markets for providers, and reduce the knock-on burden on for the NHS.

CCN’s spokesman for Health & Social Care and leader of Suffolk County Council, Colin Noble, said:

“CCN has released this report at a time when adult social care is at a crossroads. The current route is unsustainable – the fact that only one in ten directors believe their budgets are manageable is a stark summary of the current situation.

“The scale of the financial challenge ahead is evidenced in the fact that many councils will struggle to deliver a balanced budget by the end of this Parliament. This should not be mistaken as financial mismanagement; county authorities are contending with an impossible situation of seeing budgets reduce at a quicker pace than other councils, while coping with the biggest and fastest growing elderly population.

“Therefore, it is imperative that Government recognise the extreme pressures faced by county authorities sooner rather than later, to give councils a fighting chance of maintaining high-quality care services. If not, thousands of residents who deserve these services may lose the support they cherish, and the impact on the wider public sector will continue to intensify.”

The report also calls upon Government to reform NHS incentives in order to shift the funding received by providers away from rewarding contacts with patients, to promoting prevention, early intervention and integration. This change is vital for an integrated health and social care system to deliver care in the most appropriate and effective surrounding for local residents.

The results of CCN’s survey also highlights growing concerns from ASC directors on health and social care integration, which is mirrors that of the sector. The overwhelming barriers to integration, they believe, are conflicting targets and incentives, and misaligned financial settlements between health and social care – which is why CCN is calling for reformed incentives and a frontloaded BCF so it is not out of sync with NHS funding.

Almost half – 42% – of ASC directors felt their local authority had been actively involved in the development of their area’s STP, and 77% believe STPs will fail on the aim of ensuring services are sustainable.

Cllr Noble added:

“The Government’s ambition is to integrate health and social care by 2020, but as our survey shows, directors have little faith that STPs are the silver bullet for sustainable services. Delivering sustainable integration will be hampered by the extreme financial pressures and misaligned incentives and funding, unless the Government looks into solving these issues now.”