Councils may have to reduce access to care without funding reform, says Adass’s Sarah Pickup
By Mithran Samuel, Thursday 14 June 2012
Councils are due to make about £2bn in adult care funding cuts from 2011-13 in response to the government’s deficit reduction plan, the Association of Directors of Adult Social Services has revealed.
Directors representing 145 of the 152 authorities in England are due to make £890m in savings this year, found Adass’s annual budget survey. This is in addition to £991m in savings identified in last year’s Adass survey covering 2011-12, the first year of the government’s cuts programme.
Directors say 77% of this year’s reductions (£688m) will be achieved through service re-design and efficiency savings; of the rest, £77m will come from increased charges for services and £113m (13%) from reducing levels of services. For instance, six councils have raised their eligibility thresholds from moderate to substantial.
‘Desperate need’ for reform
Adass warned that service reductions would increase as a percentage of overall savings without government action to introduce a sustainable social care funding system, as councils were having to balance declining budgets against increasing demographic pressures and rising costs of care.
“It could not be clearer that there is a desperate need for politicians from all parties quickly to find an answer to how we, as a nation, are going to adequately fund social care services in the future,” said Adass president Sarah Pickup. Without this, she said, there was a “real risk that access to care will have to be restricted”, and fees to providers “squeezed further with a risk to ongoing capacity and quality of care”.
Her comments come weeks before the government produces a White Paper on adult care that is expected to sidestep both the issue of existing shortfalls in resources and the proposals for longer-term reform set out by the Dilnot commission last year, which include a £35,000 cap on lifetime care costs.
NHS funding ‘propping up’ care services
Concerns were also raised about how councils planned to spend resources transferred from the NHS, designed to fund social care services that benefited the health service and promote integration between the two services. Adass found that 35% of resources transferred in 2012-13 had been allocated to avoid social care service cuts and 12% to deal with funding pressures.
“It is significant that nearly half the money allocated from the NHS budget to improve joint working between health and social care is being spent on propping up existing services and mitigating the impact of budget cuts,” said King’s Fund senior fellow Richard Humphries. “Using NHS funding as a sticking plaster does not address the pressures facing social care.”
“This survey reinforces the need to move much more quickly to achieve closer integration between health and social care and deliver a long-term funding settlement for social care based on the proposals set out by the Dilnot Commission.”
Behind the Adass figures
The 145 directors surveyed plan to spend about £13.2bn in 2012-13 between them, having spent £13.4bn in 2011-12. The reason this £200m budget reduction is significantly smaller than the £890m of savings allocated is that councils have put in money to the adult social care budget to cover the impact of inflation and demographic pressures.
It is reasonable to talk in terms of an £890m reduction in adult social care spending, rather than a £200m reduction, as the money to cover inflation and demography is designed, in effect, to help councils “stand still”.
Compared with last year, councils have found a greater proportion of savings from service redesign, 77% up from 69%, and a reduced proportion from service cuts, 13% down from 23%.
Directors surveyed are already earmarking savings for 2013-14 (£480m) and 2014-15 (£340m), both years in which government funding for councils will fall. It is also worth stressing that the totals in the survey reflect the responses of 145 authorities, 95% of the total. So the totals spent – and saved – by all 152 authorities will be greater.