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Leaders pile more pressure on May for urgent social care reform

Despite the extra social care money introduced in the Spring Budget, only a staggering 7% of directors are confident that planned savings for 2019-20 will be met, with even less than that feeling at all optimistic about the future financial situation of the health and care economy in their area.

Other similarly eye-watering findings were included in this year’s ADASS Budget Survey, which painted a picture of a sector led by directors consistently voicing major concerns about the sustainability of the market going forward.

Failure within the provider market affected at least 69% of councils in the last six months, and 74% of respondents argue providers are facing quality challenges.

Because of reduced budgets and the race to make unrealistic amounts of savings, spend on prevention – the “most important priority area” in order to cut down on future need – will fall to just 6.3% of the total cash pot this year.

“The opportunity to invest in prevention to reduce future demand is being hampered by the need to help those with greatest and immediate need – those who we have a statutory duty towards,” said Margaret Willcox, president of ADASS.

“With providers continuing to close or return contracts back to councils, more people are struggling to access the care they need and depend on. To help remedy this worrying situation, the new government needs to tackle the chronic underfunding of adult social care which still remains on a cliff edge.”

Councils are having to make 8% cuts in overall budgets for a second year in succession due to increasing costs, and directors plan to make further savings of £824m this financial year – bringing cumulative savings since 2010 to a whopping £6.3bn.

But these savings are proving impossible against a reported overspend of £366m against 2016-17 budgets. Only 31% of the ADASS survey respondents are fully confident that planned savings for this year will be met, with this figure plummeting to a worrying 7% in 2019-20.

The care market itself is also shifting. For the first time ever, financial pressures due to the increasing care needs of younger adults with disabilities or mental health problems have surpassed those linked to older people.

In almost all areas, the existing Better Care Fund (BCF) is providing no more resources in real terms, with the ADASS report stating: “It is important to note that the BCF has not provided much more benefit in budgetary terms to local authorities to protect adult social care beyond the original government decision in 2010 to transfer resources from the NHS.”

In 2017-18, as before, most of the BCF cash will be used to avoid spending cuts in existing services rather than investing in prevention or transformation. Around a third of directors fear there will be no adequate protection through the BCF in the coming year.

Richard Humphries, senior fellow at the King’s Fund, also highlighted the survey’s finding that only one-third of councils are planning to spend new BCF funding on measures to speed up the discharge of patients from hospital, which he argued “echoes similar findings yesterday from NHS leaders”.

The government must act now

“Given the huge pressures facing social care services, expecting this money to double up by coming to the aid of the NHS was always likely to prove to be a triumph of hope over expectation,” said Humphries.

“The government’s forthcoming consultation paper on social care must set out costed options for putting the system on a sustainable footing, and in doing so strike a fair balance between public and private funding.

“Successive administrations have ducked this challenge, but the government must follow through on its commitment to act ‘where others have failed to lead’ by tackling one of the burning injustices of our time.”

The LGA agreed that the government must step up to the plate, given that higher funding does not remove existing demand, costs and difficulties from services.

Cllr Izzi Seccombe, its Community Wellbeing Board chair, added that the survey demonstrated local authorities are doing everything they can to protect budgets, but further savings “inevitably” need to be made.

“The government should set out in detail its proposals at the earliest opportunity for how it will close the funding gap and deliver a long-term sustainable funding solution for social care,” she argued. “Adult social care is at a tipping point, and unless urgent action is taken we will continue to see more and more of the consequences of underfunding that we have seen in recent years, particularly care providers either handing back contracts to councils or ceasing trading altogether.”