Council cash squeeze means country faces ‘no realistic prospect of progress’ for integrated care

The government is still “a long way” from achieving an effective strategy for integrated health and social care and progress has been blocked by a “council squeeze,” MPs say.

In a report by the Public Accounts Committee (PAC), they warned that despite “a lot of talk within government” over how to accelerate the process, there is “no realistic prospect of progress” in integrating the health and social care sectors.

The MPs say the financial squeeze on councils has blocked progress, with financial pressures and an ageing population increasing the need for joined-up care.

Real-term local authority spending on adult social care has decreased by 5.3% between 2010-11 and 2016-17, whilst the number of people in England aged 85 and over has increased by 28% from 2006 to 2016.

The PAC has also urged the government to set out a costed 10-year plan for social care alongside the 10-year plan for the NHS.

Meg Hillier, chair of PAC, said: “The time for warm words and wishful thinking is over. If government is serious about delivering the benefits of integrated health and social care, it must act to make it happen.

“Social care has suffered long-term underfunding and it is unacceptable that councils, under considerable financial pressure and facing growing demand for care services, must wait until 2020 for clarity.”

The report acknowledged that lots of government discussions have taken place, with 12 white papers, green papers and consultations, as well as five independent reviews, in the last 20 years.

Renaming the government department was a positive sign of intent, yet the report found no strategy to achieve the long-term aim to integrate the two sectors.

Hillier continued: “Government must also step up efforts to break down barriers to integration across the country.

“There remains a wide gap in pay and career structure between people who work in the NHS and those in social care, whose workforce suffers from low pay and low esteem.

“As I have said previously, social care is skilled work that transforms people’s lives. It could and should be a source of national pride.”

Chair of the LGA’s Association’s Community Wellbeing Board, Ian Hudspeth, said: “Councils are determined to do all they can to ensure that exceptional, joined up, person-centred care and support is delivered in their communities.

“But with adult social care now consuming almost 40% of council budgets and facing a shortfall in funding of £3.5bn by 2025, the need for a long-term funding plan for adult social care has never been so urgent – the government must either outline this in the upcoming budget, or the green paper on social care.”

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