Pickup: Huge scope of social care duties means BCF is not enough

The LGA has called on the government to not forget that adult social care does not only cater for elderly people – in fact, more than 40% of the budget is spent on adults aged between 18-64, with 35% being spent on people with learning disabilities alone.

During a Public Accounts Committee (PAC) hearing earlier this week about the integration of health and social care, Sarah Pickup, deputy chief executive of the LGA, revealed these figures in the latest call to government for fresh funding for adult social care – and reminded the committee that adults with complex needs and learning disabilities should not be left out of the social care provision debate.

Pickup went on to argue that social care encompassed a “huge set of issues”, and that the government’s Better Care Fund “did not get to the nub of the problem”.

“The problem with always thinking that by putting some money in, we will get some improvements and better things, is that we are just plugging a gap in money that has been taken away, while demand is rising,” she told MPs.

The LGA today reinforced this message, with Cllr Izzi Seccombe, chair of the LGA’s Community Wellbeing Board, saying: “Social care is about far more than just supporting our older citizens. It is about meeting a wide range of different support needs, affecting people of all ages. These include the thousands of people with learning disabilities who rely on care and support from their local council on a daily basis.

“But without new money, the support provided to adults with learning disabilities and those other groups who have care needs will be seriously under threat. We need the government to deliver a long-term, sustainable solution to solve the social care funding crisis, and not more short-term fixes.

“A young person with a learning disability who has their whole life ahead of them needs to know they have a social care system that will be there for them in the decades ahead.”

Cllr Seccombe also echoed the point that year-on-year “sticking plasters” were not the solution to ensuring adults with learning disabilities lead “dignified independent lives”.

“Councils face a real financial challenge to provide the best possible support for growing numbers of people with learning disabilities who rightly want care services to help them live their life as they see fit,” she added.

“But the system is now on the brink of collapse, and we call on government to do the right thing and use the Spring Budget to inject genuinely new money into adult social care.”

This point was reinforced by Rossanna Trudgian, head of campaigns at Mencap, a learning disability charity, who said: “The demands placed on our critically under-funded and under-resourced social care system are growing from all groups, including people with a learning disability. Despite this it has taken too long to acknowledge the social care crisis, meaning the sector is now in need of an urgent injection of funding to avoid collapsing.

“The current lack of funding for the sector means people with a learning disability are struggling to access the care and support they desperately need to ensure they are able to maintain their health, live independent lives or find employment and instead are stuck at home becoming increasingly isolated and worried about the future.

“Short-term solutions such as the social care precept are inadequate and will fail to bring the sector back from breaking point, the funding gap is too big.”

Trudgian also called on the chancellor, Phillip Hammond, to make social care a priority in the Spring Budget next Wednesday, describing it as a “real opportunity” to avoid increasing numbers of people missing out on support and edging closer into poverty and sickness.

Health and social care integration

Health and social care integration has long been touted as a way of easing pressure on the waning adult social care budget.

But NHS England has consistently emphasised that while integration has the potential to be successful, new funds are also required rather than a reallocation of funds from pots such as the Better Care Fund.

Its chief executive, Simon Stevens, said during the PAC inquiry: “We are conflating integration with social care funding and availability.

“You need a properly resourced social care system, and you need proper joint working at all the hand-off points and for key client groups that are doing health and social care. Just doing one is not a substitute for the other.”

However, some government figures present at the hearing remained sceptical about the benefits of integration altogether, with Karin Smyth, Labour MP, asking: “Why on earth are we putting more money into integration when there is no evidence to suggest that it works?”

Jo Farrar, director general of local government and public services at the DCLG, argued that further evidence was needed to be sure that integration was having an effect on improving social care.

“The point is that this is early days and we are still gathering evidence,” she said. “We are not saying that integration isn’t a good thing. Integration is a good thing. Older people want to have one point of contact, and to do that they need one assessment number.”

Chris Wormald, the Department of Health’s permanent secretary, backed her up, admitting that the National Audit Office had correctly observed that the evidence base around integration worldwide “is not great”.

“That is just a fact. That is one of the reasons why we are doing the evaluations that Jo was describing earlier. I don’t think anyone seriously doubts that having one identification number for the same patient when they are shared across local government and the NHS is better than having two,” he explained.

“I don’t think anyone seriously doubts that having one assessor rather than several is a better thing.”

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