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Acute care resources must be redirected into community care - ADASS

Funding must be transferred from acute care to community and preventative care in order to reduce the financial pressures on social care, the vice president of the Association of Directors of Adult Social Services (ADASS) has said.

Speaking at a debate at the Health+Care Conference in London, Margaret Wilcox warned that social care is facing acute funding pressures.

She said that according to the latest calculations, the ageing population will cost social services £1.5bn - £2bn by the end of the year, the National Living Wage, which is currently being reviewed by the Department of Health, will cost £1.6bn in the next three years and deprivation of liberty safeguards assessments will cost £176m.

“From ADASS’s perspective, we have to stop and reverse the reliance on acute care and redirect some of those resources into prevention and acute care,” said Wilcox.

She added that existing initiatives to finance social care would not be enough. She said that the Better Care Fund would not supply the money needed, whilst the social care precept on council tax suffers from the problem that council tax is lower in areas of greater need, and in many councils is dependent on decisions taken after local elections next year.

Wilcox added: “While we welcome the Spending Review, it’s too little too late because we won’t see any of the real money by 2020, by which time we will have had five years of reductions”, saying that social care budgets have already been cut by 33% over the past five years.

She also said the care sector needs one million extra care workers in the next five years, but may not recruit them because the field is not “a very attractive career prospect.”

Wilcox said that the best approach to social care funding was to “think of the money as one pot”, adding that Gloucestershire County Council, where she works, has pioneered the idea of the ‘Gloucestershire pound’, where funding is seen as one pound that has to be divided among Gloucestershire services.

Integrated care challenges

She warned that one of the greatest challenges to delivering integrated care would be the mismatch in terms of funding, since health care is free at the point of delivery but social care is means tested.

Tom Jackson, chief finance officer and deputy chief officer at NHS Liverpool CCG, who also spoke on the panel, agreed that greater integration was needed.

Speaking about sustainability and transformation plans (STPs), he said: “They’ve got to be a bit more ambitious. Especially, they’ve got to include some of the challenges facing social care.”

However, Wilcox added that social care has made progress in the past five years, particularly in the area of more personalised care, and this was important to maintain in integration of services.

“If the best measure of future behaviour is past behaviour, then we have managed to make the savings so far,” she said. “I think where people are happy is that the things they get, whether it’s a direct payment or a personal assistant or a service that’s delivered to them from the provider agency, that range now is so much greater for so many people that it feels much more personal because its’ more tailored to their needs.

“If we are going to make this work then we have to match that with the resources, and I think that one of the things that colleagues in the health service may not understand is that the responsibility for social care is protecting vulnerable people and meeting the needs that other services can’t meet.

“That’s not necessarily to say that a local authority has to meet all of those substantial critical needs. If we can get that balance right, then we can survive. I think the mistake will be if we lose the ambition to have services that are tailored around the individual and their families and carers.”


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