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All eyes on the Budget

Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), looks ahead at the upcoming Autumn Budget to assess what needs to be done to fix the ailing social care market.

Apparently one of the most watched programmes on Channel 4 this year featured a group of young children spending time with the residents of a care home. It was uplifting viewing, demonstrating the great good that happens in care settings throughout the country and the common bonds that unite all generations irrespective of age. ‘Old People’s Home for 4 Year Olds’ offers a timely reminder of the value of good social care at a time when the system is creaking. This year’s budget survey leaves no doubt of the intense financial pressures on local authorities and providers. And no one can be happy that one in five registered services are assessed by CQC as inadequate or requiring improvement.

ADASS is pleased that the government recognises that something must be done. All eyes now rest on the chancellor’s Budget and the consultation on the future of adult social care that the government has promised. The £2bn additional money announced in the last Budget was warmly welcomed, but will not meet all of the extra costs arising from the National Living Wage and rising levels of need, never mind addressing the bigger funding and workforce issues experienced by providers. That is why the government has acknowledged that longer-term reform both of funding and delivery is needed.

Its promised consultation needs to set out a full range of options to place funding on a more sustainable footing and addresses the needs of people of all ages. Whilst it is right that people with savings and property should face protection from catastrophic care costs, the needs of younger disabled people who have never been able to acquire savings or property should also be central to a new funding deal. As the furor during the election campaign showed, the choices about where extra money should come from are politically very difficult. But recent evidence of support from MPs across the political spectrum for a cross-party approach is encouraging.

The importance of a mature and constructive relationship with our NHS partners has never been more important – we face a shared challenge of demand outstripping resources and the need to develop a much more joined-up approach that focuses on prevention and reduces the need for admissions to hospitals and long-term care. ADASS will continue to work hard with the NHS to reduce delayed transfers of care, recognising that these are but one symptom of the failure of the whole system to offer individuals the right care, in the right place, at the right time.

That the biggest single cause of delays is waiting for packages of care at home should alert us to the dangers of hitting a target, but misses the point. Many of the operational pressures faced by the NHS and local government are underpinned by deeper-seated challenges that demand the wider transformation of the health and care system. This will require the full engagement of local government in sustainability and transformation partnerships. The emergence of accountable care systems creates real opportunities to develop a place-based approach, but again, the involvement of adult social care and other key local government services, such as public health, must be designed in from the outset.

Numerous white papers and green papers over the last decades have failed to achieve lasting reform of adult social care. Expectations were raised when the Conservative election manifesto declared that ‘where others have failed to lead, we will act.’ The government must now follow through on this in the forthcoming consultation process. ADASS stands ready to work with the government to build a better social care system that is fit for the 21st century.




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