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Almost 80% of councils spend more on social care than devolved GM

If Greater Manchester (GM) was a single unitary authority, it would be ranked in the bottom third nationally for its social care user satisfaction – and around 77% of local authorities with social care responsibility would be spending more on their services than the devolved region.

In board papers published ahead of a meeting this Friday, GM Health and Social Care Partnership (GMHSCP) outlined the findings of a “rapid review” of social care performance its joint commissioning board had ordered during a meeting on 15 November last year.

The outputs of the review were intended to provide an overview of GM’s current performance and indicate the issues that need to be prioritise within its ongoing transformation plan.

Amongst other key findings, the review found that if the GM’s 10 local authorities were taken as a unitary, its spend per head on social care user would be in the 23rd percentile countrywide – meaning 77% of councils that provide care would actually be spending more.

“Within GM there is significant variation, but at an aggregate level GM would have needed to spend £79m more on social care in 2015-16 to meet the England average,” the papers explained.

Again taken as a unitary, GM would be ranked in the bottom third for service user satisfaction, meaning 71% of local authorities would have recorded better levels of satisfaction.

It would also be in the bottom quartile for the quality of its residential and nursing care, as well as for quality of domiciliary care. If performance moved to the third quartile instead, 7,500 more people would be receiving better care in residential and nursing provision.

These stark findings are significant given that GM is the country’s frontrunner in terms of health and social care devolution, having received a £6bn devolved package from Whitehall last financial year.

It has also reiterated time and again that social care is critical to the successful delivery of its transformation plan, ‘Taking Charge’, and the achievement of clinical and financial sustainability. In fact, previous board papers had already warned that a faltering social care system could end up undermining GM’s transformational efforts over the next 18 months, and potentially jeopardise the achievement of NHS savings during this Parliament.

“If the financial gap in GM is to be bridged, then a social care offer that looks beyond traditional boundaries has to be designed and mobilised,” read the latest GMHSCP board papers.

“Social care, both publicly and privately funded, is an integral part of delivery of community-based models of care. These models are being designed to provide effective alternatives to hospital-based care, and will support GM in achieving its objective of treating as many residents in the community as is possible, significantly reducing the number of people in acute settings that could be treated more effectively closer to home.”

Nationwide, councils are all calling for a cash boost in the social care market – but were left disappointed by this week’s local government finance settlement, which confirmed there would be no fresh funding to the system.

Within GM, the funding gap has been calculated at £81m just in 2016-17, rising to a whopping £241m by 2020-21. The latest work, as set out in its STP submission last year, shows a remaining gap of £176m just for social care.

“The increasing demands on the social care system – including demographic pressure and increased costs to implement the National Living Wage – are a contributory factor to a significant increase in delayed discharges, unprecedented pressure on the Urgent and Emergency Care system, delays in accessing mental health services, reductions in vital preventative services, and significant market challenges in both domiciliary and residential home provision,” added GMHSCP’s Steven Pleasant, who penned the board papers.

But despite the negative findings of the region’s latest review, which demonstrates “the need for a co-ordinated transformation of adult social care”, it also confirmed that there are “strong examples of innovative responses to care challenges and service user needs” across all 10 localities.

“Responding to the variation and performance challenges evident in the baseline analysis, and building on good practice from GM and elsewhere, the adult social care transformation programme will focus on priorities that improve outcomes for some of the most vulnerable members of the population,” the paper said.

More information on the region’s transformation priorities for its social care system, including plans for a “radical transformation” of public services and collaboration, can be found in its Adult Social Care Transformation Plan.


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