11.10.16
Integration alone ‘will not solve challenges of social care’
The social care system will need more funding as well as integrated care to be sustainable, sector leaders have told MPs.
In an appearance before the Communities and Local Government Committee, Ray James, immediate past president of the Association of Directors of Adult Social Services (ADASS), said: “I don’t think there is evidence anywhere in the world that integration alone will solve the scale of the challenges we face in adult and social care. It has to be both – adequate resources and integration.
“I don’t think you can get away from the fact that this system is not sustainable with the current assumptions about GDP and levels of funding when you look at demand going forward.”
A recent report from the King’s Fund and the Nuffield Trust said that the care system is “failing” because of its increasingly unsustainable finances.
Sarah Pickup, deputy chief executive of the LGA, said that social care funding would stay at the same amount from 2009-2010 to 2019-20, meaning it was facing “10 years of flat cash for social care in the face of demographic pressures, inflation, deprivation of liberty safeguards, the social care act and all the other pressures and expectations that have come our way”.
She pointed out that existing measures the government has promised for raising social care funding will not be enough to address the shortfall.
Pickup added that the LGA had calculated that even if every council brings in the new social care precept in full, new pressures on the social care sector would still cost £1.3bn more than the precept would provide.
“We see a gap even if everybody did what was necessary in full,” she said, “and that forward gap is only the forward gap, it doesn’t fund the existing pressures in the system.”
Pickup also said that while the Better Care Fund had allowed some local health economies to “think differently”, it was hard to do in areas where the council and the CCG were very financially challenged.
“It’s not sufficient on its own,” she said. “It’s a very small settlement to spend. Integration has got to go way beyond the Better Care Fund, we’ve got to think about community infrastructure, and about primary care being sufficient to prevent those numbers rising in the future.
James said that the Better Care Fund wasn’t new funding, but was “existing money within the system that we were being rightly challenged to think about how we might use to best effect”.
The Department of Health has ignored councils’ pleas to bring forward the Better Care Fund, with just £138m being delivered in 2016-17 despite councils saying they need £700m.
A recent Public Administration and Constitutional Affairs Committee report also warned that the fund will only be delivered via the New Homes Bonus, which it called “an extraordinary way to deliver essential public services”.
Pickup said that properly planned devolution might deliver the necessary funding for social care, including “empowering” health services to make decisions without “override”.
Regarding the devolution of business rates to councils, she said: “If we get the distribution method right, we may have a sustainable solution. If every penny of the resource is spent taking on new responsibilities, we will need central government funding.”
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