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Social care has reduced pressures on the NHS, now the pressures must reduce on care too

Source: PSE Oct/Nov 2018

Glen Garrod, president of the Association of Directors of Adult Social Services (ADASS), explores the thorny issue of funding ahead of the government’s forthcoming green paper.

As the voice of social care teams across the country, ADASS is determined to help social care teams deliver care which both reduces pressure on our NHS and helps people live as independently as possible. This will also help us ensure that people are admitted to hospital only when necessary, allowing frontline health service colleagues to get on with the job in hand.

Social care enables this by providing the person-centred essential care where people need it, which occurs mostly in their own home. The skilled and dedicated social care workforce has done a tremendous job over the last year with limited resources, saving the NHS almost £60m by keeping people out of hospital. This demonstrates the ability of social care to make an impact.

However, when not one adult social care director is confident in meeting their statutory duties across the country, it’s clear that we have a crisis in care and that continued progress to reduce delayed transfers of care from hospital is at risk. It’s essential that the government builds on the work of ADASS, the LGA and others in the sector, and delivers the green paper – which must contain a long-term funding solution – as soon as possible.

In the meantime, however, urgent and immediate funding is needed to help social care keep on track with the pressures being faced and, in turn, reduce those pressures on the NHS. The best way to help people live as independently as possible, for as long as possible, is to provide effective support in the communities in which they live. 

We know the impact that adult social care can play – ADASS’ recent estimates are that it has saved the NHS almost £60m through reducing pressures.

Social care, which delivers care in home and community-based settings, is essential for encouraging older people and adults with disabilities to live as independently as possible, keep them out of hospital, and thus reduce demand on the NHS.

Since the introduction of relatively small annual cash injections from 2017-18, the number of delays to transfers of care – time wasted when people are unable to leave hospital owing to a lack of somewhere suitable to receive support – attributable to social care has fallen dramatically by 41%, from a high of 74,228 last March to 40,209 this June.

The NHS’s excess bed days calculations put the saving per day of having one extra bed available in hospital throughout 2016-17 at £313.

Over the last year, the number of delayed transfers of care days attributable to adult social care has fallen by 187,864, meaning that there has been a reduction of almost £60m in NHS costs as a result of improved adult social care performance when compared to the previous 12 months.

The NHS is celebrating its 70th birthday this year, and it does an incredible job looking after people in need of care. In recent years the health service has performed brilliantly, despite increased pressures from an ageing population and diminished resources. ADASS would like funds to also be supplied to social care so the two sectors can ensure people get emergency treatment when needed, but live as independently as possible.

That’s why we are calling for the government to urgently bring forward a long-term funding solution for adult social care in its forthcoming green paper, and in the meantime to supply interim funding to help the sector cope with its current pressures.

In addition, the analysis found:

  • The average cost of residential care is £91.10 per day, which is £221.90 cheaper than an excess bed day in hospital. This demonstrates the significant savings that social care can offer the taxpayer, aside from the fact that it provides tailored care at home and in the community, where people would rather have it;
  • The cost of delivering the 2016-17 excess bed days in hospital was nearly £254m. If these had been provided through residential care, that cost would have been significantly less, at almost £74m;
  • For 2017-18, the cost of providing excess bed days in hospital would have been £195m, which would have fallen in residential care to nearly £57m.

ADASS believes that supporting people’s wellbeing at home needs to be a huge focus of care provision going forward. The best way to reduce pressure on hospitals is to provide care which means people don’t end up sick or injured and needing hospital in the first place. With an overall significant increase in attendances and admissions to A&E generally, the need for interim funding to be supplied to social care to reduce the pressure on the NHS is urgent – and this funding must also be supplied to community services and primary care.

Recently, stakeholders from across the sector have been putting forward plans which could address funding shortfalls in adult social care – with the LGA growing so frustrated as to publish its own green paper, outlining a range of possible options government should consider in order to place social care on a sustainable footing.

ADASS is now joining these calls with a renewed push for a green paper that delivers a long-term funding solution. We’re also advocating on social media and have recently unveiled an animation detailing the scale of the social care crisis and the need for urgent funding.

With long-term funding plans and an emergency cash injection to shore up the sector, councils could make a real difference in creating the conditions for people to live as independently as possible for as long as possible. Together with the excellent work of NHS teams in treating people, ADASS is determined to deliver a collaborative approach which can not only reduce NHS pressures, but support the health service by delivering treatment that is person-centred and individualistic.

But without at least some short-term emergency funding, pressures on the NHS could grow, meaning increased funding for the health service could be throwing money at the symptoms of the problem rather than tackling the underlying causes of the situation. As a minimum, local authorities should have greater influence when it comes to determining how money is spent on primary, community and mental health services.


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