The UK’s leading adult social care directors have issued a stark warning that chronic underfunding is undermining the Government’s health reforms, as councils are forced to slash preventative services and focus solely on crisis care.
According to the ADASS annual survey, local authorities have cut spending on early intervention by over 10% this year, despite the Government’s emphasis on neighbourhood health and prevention. The shift is being driven by spiralling costs and rising demand for complex care, leaving councils with no choice but to overspend by £774 million last year, which is the highest in a decade.
As people live longer with multiple conditions and disabilities, care packages are becoming more intensive and expensive. Many now require multiple daily visits, home adaptations, and support from multiple carers.
Three-quarters of directors report a surge in people with complex needs who would previously have been eligible for NHS Continuing Healthcare, a system now plagued by a postcode lottery, with access varying dramatically across the country.
The survey also reveals that care workers are increasingly being asked to perform NHS tasks, often without funding or training. All directors surveyed believe that rising NHS pressures will further strain adult social care in the year ahead.
ADASS President and Director of Adult Social Care at Camden Council, Jess McGregor, said:
“The maths simply doesn’t add up – more people are coming to councils for help and their care is complex and costly, which means we don’t have funds left to provide the early support and prevention that would stop people’s health from deteriorating and help them avoid spiralling into crisis, where they frequently end up in hospital.”
“We shouldn’t have to choose between helping people with complex needs now and preventing others from getting unwell – we need to support people at both ends of the social care spectrum. But without more investment to keep people well and independent at home, we risk undermining the shift towards prevention and neighbourhood health that Wes Streeting, the NHS and this Government are rightly championing."
Despite these challenges, the Government’s latest Spending Review offers up to £4 billion in additional funding by 2028/29, but this assumes all councils raise council tax by 5% and may be absorbed by rising costs such as national insurance, inflation, and a potential Fair Pay Agreement for care workers.
ADASS is urging the Government to match its rhetoric with real investment, warning that without immediate support, the vision of integrated, preventative care will collapse, leaving more people in crisis and costing the state more in the long run.
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