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Current Issues in A dult Social Care Helen Sumner National Adviser, Adult Social Care Local Government Improvement & Development. Content. Recent announcements The policy context The financial context Our programme. Key announcements.
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Current Issues in Adult Social Care Helen Sumner National Adviser, Adult Social CareLocal Government Improvement & Development
Content • Recent announcements • The policy context • The financial context • Our programme
Key announcements • NHS White Paper (July) and Government’s response (Dec) • Carers Strategies (November) • Public Health White Paper (December) • NHS operating framework (December) • Health & Social Care Bill (January – changes to health) • Mental Health Strategy (January) • Law Commission Review report (May?) • Care & Support Commission report (May/June?) • Social Care White Paper (Queen’s Speech – May 2012? – changes to social care)
The policy context: personalisation • New sector wide agreement on transforming adult social care • New vision for adult social care • Existing milestones to be replaced by a new set of benchmarks • Not just personal budgets • Making links with safeguarding
The wider context ‘Bottom-up’ more than ‘top-down’: • Big society • Simplified grant funding and greater freedoms • Reduction in burdens of performance management • Consultation on adult social care, public health and NHS outcomes.
The wider context - money • Existing social care grants (£2.4 bn by 2014) wrapped up and inflation proofed (unringfenced) • New social care allocation £530m rising to £1bn over 4 years (unringfenced in RSG) • New transfer of responsibility grants (but not new money) for learning disabilities and health reform, and for public health • New NHS support to social care: £800m rising to £1bn over 4 years • Re-ablement funding - £150m rising to £300m (via NHS)plus an extra £162 million this financial year • Big impact: Adult social care is 40 – 50% of the available budget for top tier council
A good settlement but… • Local government facing reduction of 26% in grant funding over SR period • Central government contributes 62% of social care through grant and councils contribute 38% through council tax • Distribution issues for grant create disproportionate effects
The size of the gap • - LGA submission to SR estimated at 25% budget reductions + 4% of demographic pressures = £6.33bn over 4 years • + Offset by £2bn in payments by 2014 • + Sector agrees 3% efficiency savings possible (from telecare, reablement, different service patters, review of business processes etc.) - £1.7bn • + or - If pay and price inflation is fully funded (DH and LGA disagree) • = Gap closes to around £2.63bnin CSR period- £657m per year
Key pressures • How much spend is “untouchable” • Still need for progress in prevention and personalisation • Impact of cuts in related council areas – housing, Supporting People, family support, leisure etc. • Unknown impact of benefit changes on demand • What more is there to do if already made efficiencies • NHS unsettled by change, with the worst settlement since 1951
How can social care do ‘more for less’? Early intervention then efficient processes: • Ensure meeting needs • Get value for money in commissioning • Understand data better, including cost comparisons • Croydon found efficiencies of £6.2 million over 4 years through work on engagement using DH tools and predictive modelling • Improvement and Efficiency South East estimated that their Care Funding Calculator can save 12 per cent per placement.
Then even more for even less Draw on local partnerships and community capacity: • Collaborative commissioning - with providers to design innovative new services • Social enterprise and micro-businesses in Halton as alternative to traditional day care • Reconfiguring and joining up services • Hertfordshire developing shared services between the council, hospital trust and NHS • Cross London initiative on provision of community equipment could save £12.3 million per year • Effective use of community resources
For information: key productivity resources • LG Group productivity work – www.local.gov.uk/lgv2/core/page.do?pageId=579930 • ADASS toolkit on better use of resources: www.adass.org.uk/index.php?option=com_content&view=article&id=671:resources-reduction&catid=144:resources-reduction&Itemid=440 • Audit Commission work on joint financing across health and social care www.idea.gov.uk/idk/core/external-link.do?redirectUrl=http%3A//www.audit-commission.gov.uk/nationalstudies/localgov/pages/91029meanstoanend_copy.aspx • A recently issued report by the Social Care Institute for Excellence examines the potential for personalisation to result in cost efficiencies and improved productivity www.scie.org.uk/publications/reports/report37.asp • Former Director of Community Services in Coventry and former DH Director of Strategic Finance), John Bolton, provided a key paper on efficiency and personalisation: www.csed.dh.gov.uk/_library/Resources/Personalisation/Personalisation_advice/298683_Uses_of_Resources.pdf • Examples of joined up services between adult social care and health can be found on www.dhcarenetworks.org.uk/csed/ICSPP/ • CIPFA Adult social care benchmarking clubs http://www.ipfbenchmarking.net/pdf/AdultsFlier.pdf
For information: Local Government Improvement & Development programme • Leadership academy • Masterclasses and scrutiny event • Lead member ‘Must knows’ • Peer support and tailored support • Community of practice (CoP) • Outcomes Based Accountability • Safeguarding & Ageing Well programme
Contact details Helen Sumner Joint National Adviser - Adult Social Care Local Government Improvement and Development Layden House 76-86 Turnmill St London EC1M 5LG Helen.Sumnerl@local.gov.uk Visit our website at www.local.gov.uk/improvementanddevelopment