The Comprehensive Spending Review has confirmed that local government is going to be making a lot of very tough decisions in the coming months, with local government funding from the centre reduced by 26% over 4 years.
In recognition of the pressures on the social care system the government has allocated an additional £2bn by 2014/15 to support the delivery of social care.
The additional money comes in two parts. Half of the extra money will come from an increase in Department of Health funding for councils. The money is in addition to existing DH grants for social care which will rise in line with inflation to £1.4bn by 2014/15. All this money will be rolled in to councils’ general grant, which is not ring-fenced.
The rest of the extra money for adult care will come from the NHS. This £1bn includes up to £300m per annum for re-ablement to help avoid demand upon social care, while the remainder will be used to support other social care services. The money will be allocated to primary care trusts – and new GP consortia 2013 – to spend on social care measures that benefit the NHS. There is no indication as yet as to how NHS commissioners will be held to account for spending this money.
In a Dear Colleague letter David Behan, Director General for Social Care writes that “with an ambitious programme of efficiency”, there is enough funding available both to protect people’s access to services and deliver new approaches to improve quality and outcomes”, though ”tough choices” will still need to be made. Care services minister Paul Burstow has told councils that they have no excuse to cut adult social care and that the extra money would provide councils with “the wherewithal to meet the demographic pressures”.
In addition to this funding there will be two new grants issued from the Department of Health over the SR period reflecting a forthcoming transfer of responsibility for services from the NHS to local authorities: Learning Disabilities and Health Reform grant (an un ring-fenced, specific grant worth around £1.3bn from 2011/12) and the Public Health grant (which will be introduced from 2013/14).
Social care leaders broadly welcomed the funding announced yesterday but warned that it is unlikely to help councils manage the cuts or cope with demographic pressures. ADASS had calculated, in their submission to the Spending Review that there would be a £5.7 billion shortfall in adult social care funding. In view of the overall cut in funding for councils, local authorities will now face extremely difficult choices about which services they can keep on running. ADASS has cautioned that with the extra finance not being ring-fenced “some very tough local decisions about the share of the overall budget going to adult social care are going to have to be made”.
The challenges for local adult social care departments are enormous. They must not only ensure the critical intelligence to support decision-makers, commissioners and providers, but also make a crystal clear case for the need to safeguard social care resources.
In reviewing capacity, local partners need to ask two key questions:
- Have we got the critical local intelligence we need to make an effective case for people who depend on publicly funded services and budgets for their care and support?
- And how can we develop intelligence to support a business case for upstream investment in preventive services that may bring potential savings in the future?