Most of us would prefer to spend our final years living independently, but nearly all of us will need care in later life – in many cases, residential care. Safeguarding the quality and affordability of social care while public sector funding continues to shrink will depend on local authority initiatives to reform funding and adopt preventative care models.
Looking after our ageing population is a key public policy challenge of our time. The number of elderly people requiring care looks set to continue to grow at the same time as the number of working age people paying tax to support them is diminishing. Evidence drawn from UK council budgets undermines government claims that there is no funding crisis in adult social care and many authorities forecast a critical divergence of resource and demand by 2015.
While it is certainly an issue for central government, it is local government that leads on the commissioning and delivery of social care, rather than acute health services. Local government must therefore lead the way in creating an integrated preventative system for the future. The significant funding gap that exists in social care can only be resolved in the long term through the creation of such a system.
This radical shift in focus will require tough political decisions about the allocation of budgets between acute and preventative care and the governance powers of Health and Wellbeing Boards. But councils across the country are already exploring initiatives such as managing the demand for and cost of care by helping people live independently for longer and remain financially independent. Some are stimulating innovation and increasing the range of options that are available both to individuals and to public agencies by shaping social care markets.
Independent living, financial independence and market shaping constitute a local pathway towards improved care. The steps along this pathway – financial advice, carer support, joined up services or effective commissioning – can all be achieved now at little or no cost.
Where this innovation exists, it must be supported; where it does not, it must be emulated. Each local authority should develop its own local strategy based on this tripartite approach so that they have a clear vision of how to achieve the best possible care within their resources.