Local authorities are facing a £634 million budget gap in the funding of social care and bold decisions must be taken within this parliament if a crisis is to be averted, according to a report published by the RSA.
Plugging the Gap in Social Care reveals that many local authorities forecast a critical divergence of resource and demand in social care by 2015. The report argues that even if the government does manage to introduce its long awaited Care and Support Bill, an agreement on long term funding may still be difficult to achieve before the next general election.
The report maintains the government will also be throwing good money after bad unless funding reform is accompanied by fundamental shift in focus towards preventative care (the type of care commissioned by local authorities not by acute health services)
It argues this will require some tough political decisions about the allocation of budgets between acute and preventative care and the governance of Health and Well-being Boards. There is little immediate indication of these nettles being grasped.
Serious consideration should be given to pass-porting money across from the NHS to prevention in the next spending review, the report argues. For example, if the amount of money underspent in the NHS (£1.5billion in 2010) were to be reallocated towards integrated preventative services, we would be able to close the funding gap in social care.
The report warns there are significant barriers and challenges to making this type of integration work effectively, including different funding regimes for health and social care and the government’s increased focus on choice and competition.
On a more positive note, the report shows that whilst we are some way off an 'integrative preventative utopia', local authorities are pioneering innovative new ideas to help ‘plug the gap’ and deliver effective care for older people despite budgetary pressures. This includes an increased focus on:
Independent living (helping to manage demand for expensive care services by helping older people stay in their own homes)
Financial independence (reducing costs to the state and giving citizens more autonomy by helping them manage their resources)
Market shaping (using commissioning power to shape and maintain a vibrant local market of care provision, allowing people a real choice)
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.
Crucially the steps along this pathway: financial advice, carer support, joined up services or effective commissioning, can all be achieved at little or no cost and can all be achieved right now, the report argues.
Commenting on the report, author Jonathan Carr West said:
"Evidence drawn from the real budgets of councils across the country undermines the government’s claim that there is no current funding crisis in adult social care. Crucial to driving down costs and delivering better outcomes is a switch focus to preventative services - but this will require not just political bravery but structural and budgetary reform.
Adult social care is big politics but it is also the stuff of everyday lives. It is currently only through the everyday interventions of local authorities that we are managing to plug the gap between an unsustainable present and the future we want and need."
Notes to editors
1. For more information contact RSA Head of Media Luke Robinson on 020 7451 6893 or firstname.lastname@example.org
2. Dr Jonathan Carr-West is a director at Local Government Information Unit (LGiU) where he leads the policy team, which seeks to strengthen local democracy by leading new thinking and practice on how local communities can have more influence over the areas they live in and the services they use and how local government can help them to do so.
3. Through a series of papers published in 2012, Plugging the Gap will develop ideas for practical responses to the shrinking state and cuts to services. The project will focus on how local services, citizens, networks and community assets can be better deployed to plug the gap of a shrinking state, while speaking to longer term questions around the shape of services and citizens roles in delivering these.