MPs were warned today that growing demand, new burdens and significant budget cuts meant that additional funding for adult social care was too little, and would come too late, to protect services for the most vulnerable. President of the Association of Directors of Adult Social Services (ADASS), Ray James, was giving evidence to the Health Select Committee on the impact of the Comprehensive Spending Review health and social care.
Multiple pressures on the system are contributing to a crisis in adult social care, including:
- A 16 per cent increase (1.6 million people) in those with a limiting long-term illness between 2001 and 2015
- The number of people aged over 85 is expected to more than double from 1.3 million to 2.9 million in the next 20 years
- Adult social services budgets have been cut by £4.6 million, or 31 per cent, in the last 5 years
- The welcome introduction of the National Living Wage is expected to cost the system at least £1.6 billion a year by 2020
- New Deprivation of Liberty Safeguards will cost councils at least £176 million per year
Financial pressures have forced councils to reduce the level of care available to older and disabled people to make sure that they can provide for those in most urgent need. 400,000 fewer people now receive social care services than in 2009/10. A push towards personalisation means that satisfaction with services has remained at 91 per cent – a testament to councils’ determination to do the very best for every individual with the limited funding available, but Mr James highlighted that constant rises in demand and cuts in funding meant the next two years would be the “acid test” as to whether councils could continue to meet their statutory responsibilities.
The latest figures from NHS England highlighted that more delayed transfers of care than ever before are now attributable to social care, in particular limited availability of home care packages. The key challenge for the NHS and social care is to stop and reverse the reliance on acute health care, and invest in prevention and support in the community. However, millions of pounds worth of cuts to public health funding and the delayed introduction of additional Better Care Fund money, on top of existing cuts, are making that increasingly difficult, putting more strain on the entire health and social care system.
The Comprehensive Spending Review gave social care authorities the opportunity to raise council tax by an additional 2 per cent specifically to cover social care costs. While recognition of the need to tackle the deficit in social care funding was welcome, this blanket approach does not take into account evidence of need, and even if every social care authority used the full precept, there would still be a minimum funding gap of £1.4 billion from April – and even more the following year. Mr James also highlighted to the committee that those areas with the greatest need were the areas capable of raising the least amount via the council tax precept.
All members of the panel giving evidence were clear on the risks to the sector over the next two years. Speaking after the hearing, Mr James said:
“More people are now living longer, with increasingly complex needs, while adult social care budgets have been cut by 31 per cent in the last five years. The Government has promised more money but it is too little and too late. Unless the Government addresses the chronic underfunding of adult social care – and quickly – many services will be at significant risk over the next couple of years, with worrying consequences not only for the NHS, but most of all for older and disabled people, their families and carers.”