CareKnowledge editor Jim Kennedy looks at the way social services in England are being affected by the Government’s austerity package following ADASS's latest budget report:
ADASS has just published its 5th annual budget survey report. This series of reports looks at the way adult social services in England are being affected by the Government’s austerity package – and, in particular, by its programme of severe cuts to local government funding. ADASS’s report does not make for reassuring reading.
The report is based on a survey of all local authorities to which 95% responded. The tone is one of increasing desperation about the pressures being faced and of worry over the reductions in service that are having to be put in place.
The survey report, though, also makes two important points about the context for its findings. One is that local government has continued to seek to protect social services from the worst of the cuts – and the report provides a list of the steps that have been taken to that end.
The other is that, over the period since the reports were initiated, the NHS has had the level of its funding reasonably well protected. This second point is put with greater force because of the growing expectation that the two services will work together – and whilst the additional funding to be delivered through the Better Care Fund is welcomed in the report – ADASS see real problems ahead.
Pressures are mounting at the same time as demand
One is that the Fund does not bring new money into the overall health and care system, but comes mostly from existing NHS budgets. This is a cause of concern that ADASS’s colleague managers in the NHS have already voiced.
The other contextual point is that pressures are mounting just as new hope – and greater public expectations – are being introduced to the system with the passing of the Care Act, which will also make new organisational demands of social services departments.
The report makes use of National Audit Office (NAO) findings as well as the survey to illustrate the scale of the pressures falling on social services.
For example, it says:
• This is the third year of continuing cash reductions and the fifth year of real terms reductions in social services spending with the money invested in Adult Social Care reducing by a further 1.9%1 (£266m) in 2014-15
• Spending on adult social care has fallen by 12% in real terms at a time when the population with potential care needs has risen by 14%
• All of this means that there has been a tightening of eligibility criteria, with fewer people getting the support they need – and with an NAO graph showing a 28% reduction in the number of people receiving support from 2008/9 to the present
Future concerns centre on:
• Continuing reductions in the number of people receiving services
• Councils facing increasing legal challenge
• Providers facing financial difficulty with increasing risks of individual provider or wider failure
• The NHS coming under increasing rather than reduced pressure
Now comes the hard part for this blog. I’m genuinely a great believer in council-run social care. I think it makes an enormous contribution to individual and pubic wellbeing. But will anyone really care about these latest figures? Has the public noticed what is happening? Are they up in arms about cuts in their services? Will the current government – or the next one – think it’s politically worth responding to these service concerns?
If the answer to any of those questions is an honest ‘no’, there may be a number of things that cause that circumstance. The cuts affect individuals. They won’t be able to spot the cumulative results. Social care has always been rationed. How can an individual know whether the service they get is down a notch or two on what it would have been?
And, local government has been fastidious about protecting social services; efficiency savings have steered a course away from service reductions wherever possible. In other words LAs success in managing the cuts cloaks the real pressures the system is under. For some, the latest survey will also add to a belief that public services always cry wolf, but, things seem somehow to stagger on.
Finally, of course, social care sits right next to health. Paradoxically, although people with a whole–systems view may be able to see that that makes adequate investment in them a priority – others, including many in the general public, pleas for more social care resources will always take a poor second place to those made on behalf of the NHS.