Listening to the chorus of concern around social care

Leading figures from the social care sector gathered in Manchester at the beginning of the month for the annual children and adult services conference. As ever the programme reflected the efforts (too often unsung) of the 1,500,000 people working to offer care and support to older and disabled people – often despite, and not because of, the system.

But the overall mood of the conference was sombre – a new survey revealed that in the last six months nearly two-thirds of council areas had experienced care home closures, and home care contracts had been handed back in more than half of areas. Budget overspends are growing and local authority apprehension, if not fear, about financial sustainability and the high risk of legal challenge was palpable.

Many councils have worked hard to remove more than £5 billion from their care budgets over the past five years by adopting better models of care that manage demand and reduce the need for formal services. One experienced director of social services commented, ‘the number of people who need help with getting out of bed, getting dressed, going to the toilet and eating is growing. You can’t manage demand for those things’. In a recent report by the Nuffield Trust, Social care for older people, it was concluded that most councils had run out of road in making cuts without damaging access to, and quality of, care.

The priority for this Autumn Statement is to address the critical state of adult social care, recognising the inter-dependency with the NHS. So we conclude that the Chancellor should bring forward to next year the extra funding it has already promised through the ‘improved’ Better Care Fund – planned to reach £1.5 billion by 2019.

Beyond the Autumn Statement, the NHS and social care together will need increased funding as the Secretary of State for Health has himself recognised. If the government is not prepared to address these longer-term funding challenges then it will need to be open with the public about the consequences for access to services and quality of care.

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