Spending on tackling long-term conditions, antisocial behaviour and worklessness could be cut by 15% across London through greater agency integration, a report for London Councils found today.
Savings could be made through more use of early intervention, greater accountability of staff to customers and the removal of overlapping roles between agencies, the study by PricewaterhouseCoopers found.
The report evaluated the potential savings from a London-wide roll-out of the government’s Total Place scheme, which aims to improve efficiency through enhanced public sector collaboration in local areas. It has been operating in two London boroughs, Croydon and Lewisham, since April 2009.
The report looked at applying the Total Place approach, which involves mapping all public expenditure across an area, to manage chronic care, tackle antisocial behaviour among young people and return people to work.
It found £1.6bn a year could be saved on the current budget of £10.6bn.
The report estimated that expenditure by councils on social care for people with chronic conditions in London totalled nearly £2bn a year, with PCTs spending a further £3bn. It said services were too fragmented and concentrated on treating acute needs rather than preventing people from entering the acute care system.
It calculated annual savings of £880m could be made across the £5bn budget by shifting NHS spending towards prevention and by building care around patient needs to ensure it was delivered in the most appropriate setting. This should include more use of individual budgets.
The report also proposed greater use of individual budgets in the welfare-to-work system, with claimants controlling resources now spent on them to help improve their employment prospects. It said this approach could help hive £630m a year off the £5bn cost of worklessness to London’s public sector.
To tackle antisocial behaviour among young people, the report recommended more intensive support for offenders early in their offending powered by greater co-operation between agencies and the integration of youth offending teams into local authorities.
It said savings of 10% could be made on current spending of £650m a year in London. The report called on local authorities to take a lead in these reforms but said moving to such a system would require considerable investment in the short-term.