Jeremy Dunning examines the value of grants targeted at specific client groups as they face the axe
(pictured: Ken Wragg and Jenny Hand, see below)
The government is widely tipped to axe many or all of the specific grants targeted to fund services for vulnerable adults, in this month’s spending review.
While the move is designed to give councils more flexibility in deciding how money is spent, there are widespread concerns that crucial services could be slashed as a result.
Specific grants at risk include the £26m Aids support grant, designed to fund social care services for people with HIV/Aids, and the stroke strategy grant (£15m), introduced to help councils implement the 2007 stroke strategy and due to come to an end next year. The coalition removed ring-fencing from both grants earlier this year.
The government is also expected to axe the £4.4bn area-based grant, a broad funding stream that includes a number of former ring-fenced grants that still receive explicit funding allocations from government. These include the £256m carers grant and the £1.64bn Supporting People programme, which funds housing support for groups including learning disabled people, domestic violence victims and people who misuse substances.
Campaign groups warn that without specific funding streams, services for vulnerable or marginalised groups will be overlooked.
The National Aids Trust says the impact of the removal of ring-fencing for the Aids support grant is already being felt.
“NAT is already hearing accounts of funding being redirected elsewhere at the local level,” says policy and parliamentary officer Laura Dunkeyson.
Things could become worse without the named grant, she warns.
“Without the named grant, social care for people with HIV is in great danger, with serious implications for how well many do on treatment and for wider public health.”
Joe Korner, director of communications at The Stroke Association, says: “We are actively engaged with service commissioners who fund the projects to defend stroke services and where this is not possible, to ensure alternative arrangements are in place so that stroke survivors don’t lose out.”
Community Care has looked at services for three client groups funded through specific grants to see what service users have gained and what they could lose.
Aids support grant
Ken Wragg was diagnosed as HIV positive nine-and-a-half-years ago.
The news came as a shock. The 59-year-old says: “HIV was devastating. I felt I should have a placard around my neck with the word ‘unclean’.”
However, two services, funded through the Aids support grant, have provided Wragg with emotional assistance and advice as well as access to the financial support he requires. He now volunteers for one of the services that supports him, Leicestershire Aids Support Services (Lass), which provides advice and support as well as a drop-in HIV test service. Most of its £90,000 in annual funding comes via the Aids support grant, through Leicestershire and Leicester councils.
Chief executive Jenny Hand says the service is vital, given Leicester’s high HIV rate, as it finds people early, helping them support themselves, saving money.
“For each positive test you will save the health service £250,000 in further onward transmission costs,” she says. “We train volunteers to do the tests and have saved £11m over 18 months.”
This gives her confidence that she can make a good case for continuing funding, although she is bracing herself for cuts, with other sectors also fighting for the same pot of money in Leicestershire.
Wragg’s needs at the time of his diagnosis were to see a counsellor. But two years later, Lass’s services, and two specialist social workers, also funded through the support grant but employed by Leicester Council, came into their own after he picked up another illness. He became so ill he was unable to work, forcing him to use his savings. The illness also triggered the rapid progression of the HIV virus so he is now on a cocktail of drugs.
The specialist social workers assessed him as eligible for disability living allowance and encouraged him to apply, allowing him to fund support at home.
For Wragg this is essential. “It relieves me from my domestic duties, which means I can volunteer at Lass. It means I can give something back to society.”
He is convinced that without the social workers – and Lass – he would not have received this help.
Stroke strategy grant
A community support service is at risk in Bath and North East Somerset, because its funding from the stroke strategy grant is due to come to an end next August.
The Stroke Association service provides long-term support for stroke survivors, stretching beyond the four weeks of rehabilitation that many receive.
Community stroke co-ordinator Anna Ladhams says this is vital for some clients, who can take years to recover. “It means the client feels they’ve not been abandoned, and if anything crops up they can give me a call,” she says. “It’s something health professionals haven’t the time or capacity to do. It’s filling in the gaps in the stroke service already set up.”
Ladhams sits as part of the local primary care trust’s community rehabilitation team and carries out six-month reviews of patients for them.
She been in post for 12 months and has had 30 referrals over that period, including from GPs, hospitals and clients.
But despite there being no similar service available in the area, there is no indication her post will survive when funding comes to an end.
Charles Russell, 77, of Saltford, near Bristol, has had five strokes since September last year and has been using Ladhams’ services since April this year.
Through her help he accessed funding for a chair-lift and a sit-in shower, and is eligible for a mobility scooter.
He is convinced that he would never have got as far as he has without her help. “I wouldn’t have known where to turn. If that’s taken away I feel a lot of people like me will suffer,” he says.
“Without it I would survive but not in the sense I’m doing now because I would have no-one else to see.”
The Barnet Carers Centre delivers services funded through the carers grant.
These include a helpline, a drop-in centre, support groups, counselling, and respite care. The centre also provides information and advice.
Without the grant such services would probably not be provided, says deputy director Joanna Christophi, who fears that cuts could be disastrous for carers.
“There wouldn’t be anyone to talk to. They get that through the helpline and drop-in centre,” she says.
Christophi says she accepts the need for savings but warns there is nothing else like the centre for carers in Barnet.
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This article is published in the 7 October 2010 edition of Community Care magazine under the headline You’ll Miss it When it’s Gone