NHS must spend more on adult social care, say MPs

The NHS should spend more on adult social care to improve the quality and cost-effectiveness of support for people with long-term conditions, MPs said today.

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The NHS should spend more on adult social care to improve the quality and cost-effectiveness of support for older and disabled people, MPs said today.

A government mandated transfer of £648m from primary care trusts to councils had been effective in boosting funding on adult social care, said a report from the health select committee.

Similar annual transfers are due from 2012-15, alongside further NHS spending on reablement social care services. However, the total spend – about £1bn a year – is just 1% of annual NHS funding, the MPs added.

“Clearly there is scope to extend transfers of this kind,” said the report, on public expenditure in health. “The committee believes that, as a matter of urgency, the Department of Health should investigate the practicalities of greater passporting of NHS funding to care.”

Older people’s charity WRVS said it was vital to shift NHS resources into social care and low-level services for older people, such as befriending, to prevent hospital admissions. Chief executive, David McCullough said: “We know there are plenty of occasions when care in hospital is the only way for someone to be treated, but we also hear of many older people who end up in hospital almost inevitably, because they are living extremely lonely lives with no real local support to prevent their health from deteriorating physically or mentally.” 

As Community Care revealed last year, much of the transferred funding has been used as intended by government to fund services that reduce pressures on the NHS, such as reablement, telecare or support for carers, or support greater integration between the sectors.

However, government figures show £116m of the £648m has been used by councils to maintain eligibility thresholds under the pressure of Whitehall cuts to councils, which the MPs said was “deeply concerning”.

“This suggests that this money (which was intended to support greater integration of services) is in fact being used to maintain the existing system,” the report said. “To the extent that this is true it is a lost opportunity to promote the necessary process of service integration.”

With 13% of councils raising eligibility thresholds last year, the committee said this demonstrated that government funding for councils from 2011-15 – a 28% cut in real terms offset by the funding transfer from the NHS –  had not been sufficient to maintain adult social care services at existing levels.

Care services minister Paul Burstow caused controversy among social care leaders last week by asserting his long-held view that the settlement was sufficient, in evidence to the committee’s separate social care inquiry, which is due to report shortly. This prompted an open letter rejecting his view from 33 charities.

With the government due to deliver its response to the Dilnot commission on the long-term reform of care funding this spring, the committee said: “The challenge for local
authorities and the government is to continue to provide a meaningful service until a new system is in place.”

Learn about the latest news and practice advice in dementia care at Community Care’s conference on the topic on 23 February in central London.

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