Social care left to pick up costs as health agencies ‘narrow activities’

NHS bodies are “narrowing the definition of health care” to cope with deficits, loading more pressure on to social care, the Association of Directors of Social Services has said.

In a toughening of its stance on the knock-on effects of NHS deficits on social care, the ADSS said a snapshot survey it had carried out found evidence of health bodies stopping activity they would once have provided, leaving councils to pick up the pieces.

This was more common than primary care trusts withdrawing money from social care or jointly commissioned services, though overall the national position was “patchy”.

Hampshire Council adult services director Rea Mattocks said a redefinition of health care was one of the main reasons her department had overspent by £11m in 2005-6 and faced a £20m overspend this year.

The council is to consult on restricting eligibility to adult care to the most dependent people – those categorised as “critical” under fair access to care services regulations – with support no longer offered to those with “substantial” needs.

She said: “People are being discharged from hospital when previously they would not have been. The issue for Hampshire and many other places is that social care budgets have not been increased to accommodate this change.”

This meant the council was dealing with people with more intensive needs, resulting in a rise from £9,400 to £12,900 in the average annual cost of an adult care package over the past two years, she added.

The ADSS and the Local Government Association have made a submission outlining their concerns to the health select committee’s inquiry into NHS deficits.

However, NHS leaders have claimed that health services are being equally affected by cost shunting from social care.

The NHS Confederation said a straw poll of 19 NHS chief executives found three had pulled out of joint arrangements with councils, while in three cases local authorities had pulled the plug.

A spokesperson said health services also faced increased demand from people excluded from social care because councils had raised eligibility criteria.

• Hard up Bradford Council is to consider whether to restrict services to clients with “critical” and “substantial” needs, excluding those with “moderate” needs.

Click here to see Health Special article Taking the accent off the acute.