Editorial Comment: Short changed yet again

There was a collective wince in social care last week when the comprehensive spending review was announced. We knew the funding for the next three years was going to be tight, but some had dared to hope for slightly more.

Health and education are still the priorities, with councils only receiving a 1% real terms annual growth in funding. Even the government’s much publicised aim of ending child poverty was pushed further off course by measly tax credit increases.

Despite the rhetoric from politicians on the importance of social care, this settlement neither keeps pace with demand nor encourages further changes in service delivery.

Some are going to have to review their strategies on this. The sector is already characterised by tightening eligibility criteria and, in the short-term, it will only get worse with social services being forced into providing an exclusionary, acute service. Those teams feeling the pinch are going to have to provide people entering the system with intensive support so they can regain their independence as soon as possible.

While survival will often be the instinct, social care has to keep striving to innovate. Councils are mandated to make 3% annual efficiency savings, which the government suggests will release £4.9bn for local authorities to direct into frontline services.

To make this a reality the sector is going to have to get better at sharing best practice. There are no easy answers in the personalisation agenda but both effectiveness and efficiency can be found through giving people more choice and control and improved commissioning.

At least, in the longer term, there’s a chance to slip the noose. The CSR recognises the need for a “radical rethink” of social care and support for all adults, promising a green paper next year to focus on the reform of services.

Meanwhile, the accompanying public service agreements map out the general direction of reform by emphasising independent living, choice and control, person-centred care planning and prevention, the latter thankfully seen as going wider than social care. Just as significantly, the indicators will be put in place to measure progress towards reform, including an all-important common assessment framework covering both health and social care.

While these are the building blocks for achieving the aims of last year’s health and social care white paper, Our Health, Our Care, Our Say, the scale of change required at a local level should not be underestimated. If that is the price of genuine user empowerment, many social care professionals will be happy to make their contribution.

But there is a financial cost for the government too and the green paper should be the first clear indication whether it is willing to pay it.

Contact the authors
Mike Broad
Mark Ivory