Adult care directors have raised concerns over government plans to transfer NHS adult learning disability funding for social care to councils on the basis of existing spend rather than assessed need.
Councils are set to take over primary care trusts’ remaining social care funding and commissioning responsibilities on 1 April 2009, in line with their lead role in social care, leaving PCTs with responsibility for healthcare for people with learning disabilities.
In a circular sent to health and council chiefs yesterday, the Department of Health said the amount transferred should be based on existing spend for 2007-8, “with an uplift for inflation and any other factors to be agreed locally”. The DH wants the amount decided locally by December 2008, and said there was a “clear expectation” it should be transferred for the 2009-10 financial year.
This quashes the idea that the transfer would be staged, as mooted by care services minister Ivan Lewis in an interview with Community Care last month.
Tony Hunter, co-chair of the Association of Directors of Adult Social Services’ resources network, said it was “keen to ensure that the transfer is at a sufficient level” to help the development of the personalisation agenda.
He said: “It has been difficult to establish a baseline for transfer, despite huge goodwill between PCTs and councils, because of the variation in arrangements which have developed over many years. This is why we are concerned to attract sufficient resources based on need rather than historical arrangements.”
Using existing spend is ‘practical’
But David Stout, director of the PCT Network at the NHS Confederation, said that basing the amount of cash transferred on existing spend was “practical” given the timescale set out by government.
He argued that deciding on a “needs-based formula” for funding would be “extremely complicated” to achieve within the deadline, adding: “Spend and need are not completely unrelated.”
The circular revealed that in 2009-10 and 2010-11, the money would be passed from PCTs to councils locally, with the DH funding authorities directly from 2011.
Stout said he believed the timescale set out by government was “achieveable” though this would depend on the existing arrangements between councils and PCTs.
Partnership funding arrangements for social care for people with learning disabilities are already in place in around 80% of local authority areas. But the DH guidance said “more detailed work” could be needed to reach agreements where such arrangements were not in place.
A mediation panel, made up of members of strategic health authorities, Adass and government regional offices for the regions, could be used as a “last resort” in cases of disagreement, according to the DH guidance.
Stout admitted that transfer of funding “could be challenging” and predicted there would be clashes. But he hoped that mediation would only be necessary in a few cases.
Hunter agreed, saying: said: “Given the strength of relationships and shared values this will not be acrimonious, but more a request for assistance in order to move on quickly.”
The idea to transfer the funds to councils was included in the government’s Valuing People Now consulation published last December.
PCTs spend an estimated £2bn directly on people with learning disabilities, about 85% of which is on social care. Last year, the then learning disability tsar Rob Greig estimated that each English council would have to increase spending on learning disability services by £1m every year for the next decade to provide good quality care.
DH circular: Valuing People Now: Transfer of the responsibility for the commissioning of social care for adults with a learning disability from the NHS to local government and transfer of the appropriate funding