Government to expose ‘efficiency gap’ in local authority adults’ services

Significant variation between similar councils in expenditure on services is not reflected in performance, says lead official

The government is to expose an ‘efficiency gap’ in local authority adults’ services, with significant variation in expenditure on services by similar councils that is not reflected in their relative performance.

That was the message from the Department of Health’s lead social care official, Jon Rouse, in a speech to Community Care Live yesterday.

Rouse said that local authorities would be expected to deliver a 3% efficiency saving on their adults’ services budgets in 2015-16, something the Association of Directors of Adults Social Services had said was achievable.

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This is less than the 5% annual efficiency saving achieved to date, but Rouse said that it was becoming harder for authorities to achieve savings on their budgets.

However, he warned said there was a “differential picture” across the country, with significant differences in unit costs for services between authorities and “very little correlation between costs and outcomes”.

Significant variation in efficiency

“We will be publishing shortly an analysis of how councils compare against their statistical neighbours, [the councils who are similar to them] and there is significant variation,” he warned.

In a session on the implementation of the Care Act 2014, Rouse also confirmed that the DH would provide no more than the £470m it had already promised councils in 2015-16 to implement the legislation.

The funding is being provided partly through the Better Care Fund (£185m) – the pooled budget for health and social care that will be set up from 2015-16 – and partly through a separate specific grant (£285m).

The government is due to publish its draft statutory guidance and regulations on the Act for consultation next week. Rouse said that should its assessment show that £470m is insufficient to implement the Act, the guidance and regulations would be revised to make the resulting requirements on local authorities less burdensome.

No additional money for Care Act

“There won’t be additional money in the system for 2015-16,” said Rouse. “What we have to think about is the final content of the regulations and guidance so that there’s a fit between the ask [of local authorities] and the money available.”

He also said councils would have the flexibility to move money around if they found that certain elements of the Care Act costed less than had been anticipated, and others more, but the overall pot would not increase.

Earlier, Andrew Webster, associate director for integrated care at the Local Government Association, had said there was a widespread belief in local government that the money provided for implementing the Act was insufficient.

“We are working with a few councils to try and work out what the financial implications are,” he added.

The consultation on the draft regulations and guidance will last 10 weeks and the government will use the results to inform its final requirements for councils’ implementation of the Act in 2015-16, which will be published in October.

Questions councils must answer

Rouse said this would give authorities a “six-month run” to prepare for implementing the Act. However, he said authorities should be earnestly preparing already for implementation and set out six questions they should be able to answer:

  • Do they have a programme for delivering the Care Act in place and a lead person in charge of this?
  • Do they know what needs to change and when:
  • Do they understand the scale of the challenge in areas such as IT and workforce development?
  • Do they have a plan for working out how many self-funders they have in their area?
  • Are they engaging with the local provider sector in delivering the Care Act?
  • How are they modelling the likely financial costs of implementation?

Rouse said he had been encouraged by local authorities’ approach so far, which is being supported by a joint office set up by the DH, the LGA and the Association of Directors of Adult Social Services and £125,000 in funding for each authority.

Making health and social care integration work

Commissioners, managers and practitioners are invited to address the key challenges in making health and social care integration work at Community Care’s forthcoming conference on the issue, on 1 October in London.

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