Social care system ‘unsustainable’ without protected funding, directors warn

Parts of England’s adult social care system will be ‘unsustainable’ unless the next government commits to providing protected funding in the next parliament, social services leaders have warned.

In a report published ahead of tomorrow’s budget, the Association of Directors of Adult Social Services (Adass) said that a protected settlement for social care was needed to plug an annual funding gap for services predicted to be at least £4.3bn by 2020.

This measures the gap between the money council leaders believe they will have to spend on adult care in 2020 and that required to maintain spending at 2013-14 levels, accounting for inflation, demographic pressures and expected efficiency savings.

The funding should be in addition to a commitment to meet the extra £8bn a year in NHS funding that NHS England says is needed by 2020 to keep the health service sustainable, Adass said.

‘Invidious choices’

The coalition government pledged to protect the NHS budget from inflation between 2010-11 and 2014-15 but the social care system has been hit hard by cuts to local authority funding. Adass’s latest annual budget survey found that councils in England have reduced their adult social care budgets by 26%, or £3.53bn, over the past four years once inflation and demographic pressures are taken into account.

David Pearson, the Adass president, said that the funding cuts had forced social services bosses to make a series of “invidious” decisions over care. As a result councils have tightened eligibility criteria for care and squeezed fees for providers – with the latter move having a knock-on impact on working conditions for staff and the financial stability of some care firms, he said.

Without extra funding those trends would likely continue, a situation that could damage the quality and quantity of care on offer, said Pearson.

“We are concerned given the backdrop it may well be that some social care services will become unsustainable by 2016-17,” he said.

“The risk is that in two years’ time that we find that something has actually gone seriously wrong and the purpose of this discussion is to avoid that happening.”

Care Act threat

Pearson said that it would be impossible to realise the ambitions of the Care Act without an improved funding settlement.

“The Act does require a decently trained and remunerated workforce, it requires sustainable provider organisations that aren’t in state of financial jeopardy and it requires integrated work at a local level. The straight answer is that this funding is absolutely required to meet aspirations of the Care Act,” he said.

Adass said that greater integration was needed between health and social care but warned against a centrally-government upheaval of services. Instead directors want to see health and wellbeing boards given powers to sign off clinical commissioning group spending plans and local authority social care budgets, Pearson said. A single shared outcomes framework for health, public health and social care should also be introduced, the association said.