By David Pearson, honorary treasurer, Association of Directors of Adult Social Services
The adult social care sector breathed a collective, yet short-term, sigh of relief after the government finally announced new funding in the spring budget.
The £2bn over three years, half of which is for the coming year, is an important step in recognising the growing gap in government funding for adult social care. If it is to make a tangible difference, it is vital that this money helps the frontline as soon as possible to relieve immediate pressures and stabilise the provider market, which is at real risk of collapse.
While welcome, it’s important to remember that this cash injection is a short-term measure. A long-term, sustainable solution must be found for funding adult social care, in order to ensure thousands of older and disabled people and their families get personal and dignified support. People are living longer and their complex needs are growing – the need to future-proof the social care system cannot be ignored.
‘Seize this opportunity’
That’s why it’s crucial that ADASS continues to work with providers, charities and independent think tanks, and has input into the social care green paper.
We are keen to build a consensus on a long-term, sustainable solution about how we provide and pay for care for years to come, and the green paper needs to help achieve this. It is an opportunity that we need to seize and get right for future generations to come.
Two years ago, an independent YouGov poll indicated that one in three people either receive or are in touch with social care services. The same poll identified adult social care as the area the public would most like to see additional government investment, apart from the NHS.
If this poll was undertaken again today, we wouldn’t raise an eyebrow if it produced the same results. Social care matters even more in 2017 and in future years to come. Most of us will need care and support at some point – that’s why social care is everyone’s concern.
‘Needs are changing’
But historic underfunding of social care, which has forced councils to save a cumulative total of £5.5 billion from budgets by the end of this financial year (2016/17), has placed social care at a point of crisis. That’s why it needs to be treated as a national priority.
At least 400,000 fewer people are getting publicly-funded help. Some of this is through effective prevention but with growing needs and demand on health and social care, we have to recognise the inevitable need for more resources in the longer, as well as the short-term.
Our needs are also changing. We are living longer, which is a success story that we should celebrate. But it also has profound consequences for the kind of care and health services we need in the future.
The number of people with learning disabilities who will need social care services is likely to rise 25% by 2030. Sometimes their needs can be complex and expensive to meet. Fewer and fewer of them are receiving public funding. This needs to be addressed.
The pattern of need is changing dramatically as well. Deaths from cancer and heart disease are falling, but more of us experience chronic illness, with 70% of the NHS budget spent on long-term health conditions.
Older people aged 75 and over will have at least two long-term conditions. Dementia and frailty in later life is soaring. Many more of us will have a mixture of needs to do with physical health, mental health and perhaps difficulty in making decisions for ourselves. They can only be met by well-coordinated ‘joined-up’ care.
The inter-dependency of NHS and social care resources means that while social care is exposed to deep and significant reductions in local government spending, the NHS can only be protected properly if social care is protected too. The case for a single, shared funding settlement, through the next spending review, which covers social care as well as the NHS and where social care is protected, is overwhelming.
The need for person-centred, coordinated care will be critical, including wherever possible, the use of integrated personal health and care budgets and/or commissioning. These will be used to meet most needs for long-term health and care support, and is considered the most powerful way to join up services around individuals and families.
Despite long-term funding uncertainties, what is certain is that good care can transform lives. It can help people live good lives, or the best they can, in a variety of circumstances. It enhances health and wellbeing and increases independence, choice and control.
We urge politicians to act to meet the significant growth in the volume and complexity of needs faced by generations that rightly expect to lead longer, more fulfilled lives.