Government changes to care funding guidance ‘unacceptable’

Local government leaders have accused the government of imposing “completely unacceptable” conditions on councils getting a share of £2bn of extra social care funding.

Last minute changes to Better Care Fund guidance published this week saw the Department of Health insert a threat to review funding allocations for councils that fail to meet targets to cut delayed discharges.

The government has said the £2bn funding pot would still remain with local government to be invested in social care. But the Local Government Association slammed the changes and withdrew its support for the guidance. The Association of Directors of Adult Social Services (ADASS) said the new conditions damaged the ability of councils to plan for the future.

Chancellor Philip Hammond promised the extra £2bn for social care over the next three years in his spring budget, making £1bn available immediately. He said councils should use this year’s allocations to fund more social care packages, stabilise local care markets, and relieve the pressure on the NHS.

On Monday health secretary Jeremy Hunt announced extra conditions, including the threat to review 2018-19 allocations for any councils that fell short of delayed discharges targets set by central government. Hunt said the changes would speed up progress on cutting delays and help free up the hospital beds needed to improve NHS performance over winter.

The targets mean that councils with the worst rate of delayed discharges attributed to social care must cut it by two-thirds by September. In areas where delays attributable to the health service are highest, NHS services must reduce this by half.

‘Wrong and difficult’

ADASS president Margaret Willcox said the disparity showed the government’s “differential treatment” of the NHS and social care. With most social services directors having already planned where to invest their 2018-19 allocations, news that the funding could be withheld was causing uncertainty, she added.

She said: “ADASS’ members have consistently prioritised discharge from hospital. Directors have already obtained a level of agreement as to how best utilise this much needed funding, responding quickly to encouragement to start to use these funds to make a difference.

“We are very disappointed by the last minute unilateral changes to guidance that have taken place in the last few days. The consequence is to undermine the collective effort required.”

Izzi Seccombe, chair of the LGA’s community wellbeing board, said: “The sudden shift in focus so late in the process to prioritise delayed transfers of care, and the threat of a review of funding allocations if associated targets are not met, is completely unacceptable to local government. Councils cannot now have confidence to plan for the long-term.

“We have had assurance that no more than 10% of funding would be affected by the performance review and that all the funding would stay with councils. But the principle is wrong and difficult in practical terms; councils have already agreed their plans locally and made commitments on how to spend this year’s allocation.”

According to government figures, 55% of delayed discharges are currently attributable to the NHS, while 38% are attributable to social care and 7% are jointly attributable.

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