The NHS will be given the majority of a £500m fund for adult social care, designed to speed up hospital discharge and bolster the care workforce.
The Department of Health and Social Care (DHSC) said today that 60% of the funding would go to integrated care boards (ICBs) – which, since July, have been responsible for NHS commissioning – with 40% allocated to councils. ICBs and councils are expected to agree how the funding is used with the DHSC monitoring how it is used, to inform future funding decisions.
Today’s announcement – which included setting out allocations for local areas, and that the funding would come in early December and January – comes eight weeks after former health secretary Thérèse Coffey said the £500m would be forthcoming.
Social care leaders have criticised the delay, with Association of Directors of Adult Social Services president Sarah McClinton saying that it had left the sector entering a challenging winter with “no certainty, no plan and increasingly little time”.
13,000 people stuck in hospitals
The core purpose of the funding is to free up hospital beds in order to support patients to move through logjammed accident and emergency departments, which have just endured their busiest October ever. Currently, more than 13,000 people who are medically fit for discharge are stuck in hospital every day.
While this has multiple causes, including pressures on carers and a lack of primary and community NHS capacity, shortages of social care services and staff are significant factors. In 2021-22, the number of vacancies across adult social care rose by 55,000 (52%), while the number of filled posts fell by 50,000.
The DHSC said that, in most areas, prioritising home care would have the greatest impact on reducing delayed discharges to social care. In a speech to NHS leaders today, health and social care secretary Steve Barclay said other possible uses included supportive technology and using physiotherapists and occupational therapists to support people’s recovery at home.
Channelling the funding through the NHS reflects a growing shift towards resourcing adult social care through the health service. NHS funding accounted for £4.1bn (15%) of adult social care expenditure in 2021-22, up from £2.8bn in 2019-20.
String of reports warn of social care’s plight
As well as bemoaning the delay in announcing the allocation of the £500m, social care leaders have also criticised its sufficiency, with several referring to it as a “sticking plaster” for the sector’s problems.
These were highlighted in several reports over the past week, released ahead of tomorrow’s autumn statement, in which chancellor Jeremy Hunt will set out government plans to make an expected £30bn in public spending cuts from 2025 onwards.
Last Friday, the County Councils Network said that three-quarters of its members were planning to tighten eligibility for adult social care due to inflation and mounting demand.
On Monday, two of England’s biggest councils, Hampshire and Kent, said they risked bankruptcy as a result of “12 years of austerity”, inflation and mounting demand for adults’ and children’s social care.
On Tuesday, ADASS warned that 94% of directors did not believe they had enough money or workforce to meet needs this winter, according to its latest survey. On the same day, the Care Provider Alliance, a collective of provider umbrella bodies, said the sector was in an “increasingly fragile position” due to a 10.7% vacancy rate, as of March and the mounting cost of living crisis.
And today, the Local Government Association said councils in England faced a £3.4bn funding gap in 2023-24 and a £4.5bn black hole in 2024-25, which meant that, without additional resource, cuts to adult and children’s social care would follow.
Cuts – not extra funding – expected from Hunt
However, as well as announcing public spending cuts for 2025 onwards, Hunt is expected to retain existing spending plans for 2022-25 in cash terms. While these allowed for real-terms increases in council budgets when they were set in 2021, this was based on the assumption that inflation would be 4.4% in 2022-23.
But the annual rate of inflation has topped 9% since April, rising to 11.1% in October, meaning the existing settlement will be much reduced in real-terms for councils.
Hunt is also expected to announce a two-year delay to the adult social care charging reforms currently due to come into force in October 2023 and including the £86,000 cap on personal care costs and a more generous means-test. It is not clear what would happen to the £2bn allocated for the reforms from 2023-25 in that event, with sector leaders calling for it to be recycled into core adult social care services, amid concerns it would be retained by the Treasury to deliver savings.