ADASS urges Government to include findings of the Commission on the Funding of Care and Support in its review of NHS legislation

Association of Directors of Adult Social Services
Date: Wednesday 11th May 2011
Embargo: 9.00 am  HRS, THURSDAY MAY 12

There is a crucial need for a sustainable solution to issues concerning the funding of social care for individuals in the greatest need, according to directors of adult social services. Their warning follows a new survey of English local authority adult care budgets, conducted by ADASS, showing that councils intend to reduce spending on adult social care by £1 billion in the coming year.

According to ADASS president Peter Hay: Andrew Dilnot has been commissioned by the Government to address these funding issues and his recommendations will need to be carefully considered in the light of the growing demographic pressures facing communities across the country. ADASS strongly feels that the current `pause in considering the future of the Health and Social Care Bill should last long enough to enable Dilnots findings to be carefully considered.

Good integration of care is a major part of the Bill, yet this will be badly compromised if there is a failure to find a national solution to funding long term care.

The ADASS survey was completed by 98% of councils in England and has produced new information on how councils have set their budgets for the year 2011-12.  Adult social care is a major part of the overall budget for local authorities and represent on average one third of Councils budgets.

The key findings from the ADASS survey are:

  • Councils are reducing their budgets for adult social care by £1bn.
  • Of the savings planned for 2011/12, councils report that they plan to achieve 69% of these savings through new ways of working and improved efficiency, 8% through additional income and 23% through service reductions.
  • The cost of meeting new demand for social care services the so-called `demographic pressure was identified as £425m. These costs arise not only due to the rising number of older people but also to very significant increases in the numbers of people with learning disabilities needing high levels of support. 41% of councils prioritised the need fully to meet this pressure.
  • 79% of councils have frozen or increased fees to providers in the independent sector, who provide crucial residential and community services for individuals in need. The independent sector provides a large proportion of services, once provided directly by councils. Local authorities commitment to maintaining fee levels so substantially reflects their determination to ensure that providers can protect the quality of the care they offer.

Mr Hay added: Adult social care departments throughout England have for some time now been concentrating their efforts on different ways of working. There are major change programmes underway to shift spending into preventative services and to help people to regain their independence as quickly as possible after an illness or hospital admission. 

Councils are also sharing with each other the innovative ideas they are each developing, to meet peoples needs with reducing resources and in cost effective ways. Savings on this scale simply cannot be achieved through doing the same things more efficiently or by trimming management costs wholesale change is required and this is what councils are doing.

"Councils will do everything they can to reduce the need to spend on long term care through advice, information, prevention and reablement and by ensuring that value for money is achieved. However, this years savings targets in councils are just the beginning of a 3-4 year programme of reductions: demographic pressures will not abate and councils ability to find alternatives to service reductions will inevitably reduce over time.

ADASS will contribute to the work of the Dilnot Commission and continue to support its efforts to find the sustainable solution that is so desperately needed. As the social care system has been under increasing pressure for some years, the recommendations from the Commission will offer the best possible opportunity to meet the needs of the most vulnerable for the foreseeable future.

ENDS

For further information contact:
Peter Hay, ADASS President 0121 303 2992
Drew Clode, ADASS Policy/Press Adviser, 020 8348 5023/07976 837755

Notes for Editors: The Association of Directors of Adult Social Services (ADASS) represents directors of adult social services in local authorities in England. DASSs have statutory responsibilities for the social care of older people and adults with disabilities, while over 50 per cent also run social housing departments. ADASS members might also share a number of responsibilities for the provision and/or commissioning of housing, leisure, library, culture and arts services within their councils.

Survey Summary

ADASS Budget Survey 2011

Social Care is such a large part of local government spend that reductions are inevitable, although Councils are working hard to offset cost reductions, meet demographic pressures and integrate funding with the NHS. The reduction in spend by £1bn adds to the known gaps in social care funding and makes it imperative that this Government delivers on its promise to see through the reform of how we pay for long term care. 

Key Conclusions:

  • Councils are reducing their budgets for adult social care by £991M, representing a 6.9% reduction against a 10% reduction in overall spending by councils.
  • Councils are reducing by £169M their spend on Supporting People.
  • 13% of councils are changing their FACS criteria. There are now 78% councils at Substantial in 11/12 compared to 70% in 10/11 and 4% at critical only.
  • 79% councils have frozen or increased fees to providers.
  • The full amount of the reablement resources has been identified with strong levels of agreement with the NHS on areas of spend.
  • 95% of the Winter Pressure allocation was identified, with 89% of councils reporting agreement on how this allocation will be spent.
  • The full year NHS Transfer is still to be determined with 57% not yet agreed
  • £425m of demographic pressures were identified with 41% of councils fully funding these pressures.

Background Notes:

10/11 Net Budget

  • Councils are forecasting an under-spend of approx 1.5% of their Adult Social Care Budget.

Demographic Pressures

  • The survey indicates demographic pressures across all groups totalling £425m. In 2011/12 demographic pressures have been quantified as £180m for Older People, £41m for Physical Disability, and £179m for Learning Difficulties, £25m for Mental Health.
  • 17% of councils are not funding demographic pressures with 42% partially funding and 41% funding in full.

Council Budget and Planned Savings Levels (excluding School Grant)

  • Local Authority budgets for 2011/12 have been set at £39.5Bn which includes savings of £4.4Bn over 2010/11.
  • Adult Social Care is a substantial part of the overall budget for Councils across the country, representing 1/3 (34%) of Councils net budgets for 2011/12.

Adult Social Care Savings

  • Adult Social Care will provide a contribution to savings in 2011/12 of £991m, representing 6.9% of the 2011/12 Adult Social Care budget before savings. I.e. £991m of £14.4Bn
  • The £991m breaks down as follows - Efficiency £681m (69%), Income £84m (8%) and Service Reduction £226m (23%).

Savings from Supporting People Budgets

  • The survey data identified £169m savings from Supporting People in 2011/12, a further £66m in 2012/13 and a further £39m in 2013/14.
  • The 11/12 savings break down as: Efficiency 91m (54%), Income £50k (0%), Service Reduction £78m (46%).

Reablement (£70m one-off)

  • 98% of the allocation has been identified:
  • 89% agreement in how this allocation will be spent across Health and Social Care services.
  • Joint planning of services has seen 48% (£33.2m) spent directly on Council services, underpinning the importance of reablement to the Health and Social care economy - 20% of councils reported all the allocation was spent on Adult Social Care services provided by the Council

NHS Transfer (£648M full year).

  • 99% (£646.9m) of the total allocation was identified by respondents to the survey 
  • 24% will be deployed to avoid cuts to services:
  • 10% to cover demographic pressures; and
  • 9% to spend on additional services.
  • At the time of the survey, Local Authorities were still planning the use of the remaining funding (57%).

Winter Pressures (£162M one off)

  • £154.3m identified by councils - some discrepancy with matching this with total allocation given to PCTs, but accounts for 95% of total allocation.
  • 87% (£133.9m) of the identified allocation has been passed to councils from their PCTs.
  • 131 councils had reached agreement with their PCT on how to spend this money, the survey identified that £15.8m (10%) would be spent on NHS services.

Fees (independent sector)

  • 61% of councils have frozen their fees and 18% have reduced fees, 18% report an increase in fees with 3% still awaiting final decisions.

Fair Access to Care criteria

  • 13 % (19) councils changed their eligibility criteria between 10/11 and 11/12, of whom 15 councils moved from Moderate to Substantial.
  • 78 % (116) at Substantial.
  • 15 % (22) at Moderate.
  • 3% (4) at Low.
  • 4% (6) at Critical.