Directors 'pulling out the stops' to protect the front line  

Association of Directors of Adult Social Services
Date: 30th September 2010
Embargo: 21:00 Hrs 30th September 2010

Directors of Adult Social Services have assured ministers that they will do, and are doing, everything possible to make savings within their care budgets which will not damage front line services. They have also warned, however, that without further rapid investment by the NHS in social care, cuts in direct services will be `unavoidable.

At a special meeting of ADASS members earlier this week, a paper was presented which encouraged directors to focus strongly on:

  • Prevention Ensuring information about all local services is available so that people are not required to use health and social care earlier than they need to, and providing access for them to mainstream life as citizens, prolonging their independence; enhancing their wellbeing,
  • Recovery enabling people to recover as fully as possible and managing crises in ways which maximise their chances of staying out of hospital,
  • Continued support Giving people the opportunity to choose from a range of services which offer value for money,
  • Efficient process Making sure that support is available at the most economic cost and acceptable quality both to people who qualify for council services and, in some cases, to people who fund their own care and support,
  • Partnership Getting all relevant  agencies as well as health and social care to work together to achieve these outcomes,
  • Contributions Ensuring that individuals and those who support them are expected and enabled to make a fair contribution to this support financial and/or informal support from family, friends or volunteers. Councils will recognise the value of wider social capital including volunteering, and expect such capital to be a source of support to people, and actively promote and encourage it.

But according to ADASS President Richard Jones, reductions in adult social care budgets as large as those which have been mooted in recent months will lead to `serious inroads into services for older people, and people with learning and physical disabilities, unless a reality is made of integrated local authority and NHS budgets.

He went on: A social care system that has to find the major savings we are anticipating does not bode well for the NHS particularly in the straitened circumstances health service colleagues are expected to be facing in the coming years, despite the `protected status of their budgets.

In establishing the Care Funding Commission led by Andrew Dilnot, the Government itself has acknowledged that the present social care system is not fit for purpose. It is vital that Ministers for the good of both agencies and the people they care for - support health in investing in social care services now. We need a step change in the way public resources are aligned to deliver shared outcomes for people - and local government is up for that challenge. The NHS white paper sets out an ambitious agenda which we support: backing this with a strong signal  for collaboration and pooling of resource would be very timely."

Mr Jones pointed out that at any point in time up to 40 per cent of elderly people in hospital beds are there unnecessarily. And up to 70 per cent of older people stay in hospital too long. He said: with the recent publication of the NHS White Paper we must seize the opportunity to carry out a fundamental review of how health and social care services interface. We should seize the opportunities that GP-led commissioning creates, and support investment which supports effective care close to home.

Bringing our services and budgets more closely alongside the health service will mean fewer delayed discharges; fewer unnecessary readmissions to hospital wards, and savings to NHS and local government alike. Joint investment in reablement, crisis support, telecare and preventative services reduces demand for hospital admissions and  residential and nursing care and it has been proved to delivers better outcomes for individuals and their families" 

He went on to echo the joint ADASS/LGA submission to the current Spending Review*, pointing out that no one has so far identified how large scale savings from adult social care budgets in England can be achieved. A reduction of 25 per cent in our budgets over three years would come at a time when we know we are likely to see 370,000 more people needing care and support an effective  growth in demand of some four per cent per year creating a potential challenge of up to 40 per cent for many councils.

We know further efficiencies can be made and we have a track record, along with local government, of delivering three per cent efficiency savings annually over the last spending review period. But at best this gets us close to a sixth of the way towards what we might have to find.

Reforming what we do - and how we do it - is critical. ADASS is committed to continuing to deliver personalisation, giving people real choice and control and simplifying our processes. We are also clear that we need to use the capacity that exists in neighbourhoods and in community networks to enable people to take care of themselves and those around them.

And we want increasingly to combine our resources with those of other local partners and ensure all the resources that are available are focused on delivering the outcomes citizens and communities want.

Reform is the key to our success. But reform takes time and strong and determined leadership. We have the latter but not the former. When resources reduce at the level we are anticipating, balancing reform and retrenchment will be tough. We know hard decisions will have to be made as councils set their budgets given that adult social care often represents the biggest proportion of local spend. And the core offer in many places will have to change. Councils will have to look at charging options, eligibility, and what they will have to stop doing - not because they want to but because they have to.

In making the tough decisions we will be driven by our values to support the most vulnerable at all costs and by the evidence that shows that prevention, enablement and pooling our efforts with others is the only way forward.

For further information, contact:
Richard Jones, President ADASS, 01772 534390
John Jackson, Joint Chair, ADASS Resources Network, 01865 323574
Drew Clode, ADASS Policy/Press Adviser, 020 8348 5023/07976 837755

* Copies of the ADASS submission can be found at http://www.adass.org.uk/images/stories/ASC%20Submission%20v16%20-%20final.doc