As ADASS looks forward to the Annual Spring seminar, now becoming a regular austerity event in Yarnfield, the report published in April by the Institute of Fiscal Studies (IFS) National Standards, Local Risks: The Geography of Local Authority Funded Social Care is worth scrutiny. The IFS said that whilst almost all councils had cut spending for social care, some 10% had done so by more than a quarter. However, the IFS also commented that the number of variations in council’s social care spending could not be easily explained. Unless tackled with better data, it’s likely to cause growing fustration and confusion, especially as STPs move forward
In 2015/16, the last figures available, the average social care spend per head across the whole adult population was £381 a year but varied from £325 in the lowest spending 10% of councils to £445 in the highest. Average spending fell by most in London, at 18%, and by 16% in other metropolitan districts. Overall cuts were larger in the north of England than the south.
As would be expected, councils with relatively high numbers of older people, retired people, disability claimants and deprivation levels tended to spend more. However, such factors “only explain a small proportion of the variation”, according to Co-author David Phillips He added that the report showed large differences in budgets among councils even where government assessments of spending needs were similar.
“It emphasises that the government has got its work cut out in its Fair Funding Review of how to measure different councils’ spending needs from 2019 onwards,” Mr Phillips said. “That debate could get quite fraught.”
2019 will see future funding for STPs and a challenge posed by such a range of different levels of spend in both the NHS and social care.
So what’s the answer? Hull CCG has just announced it will align its entire £400m budget with the Council’s £200m spend on social care, thus creating a much more flexible budget of £600m. This ambitious move will no doubt also be fraught but it’s an approach that could at one stroke tackle the problem of variation in spend locally.
Social care and the NHS are rich in data but poor in joint use of intelligence and analytics. When I was Director of Social Services and CE of the PCT in Barking and Dagenham we concluded that there had to be a better way forward for the use of beds. Our investment in extra care housing and intermediate care, allowed us to close 50 geriatric care beds without greater pressure on residential and nursing home beds.The problem was that back in 2001 we couldn’t readily evidence the shifts with data on an ongoing basis.
Many localities are now using scenario modelling to look at the impact of change on the whole system. Whilst this is useful, nothing beats having an ongoing dynamic way of measuring performance in outputs and outcomes across the whole system. Multiple different data sources can now be brought together and analysed as in Essex. It’s time to embrace these innovations and use data intelligently.
Julia Ross is now Chief Strategist Care and Health for Pi ltd
ADASS would like to thank Pi Ltd for their sponsorship.