National Audit Office has launched two reports: “Care Act first-phase reforms” and “Local government new burdens”.
Care Act first-phase reforms
ADASS and LGA have flagged up risks connected with estimation of costs and demand for the care act implementation. The NAO report echoes these concerns, although also notes DH has implemented Phase 1 Care Act well- (99% councils are confident that they would be able to carry out the reforms from April 2015).
Carers Assessments and Services
NAO estimates that Phase 1 will cost £2.5bn (2013-14 to 2019-20), more than half of which is for carers’ assessments and services.
NAO believe DH may have underestimated the demand from carers, basing its estimate on the number actually receiving Carer’s Allowance (CA) rather than the number potentially eligible for CA. NAO calculates a risk of £27m (26%) in extra carers assessments and services.
NAO note that demand from self- funders is uncertain, particularly from those within the community, and the Department is criticised for not undertaking detailed research to understand this demand and for making assumptions.
Calculating unit costs of assessments
NAO note DH took the median unit cost from figures supplied by councils but placed greater weight on costs supplied by councils that expected to carry out greater numbers of assessments. This group tended to have lower unit costs, pushing the DH estimate downwards and is not representative of all councils.
The NAO also raised concerns about the use of BCF to channel £174m of the Care Act Implementation allocation. NAO note this is not new money and it is not ring-fenced. Whilst NHSE has signed off BCF plans only after receiving confirmation that the Care Act money would be used as intended, it will not be monitoring whether this happens in practice.
If demand or costs exceed expectations, pressures will fall first on individual councils, forcing cuts or reductions to services. The Department may not have sufficient information and does not have a contingency fund, and longer term options could include changes to the regulations, additional guidance, peer-to-peer support and SLI.
Local government new burdens
The report underlines the importance of departments assessing new burdens on councils not only rigorously but also transparently. In addition DCLG needs to use intelligence better, to improve its understanding of the pressures affecting council's financial sustainability. The NAO note that councils still do not know whether the Government will treat consequences of the Supreme Court judgement relating to DoLS as a new burden- calculated by ADASS and LGA to be at least £97m in 2014/15.
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