ADASS Publishes ‘Damning Report’ Revealing £564m Adult Social Care Overspend

A report from directors of adult social services indicates that eight out of ten councils are projected to exceed their adult social care budget for the current financial year.

According to a survey conducted by the Association of Directors of Adult Social Services (ADASS), 81% of councils anticipate overspending their adult social care budget in 2024/25, an increase from 72% in the previous year and 63% in 2022/23.

The anticipated overspend, calculated from figures submitted prior to the Budget, stands at £564 million for 2024/25. This figure represents a slight decrease from the £586 million reported in ADASS’s Spring Survey, yet it is significantly higher than the £73.7 million recorded in 2022/23.

In the fiscal year 2019/20, prior to the onset of the pandemic, councils experienced an underspend of £197 million.

ADASS President Melanie Williams acknowledged the £600 million increase for social care in the budget as a positive development but cautioned that a substantial portion of this funding would likely be consumed by rising national insurance and wage costs.

The social care sector was quick to respond to the survey’s findings, warning that the number of people going without the care they need will rocket because local authorities are running out of money to pay for it.

Helen Walker, Chief Executive of Carers UK, said:

“Yet again, it is devastating to read the latest report from ADASS which clearly demonstrates that the challenges facing councils remain significant and are getting even worse as we head into this Winter.

“Millions of unpaid carers are bearing the brunt of this crisis when so many are already pushed to the limit. Adult social care relies heavily on the care and support unpaid carers provide to family members, friends and neighbours. They are suffering the negative effects of severe shortages in the social care workforce and the lack of funding. This is impacting their own health and wellbeing and their ability to care. 

“The increasing intensity of care many provide also means thousands of unpaid carers find it increasingly difficult to juggle work and caring responsibilities, with around 600 leaving the workplace every day to care.

“Local authorities need sustainable and sufficient funding to fulfil their duties now. We want to see the Government set out a clear plan of action for social care reform, including a National Carers Strategy, as an absolute priority.” 

Nuffield Trust Deputy Director of Policy Natasha Curry said:

“Last week saw the social care sector desperately warn that, unless funding is increased, the Budget’s minimum wage and national insurance contribution rises risk further destabilising care provision. Today’s report from ADASS provides yet more evidence of just how much financial pressure this sector is under.

“With ADASS revealing councils are now on course to overspend on adult social care budgets by £564m in this financial year alone, the report starkly illustrates last week’s Budget announcement of £600m extra for adult social care next year likely won’t even touch the sides.

“The last ADASS survey in July this year found nine-in-ten social care directors were worried their budgets would fail to cover their statutory duties, and now many are warning they will have no choice but to shore up day-to-day services through unsustainable measures such as dipping into reserves or selling off assets.

“Government ears cannot stay deaf to the repeated warning bells on social care, which are clamouring after fallout from the Budget and today’s ADASS survey. Not only does ADASS lay out the sector’s vulnerability, the report shows how the sector is fundamental to realising the government’s major shifts in health and care – but to do that it must be supported via meaningful, long-term financial support, instead of sporadic short-term handouts that simply do not go far enough.”

The social care provider organisation, the Independent Care Group (ICG), said that would only mean one thing – fewer people getting the care they need.

It urged the government to switch money from the NHS to social care urgently to tackle the ongoing crisis in the sector. Currently, 2m people are living with an unmet care need.

ICG Chair Mike Padgham said: “The results of the ADASS survey make grim reading for the social care sector. Councils running out of money can only result in less care being commissioned and lower prices paid for what care councils do buy.

“All of that spells clear and present danger for social care – and that is before the impact of the rise in employer’s National Insurance and increases in the National Living and Minimum wages come into force.

“Government after government have all turned a blind eye to the crisis in social care and to endless reports, like today’s from ADASS, which have warned of increasing problems.

“Some 14 health secretaries and 17 social care ministers have come and gone in the past 20 years and we have seen endless reports, commissions and strategies come and go without any meaningful change.

“This new Government will need to act, switch resources into social care from the NHS immediately, so that councils can keep commissioning care, otherwise the 2m who currently can’t get care will be 3m and then 4m before you know it.

“We need the Government to visit the frontline of care, see the crisis for themselves and take action. Those of us in social care are sick of saying, ‘we are in crisis’, something has to give.”

The ICG says extra funding is needed to keep social care afloat. It argues that the Government must support social care to succeed in its proposals to reform and improve the NHS, as it is impossible to reform one without supporting the other.

“The Government is committed to a 10-year plan for the NHS, which includes switching from hospital to community and from sickness to prevention,” Mr Padgham added. “That requires sufficient social care to be available, otherwise that plan will be in tatters and people who are stuck in hospital beds due to a lack of social care will be staying there.”

Responding to the publication of the ADASS Autumn Survey 2024 Sarah Walter, director of the NHS Confederation’s Integrated Care Systems Network (ICS), said:

“NHS leaders understand that they cannot improve performance or achieve some of the government’s key ambitions without a functioning social care system. These latest findings will be particularly worrying for ICSs which are working in partnership with local government to tackle health inequalities, improve population health, and drive forward the government’s three shifts.

“Our recent State of ICS report found that over three-quarters of ICB and ICP chairs were concerned that financial challenges in the NHS and local government will impact their ability to deliver on their ambitions and negatively impact partnership working. This shows that our members understand that the worsening state of local government finances could have a knock-on impact on the NHS.

“Social care is also a critical part of getting patients out of hospital and keeping patients well at home. So any worsening of council budgets could lead to further bottlenecks at the back door of hospitals which makes it harder for A&E to admit patients to wards and can create long ambulance handover delays.

“We welcome the £600 million investment for social care announced in the Budget, but also know the sector often lacks the workforce that it needs to provide services. The government’s commitment to put local government onto multi-year funding settlements will also help.

“That is why we’ve been calling on the government to commit to funding and delivering a workforce plan and reforms for the social care sector which will work in tandem with the government’s plans for the NHS.”

Head of Practice and Workforce at the Royal College of Occupational Therapists, Suhailah Mohamed, said:

‘The lack of funding for social care is a huge concern – especially as the situation seems to have got worse since the spring. Social care services, which include occupational therapists, provide support for people at home so that they can continue to lead meaningful lives. With the right support at home, there will be fewer people reaching crisis point and needing to be admitted to hospital. So there would be less pressure on NHS services, particularly important as we come into the winter.

‘Funding and resources need to be reallocated so we can do more with what little there is. That means moving more occupational therapists into community settings, so they can help people recover after a hospital stay, prevent them going back in again and, ideally, prevent them being admitted in the first place.

‘Investment in the social care workforce is critical – more investment and more focus on recruitment and retention is vital. This would allow us to help those accessing social care services manage their symptoms and do the activities they want, need and love to do in life. And support them to live in homes that are safe and suited to their abilities.’

Kathryn Smith, Chief Executive of the Social Care Institute for Excellence (SCIE), responded;

“This report is the latest in a series highlighting the scale of the “ongoing and intensifying pressures” facing adult social care. Its release comes exactly a week after the Government’s Autumn Budget—which left us disappointed by the disparity between NHS and social care funding and concerned by rising care costs.

“The increasing level and complexity of care needs means that councils are struggling to fulfil their legal obligations to individuals accessing care and support and their carers—and yet the Government is asking them to make substantial savings. With almost a half of councils with social care responsibilities likely to apply for financial support in the coming years, without action there will be implications for the quality and availability of care and support services.

“The foundations for a robust National Care Service are currently unstable. Whilst the review of Carers Allowance and the introduction of a Fair Pay Agreement are significant steps forward, social care runs as a golden thread through many of the Government’s ambitions. Refocusing the system from sickness to prevention and hospital to community, as well as the success of the 10-year health plan, are all contingent upon a healthy, thriving social care sector. This starts with reviewing the current funding frameworks, such as the Better Care Fund, and funding settlements.

“Beyond funding, we need to find new ways to deliver social care more efficiently and effectively, such as through new care models and digital innovation. The spreading and scaling of innovation create new avenues for stabilising the sector. One example is digital solutions that provide local information and support to unpaid carers. We stand ready to work with the Government to help deliver their vision for the social care sector and drive the change required.”