Social care, which delivers care in home and community-based settings, is essential for encouraging older people and adults with disabilities to live as independently as possible and crucially, keep them out of hospital and thus reduce demand on the NHS.
Since the introduction of relatively small annual cash injections from 2017/8, the number of delays to transfers of care – time wasted when people are unable to leave hospital owing to a lack of somewhere suitable to receive support – attributable to social care has fallen dramatically by 41 per cent, from a high of 74,228 last March to 40,209 this June.
The NHS’ excess bed days calculations put the saving per day of having one extra bed available in hospital throughout 2016/17 at £313.
Over the last year, the number of delayed transfers of care days attributable to Adult Social Care has fallen by 187,864, meaning that there has been a reduction of almost £60 million – £58,801,432 overall – in NHS costs, as a result of improved adult social care performance when compared to the previous 12 months.
The NHS is celebrating its seventieth year this year and does an incredible job looking after people in need of care. In recent years the health service has performed brilliantly, despite increased pressures from an ageing population and diminished resources. ADASS would like funds to also be supplied to social care so the two sectors can support people get emergency treatment when needed but live as independently as possible.
ADASS is calling for the Government to urgently bring forward a long-term funding solution for adult social care in its forthcoming green paper, and in the meantime to supply interim funding to help the sector cope with its current pressures.
In addition, the analysis found:
The average cost of residential care is £91.10 per day, which is £221.90 cheaper than an excess bed day in hospital. This demonstrates the significant savings that social care can offer the taxpayer, aside from the fact that it provides tailored care at home and in the community, where people would rather have it.
The cost of delivering the 2016/17 excess bed days in hospital was £ 253,847,069. If these had been provided through residential care, that cost would have been significantly less at £73,883,284.
For 2017/18, the cost of providing excess bed days in hospital would have been £195,045,637 which would have fallen in residential care to £56,768,873.
ADASS believes that supporting people’s wellbeing at home needs to be a huge focus of care provision going forward. The best way to reduce pressure on hospitals is to provide care which means people don’t end up sick or injured and needing hospital in the first place. With an overall significant increase in attendances and admissions to A&E generally, the need for interim funding to be supplied to social care to reduce the pressure on the NHS is urgent and this funding must also be supplied to community services and primary care.
Since the inception of the Improved Better Care Fund, enabling social care teams to access more money, delays in social care transfers have fallen by 41 per cent, from 67, 878 in July 2017 to 40,209 in June 2018.
Yet council social care teams remain concerned that they will not be able to balance the books when it comes to care budgets. In ADASS’ annual budget survey, which was responded to by 100 per cent of social care directors across the country, less than a third (32 per cent) of Directors were confident at all in meeting savings targets for 2020/21, compared to 93 per cent of Directors in 2018/19.
Not a single Director from across the country were fully confident in meeting their statutory duties as social care departments for 2020/21, emphasising the scale of the challenge facing social care if both short-term emergency funding in the Autumn Budget is not provided and if there is not a long-term funding solution provided for the sector soon.
As a proportion of delays to transfers of care, social care has only been attributable for 29.1 per cent of all delays, with the NHS responsible for 62.6 per cent. The improvement in social care delays demonstrates the impact social care can make with additional resources.
Recently stakeholders from across the sector have been putting forward plans which could address funding shortfalls in adult social care, with the Local Government Association growing so frustrated as to publish their own green paper, outlining a range of possible options government should consider in order to place social care on a sustainable footing.
ADASS is now joining these calls with a renewed push for a green paper that delivers a long-term funding solution. The organisation is also today unveiling an animation which goes live on their website today, detailing the scale of the social care crisis and the need for urgent funding.
With long-term funding plans and an emergency cash injection to shore up the sector, councils could make a real difference in creating the conditions for people to live as independently as possible for as long as possible. Together with the excellent work of NHS teams in treating people as effectively as possible, ADASS is determined to deliver a collaborative approach which can not only reduce NHS pressures, but support the NHS by delivering treatment that is person-centred and individualistic.
But without at least some short term emergency funding, pressures on the NHS could increase, meaning increased funding for the health service could be throwing money at the symptoms of the problem rather than tackling the underlying causes of the situation. As a minimum, local authorities should have greater influence when it comes to determining how money is spent on primary, community and mental health services.
Julie Ogley, Vice President of ADASS, said:
“Our health service is the pride of our nation and the envy of the world, and rightly so. The NHS is an institution that saves lives and provides brilliant healthcare free at the point of use.
“As the voice of social care teams across the country, ADASS is determined to help social care teams deliver care which both reduces pressure on our NHS and helps people live as independently as possible. This will also help us ensure that people are admitted to hospital only at appropriate times, allowing front-line health service colleagues to get on with the job in hand.
“Social care enables this by providing the person-centred essential care where people need it, in our communities. Our dedicated workforce has done a tremendous job over the last year with limited resources, saving the NHS almost £60 million by keeping people out of hospital. This demonstrates the ability of social care to make an impact.
“However, when not one adult social care director is confident in meeting their statutory duties across the country, it’s clear we have a crisis in care. It’s essential that the Government builds on the work of the LGA and others in the sector, and deliver the green paper, which must contain a long-term funding solution, as soon as possible.
“In the meantime, however, urgent and immediate funding is needed to help social care keep track with the pressures of an ageing population, and in turn, reduce those pressures on the NHS. The best way to help people live as independently as possible, as long as possible, is to provide effective support in the communities in which they live.”