NHS And DH Are ‘Flying Blind’ In Planning Services For Older People

The warning comes in a new Nuffield Trust and Health Foundation study examining cuts to social services for older people in England, published as MPs prepare to question senior officials and experts on the topic in Parliament.

The new research, which is part of the Nuffield Trust and Health Foundation’s QualityWatch programme, reveals that most local authorities are tightly rationing social care for the over-65s in response to cuts, resulting in significant drops in the number of people receiving services like home-delivered meals and day care.

It reinforces this month’s National Audit Office report into the state of adult social care and finds that older people’s social care has experienced a 15% cut in real terms since the Government’s deficit reduction programme started in 2010.

Other key findings include:

  • Almost a quarter of a million (245,855) fewer older people received publicly funded community services in the financial year 2012/13 compared to 2009/10, a 26% drop
  • Home and day care spending by councils fell by 23% (or £538 million) over the same period
  • The number of older people receiving home-delivered meals has more than halved since 2009/10, falling by 59% (54,795 people). This is in response to a reduction in funding of 46% for meals over the period
  • While the number of people receiving 10 or more hours of care and overnight care remained constant between 2009/10 and 2012/13, around 42% fewer people received lower-intensity care over the same period. This indicates that local authorities have responded to cuts by focusing on those most at need
  • Transfers of money from the NHS to adult social care have more than doubled since 2009/10, reaching £803 million in 2012/13. This suggests that cuts to social care services would have been even more drastic if not for these transfers.

As well as leaving hundreds of thousands of previously eligible older people without local authority support, the report says that these cuts mean those still receiving publicly-funded services may be at risk of poor quality care.

The NHS and Government are flying blind when it comes to managing demand

This is because the income paid to social care providers has been squeezed, which may have resulted in staff shortages, high staff turnover or reduced contact hours.

The study seeks to assess the impact of social care cuts on the health and wellbeing of older people and their carers, but finds that, due to a lack of available data, it is not possible to quantify this.

Despite increased numbers of older people attending A&E in recent years, for example, the NHS does not record whether someone is a user of publicly funded social care. Moreover local councils themselves do not hold data on those who pay for their own care, only on those whose care is publicly funded.