Government lights cautious optimism in the social care sector but now must deliver reform and sustainable funding
By Olly Swann
We recently had the pleasure of hosting a round-table event with a group of Directors from both Adult and Children’s Social Care to reflect post-Budget on what the new Government had (or hadn’t) committed to and explore the consequences of that in advance of the NCAS conference, the biggest gathering of social care leaders in the public sector calendar.
The challenges facing the social sector are well documented and few expected the Chancellor’s Autumn Statement to deliver the step-change in funding and targeted transformations required. Funding gaps dominate the current landscape, making it difficult to consider the medium-term. But our session with Directors offered these further reflections and recommendations for local and central government:
· Whole system reform now the only viable solution... The new Government’s commitments are cause for some hope across the sector. However, the Budget will have minimal, if any, impact on current delivery arrangements and the challenges councils are facing. With short-term funding commitments being swallowed by the National Insurance and Living Wage increases, whole system reforms are now the only viable solution, and the ongoing Spending Review has to grasp the nettle and set out a series of funded ambitions in the Spring. This must include a rethink of the funding models as current structures are linked to outdated funding arrangements and the benefits system when it comes to the step between children’s and adults’ services. This does not represent lives children and families lead and the challenges they face, so how can it motivate complex systems and the multitude of professions within them to seamlessly work together to deliver better outcomes?
· … and Social Care reforms must happen ASAP. The fact that children’s services were even mentioned in the Budget demonstrates real progress. The Government has committed to system reforms but the risk is that too much focus is placed upon placement spend and profiteering. Children need integrated offers that address health, employment, education and social care and show holistic understanding of the real lives of children and families that require support. Meanwhile there are no confirmed plans for Adult Social Care reform. While it’s encouraging to hear how the social care plan will run alongside the ten-year plan for health as part of a neighbourhood-based vision, we mustn’t underestimate the scale of the cultural shift required. The current challenges are forcing councils into short-term, sometimes short-sighted, action and providing little opportunity to even consider the activity needed to sustainably reform care and support.
· Housing matters. The prominence of housing issues within wider presenting needs profiles is not new for many councils, but the catalyst for change and growth definitely is. The Government’s commitments to housing must translate into local action, and whether the requirement is for quality and warm homes for individuals and families, or supported accommodation arrangements for those with higher needs, initiatives typically spanning organisational silos or interfaces need mobilising at pace.
· Time to make early intervention and prevention meaningful. Prevention and protection are very much two sides of the same coin, but we’ve been inconsistent with the former given the lack of national guidance and the variation in local finances. When grounded in needs-led intelligence, preventative services play a crucial role in identifying issues early, determining potential risks, and providing early intervention to prevent issues escalating before they reach crisis point. These programmes and services need to be seen as statutory going forwards and both the Care Quality Commission and Ofsted need to start caring about it. The Government’s wider stance on devolution and Local Government Reorganisation (often confused!) also provide an opportunity for much greater collaboration and integration across place.
· Health is a risk as much as it is an opportunity. The tensions and gaps between care and health are at risk of widening. Where the interface works well, it’s normally as a result of individual relationships and not aligned system ambitions across a place. Whilst the details are still to be revealed, we need to ensure that the c£22bn investment in the NHS is spent on the right things and not more cost-shunting exercises towards local government (AKA ‘complex care reviews’). Tensions will remain while these respective, yet dependent, systems are treated differently through the Whitehall lens.
The ICC team will be at NCAS conference this week, so please do reach out to hear more about our work in social care and at the interface with Health. Equally, if you are not attending we’d love to meet you when we’re back! Please get in touch via [email protected].