The social care time bomb: Time for seismic change
By Tony Pilkington, managing director of Younifi
The other week we saw Chancellor Philip Hammond deliver his first Spring Budget. After months of headlines claiming that adult social care had reached crisis point, to the relief of many, Hammond promised an extra £2bn over the next three years.
Yes, it's an enormous sum of money, but the reality is that it’s too little, too late and nowhere near enough to resolve the host of issues this country faces when it comes to supporting our ageing population.
Back in October, we also saw the Government attempt to offer a solution by suggesting a rise in council tax to fund social care in the future. The Local Government Association has since warned that a rise in council tax this year and next would not bring in enough money to prevent the need for deeper cuts to local services.
The reality is the current approach to social care is no more sustainable than the notion of throwing more money at it. Additionally, current public support may diminish as they see the extra billions given to social care have, at best, a limited impact and, at worst, still see cuts to services. Effectively, the "extra" will only allow councils to stand still for a short time.
Moving pots of money around to fill funding gaps and asking taxpayers for more money raises more concerns. At best, it is a short-term fix and, at worst, it could mean disaster for other public services, and the general public, many of whom simply won't be able to afford a rise in council tax.
Everyone accepts that change is required. We've seen many initiatives and pilots spring up throughout the UK. Examples include supported housing projects and groups aimed at targeting loneliness. These initiatives and pilots are launched with an aim of relieving local care pressures and positively impacting individuals in need of support. Pockets of excellence exist but what we need to support wider aims is real change from local authorities to promote them as viable alternatives to traditional care.
A fundamental shift from short-term fixes and funding projects and pilots to a programme of real systemic change is needed based on the following principles:
1. Evidence-based decision making
Local authorities have little to no visibility of what support is required, or the care packages being delivered in the area. Consequently, there is little or no intelligence about the types of care that will be needed in the future and how money can be better spent on care.
Only when we have a true picture of what is being spent and the traditional or community-based services in demand will councils be in a position to make evidence-based decisions, prioritise their efforts and demonstrate the achieved improvements.
2. Personalisation of care
The Care Act of 2014 promised assistance for all, including those not eligible for council funding, and mandatory personal budgets for those that are, giving recipients of care more freedom to spend their funds as they choose. Amid Government budget cuts, an increasing ageing population and conditions such as dementia on the rise, our demand for social care means that this promise is difficult to achieve. Putting all people at the centre of care needs to be a priority and actively promoting a wider range of care and alternative options to people that suit their specific needs.
3. True freedom of choice
Our findings, in a survey we undertook in 2016, showed that many people's perception of their choice was limited to the traditional services that the councils themselves struggle to access.
Freedom of choice can be supported by better sharing options for how people may choose to meet their needs. So, when initiatives and projects are set up, finding a way for them to be easily promoted to local people is essential for them to have the best chance to succeed. People don't know what they don't know, so how else do they become aware of the new options?
Freedom of choice also means councils have to create strategies that seek to stimulate local care markets, especially from within the community and voluntary sector, without adding greater financial and administrative burden to the council.
I believe that a new way of supporting people, councils and providers is essential to improve evidence-based decision making, personalisation and freedom of choice. Achieving this will ultimately give care recipients access to a wide range of services they may benefit from at their fingertips, ultimately creating better outcomes for all.
Fundamental change won't happen overnight and it remains to be seen how the Government's £2bn will be spent. I suspect we'll see little in the way of change and at best it'll fill a few critical funding gaps. But my view is that it's time for a complete overhaul of the current system and the answers to a system-wide and complex challenge needs to be met with new, more radical solutions.