Cutting the care cloth, by Andrew Cozens

15 Oct 09
ANDREW COZENS | As social services face higher demand with tighter funding, the sector is having to focus attention on only the most needy

As social services face higher demand with tighter funding, the sector is having to focus attention on only the most needy

There will be more than a seasonal chill in the air when delegates gather for the national children and adults services conference in Harrogate next week. Delegates will be bracing themselves for tough messages from the platform on what they can hope to achieve during the recession.

Both child and adult services have been encouraged to switch from a service focus – doing the best for your current users – towards improving outcomes for the wider population of those requiring support.

The performance regimes have changed too. Councils are judged on success in narrowing the gap in outcomes and the development of choice and control, as well as quality of life measures.

The downturn has accelerated important debates about the future for these services. Councils had been anticipating the need to reconsider spending plans at the end of the current Comprehensive Spending Review in 2011 as the growth in children’s services slowed and the additional funding for transforming adult social care ran out.

They were also aware of the need to debate the sustainable long-term model for funding for care and support to address the current unfairness and the implications of more people living longer.

The coming 12 months will be a significant period of transition. So far, there are no indications of anticipated programme funding for 2010/11 being cut or of any significant shift in the revenue support grant assumptions. Beyond that the prospects look uncertain.

The reality is that the budget squeeze is already on. Councils are reporting an increase in demand for social services and a significant drop in income as they seek to keep council tax low and not unreasonably increase charges.

At the same time, more people are exempt from charges through loss of jobs. This drop in income also gives councils less room to redirect funding to support these vital services. Even before the recession, councils were having to top up the government’s adult social care allocation by, on average, 40% and this burden is growing.

Where does the financial squeeze impinge on the policy goals for these services? All parties are talking about variations of what Liberal Democrat leader Nick Clegg described recently as progressive austerity. In practice, this means moving from a universal focus to approaches based on principles of social justice. The Conservatives have proposed means-testing tax credits and a similar challenge will surely follow around free childcare and Sure Start services. We can anticipate calls for targeting of children’s services to narrow the gap in outcomes and to invest in how best to safeguard children.

Adult social care is in a more parlous position. All three main parties have proposed increasing funding through voluntary or compulsory contributions from the wider population, offset by the promise of clearer and fairer entitlements.

But these are long-term options. The immediate prospect must be fewer people with greater needs being supported by public funds, and only those lucky enough to be inside this smaller tent enjoying the full benefits of choice and control. The only consolation for the rest is receiving support to make decisions on the use of their own resources.

But there are challenges councils are rising to. It is no coincidence that many of the Total Place pilots are looking at how they can generate simpler and more efficient approaches across local public services. Leaders in the sector have shown a hunger for evidence of what works through initiatives such as the Centre for Excellence and Outcomes and the Social Care Institute for Excellence. Based on this, the tough question is rightly being asked – if this is successful here (and saves money too), why not everywhere? This is not something the sector can duck in a colder fiscal climate.

Andrew Cozens is strategic lead for adult social care at the Local Government Association Group. The LGA national children and adult services conference will take place in Harrogate on October 21–23

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