By Keith Aitken in Edinburgh | 1 March 2012
Scottish councils and NHS boards must raise their game urgently if they are to provide vital social care services on tighter budgets, Audit Scotland has warned.
A report published today highlights a growing tendency to focus resources on people needing the most intensive support and a failure to develop joint commissioning strategies to cover the full range of needs. The auditors also found poor communication between commissioners and private and voluntary sector providers, although they account for much of Scotland’s £3bn care spend.
Commissioning social care urges authorities to work more closely with these providers to develop an understanding of their finances and prepare contingency plans in case they go bust, as a number of care home companies have in the pastyear.
The report is published at a pivotal time for social care in Scotland. Along with financial constraints, authorities have to cope with pressure from ministers to merge council and NHS provision, develop preventative spend strategies and phase in self-directed support. This gives users greater choice and control over the care they receive.
According to the report, tighter funds might be putting the preventative spending plans into reverse. Accounts Commission chair John Baillie said: ‘As budgets come under growing pressure, there are signs that councils are concentrating resources on people who need intensive support.
‘There is a risk that people who need a small amount of support may not get the help they need to live independently. Their early problems may worsen more quickly without this help and this may lead to greater cost over the longer term.’
Scottish Government plans to merge council and NHS care were announced in December, and legislation is due soon on self-directed support. The report says: ‘If services are to improve, there needs to be better information on the needs of the population [and] on the costs, quality and impact of services.’
Auditor general Bob Black added: ‘If these changes are to work well, it is essential that councils and health boards improve the planning and commissioning of care services.’
Joint strategic commissioning, the report says, ‘can help provide joined-up services to people and prevent, delay or shorten a stay in hospital’, and prevent waste.
Labour called the report’s conclusions ‘a damning indictment of the SNP’s complacency’. Shadow health secretary Jackie Baillie said: ‘Local government is being forced to shoulder a breathtaking 89% of the SNP’s budget cuts. It is a matter of huge regret that such early intervention work, which is key to prevention, remains an aspiration rather than a reality, and is even being cut back.’
