By Richard Johnstone | 13 March 2014
The government and councils do not know if the limits of the adult social care system to provide quality care are being reached as demand rises and funding is squeezed, auditors have warned.
In a report examining funding and demand in the system, the National Audit Office found that need for care was increasing across England. Despite this, from 2010/11 to 2012/13 spending fell by 8% in real terms to £19bn.
Pressures on the system are set to increase further due to the ageing population and people with long-term conditions living longer, the spending watchdog said.
The government is seeking to tackle problems through a number of reforms being introduced in the Care Bill, but these face major challenges, the Adult social care in England: overview report warned.
In particular, rising demand is set to continue amid tight spending settlements. Neither Whitehall nor councils know if the care and health systems will be able to absorb these pressures without care failures, and how long they can carry on doing so.
The Department for Communities and Local Government is expecting local efficiency initiatives to ease pressures alongside the introduction of the joint £3.8bn Better Care Fund between councils and the NHS.
The NAO concluded that although town halls have been renegotiating contracts with care providers to cut costs, including agreeing bulk purchasing discounts, there was little evidence about how to provide services most cost-effectively.
Auditor general Amyas Morse said: ‘Adult social care, including care of an ageing population, is one of the big issues we face at present. It is important to understand this in the context of the wider healthcare system of acute and primary care.
‘There are no easy answers, but we need to think clearly and in a joined-up way about the predictable and growing challenges in years to come.’
Responding to the report, a government spokeswoman said the Better Care Fund would help keep people living independently at home, get them out of hospital more quickly and prevent them from needing more support.
‘We are giving councils £1.1bn funding to help protect social care services in 2014/15,’ she added.
‘Councils have proven that by joining up services, people still get the care they need and they save money. For instance, Manchester City Council is helping people who have difficulty with daily tasks to become more independent – as a result, half those people no longer need support and a quarter have reduced care needs.
‘Councils across the country need to be more innovative so they can meet the needs of their communities,’ she added.
However, a spokeswoman for the Local Government Association said the NAO report backed calls from councils to ensure social care funding was put on a ‘sustainable footing’.
She added: ‘The budget for adult social care services has been reduced by £2.68bn over the last three years and we know that the next two years are going to be extremely tough for councils that are already feeling the brunt of these cuts.
‘The Better Care Fund has the potential to redefine how we allocate resources to maximum effect across the whole health and social care system, but government must make sure these reforms are properly funded.’
