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Health funds propping up care budgets

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Healthcare cash aimed at easing the integration of social care and health services is being used to plug huge holes in social service budgets instead, the Department of Health has admitted.

Almost a fifth of the £648m of NHS transfer funding in 2011-12 was spent by councils on efforts to maintain ‘eligibility criteria, or avoiding cutting services for some care users’, according to the DH’s annual report.

This finding suggests “funding was used to support general social care capacity, thereby ensuring that demand would continue to be met”, it added.  

Funnelling cash from the £648m transfer pot to prop up social care budgets has proven controversial as it was originally intended to help councils to join up health and social care services.

“We are clear that this funding provides a unique and excellent opportunity to forge better integrated working between the health and social care systems, for the benefit of patients, service users and carers,” A letter from David Behan, the department’s then director general for social care told chief executives of local authorities and PCTs.

The department’s annual report suggests it is satisfied with councils’ overall use of the money. “Feedback from both PCTs and local authorities has been positive, with many areas stating that these funds have been used to stimulate greater cooperation,” it said.

It also said many primary care trusts (PCTs) and councils had employed the funding to “prioritise upstream investment”. This helped delay or prevent future costs in the health and care systems.

The £648m transfer is the first of a series of annual transfers from PCTs to local authorities, which experts predict wil be increasingly swallowed up by social care. Research by the Association of Directors of Adult Social Services suggests that £284m of the £622m transfer in 2012-13 will be used to maintain social services at their current level.

Richard Humphries, a senior fellow at thinktank the King’s Fund claims that social care would be underfunded by £3bn a year if the Dilnot commission’s reforms are implemented.

He described the transfer of funds as “robbing Peter to pay Paul”. “It’s not surprising that councils used some of the money to prevent making cuts, because the funding transfer is essentially a sticking-plaster. To really change the system, there needs to be a long-term funding solution.”

One senior local government figure told LGC that some in the sector were “quietly worrying” the department could restrict how future NHS transfers could be spent. This could include preventing councils from using the money to maintain eligibility criteria. A Department of Health spokesman said there were no plans to do this.

The DH’s annual report listed the other services on which councils spent transferred funding. It said 18% was spent on ‘reablement’ services, which support elderly people to live independently at home. A further 10% was used for ‘intermediate care’, a short-term service to help older people re-adjust to living at home following hospital discharge.

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