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Breaking news: Social care allocations safe this year
Today’s big appointment: New Surrey chief revealed
Today’s Budget plea: Campbell Robb: Hammond can prevent widespread poverty
The fact that just 44 top-tier councils met their nationally imposed targets to significantly reduce delayed transfers from hospital attributable to social care will come as little surprise to most in the sector.
Indeed, when they were announced in July a number of chief executives and council leaders branded them “undeliverable”, not least as a third of councils were expected to achieve reductions on February levels of 50% or more by September. Not doing so could see them lose out on their share of the £1bn for social care in 2017-18 announced in the March Budget.
Today LGC mapped council performance against the targets, using analysis of NHS England performance data shared with us by Impower. There is substantial amount of red, denoting the 53 councils that have missed their target and whose performance is deteriorating. Impower has highlighted Milton Keynes Council, Peterborough City Council, Knowsley MBC and Hampshire CC as areas of particularl concern where already poor performance has continued to deteriorate.
However, as LGC reported last week, the bulk of councils have improved their performance since February, even if not all of them have met their target.
In this context pressing ahead with plans to withdraw funding for this year would not only be counter-productive, in withdrawing funds from areas that badly need it, it would also foster more bad feeling in the sector that is not conducive to solving the problem. While there will no doubt be pockets of poor performance, the implication of continuing with the threat to withdraw funding in year is that the majority of councils just need to try harder. This is spectacularly unhelpful.
The LGA and others were quick to point out the unworkability, and futility, of withdrawing funding with mere months to go of the financial year and little opportunity to redirect spending but plenty of chance to impact on services.
Thankfully there are signs that NHS England and the Department of Health seem to have tacitly acknowledged this. In a statement released to LGC this afternoon they said new targets had been agreed with all councils “in line with the government-specified precondition for receiving this year’s NHS-funded BCF transfer”. What these new targets consist of is not clear, but the threat of recalling the BCF cash handed to councils at the beginning of the year has rescinded, for this year at least. NHS England said the “extent to which individual local authorities actually deliver against those commitments” will be used in deciding on the final allocation of next year’s BCF.
Perhaps the threat to withdraw BCF funding this year was only ever intended as a kick up the back side and was not a misguided attempt by the health service to impose NHS-style performance management on local government.
However, the evidence tends to suggest the latter. At this year’s LGA conference in July NHS England chief executive Simon Stevens defended the threat to withdraw funding from poorly performing councils on the grounds that what he described as the existing “laissez-faire” approach was not working. The LGA withdrew its support from the guidance, claiming the threat of funding withdrawal was included at the last minute and without their agreement. Its inclusion followed months of muttering in the NHS about ensuring it got what it viewed as its fair share of the cash announced by the chancellor.
Whatever the original driver for the target, it is questionable whether it has improved performance beyond what would have happened anyway. It has certainly damaged some relationships in the process, the cost of which is difficult to quantify.