We will shortly find out the extent of reform laid out in the government’s social care green paper, with the report due to be published in the new year.
County leaders have joined the Local Government Association and others to argue that the status quo is no longer viable. Radical reforms need to be outlined and big questions need to be asked on what extent the state and the individual pay for care.
Yet there was a real risk that an emerging issue within adult social care was going to be missed altogether: working age adults who need care and support. It was only in July that the government confirmed proposals would not focus just on older people.
This addition is crucial. Last month the County Councils Network released research showing that costs for caring for adults with learning disabilities are set to rise by £2bn by 2025.
This is due to extra demand, as well as medical advances which mean that people with a range of complex disabilities are now thankfully living longer. Growing numbers of young people diagnosed with autism or Asperger’s Syndrome now also seek early help from councils to assist with daily life.
Last year, the number of working age adults in counties entering residential care rose by 30% compared to 2016-17, whilst the number of those entering nursing care rose by 25% over the same period. Many of these adults will be people with complex learning disabilities.
Much like older people’s social care, most of local government’s spending on this service will be borne by county authorities. Due to the nature of these individuals’ circumstances and age, many will have little wealth or personal assets and therefore most if not all of the costs for caring for them falls to the local authority.
For the first time this year, most counties said more of their social care budget is now spent on working age adults rather than older people. In Hertfordshire, 59% of the 2018-19 adult care budget will be spent on people aged 18-64, most of this to support people with learning disabilities.
It is hard to see how local government can continue to adequately fund this demand under present circumstances. It is imperative that a significant part of the green paper sets out how we fund this element of adult social care.
Government must also provide substantial additional resource for councils in the spending review to address these future demand-led pressures.
As part of the overall package of fair funding review, the government will publish its revised adult social care funding formula in the coming months. We must ensure the formula remains appropriate when published and that the pressures of supporting those with learning disabilities are fully recognised.
A positive outcome for local government in both reviews will ease pressures. Our network’s chairman Paul Carter and other leading figures have also recently called for a fifth of the NHS ‘birthday windfall’ to be invested into adult social care to address future pressures, focused on providing more community-based care.
The government’s recently floated proposals – such as the over 40s levy – show the level of shared risk and ambition the government is considering to adequately fund care services.
On the other hand, the LGA’s recent consultation results on social care show that council leaders believe that national tax should be considered as a solution. It is these types of reforms that will require debate over the coming months to ascertain how palatable they are to the public in the current political and economic context.
Extra and fairer resources, alongside a sustainable funding solution outlined in the social care green paper, will be crucial if we are to continue providing high-quality care services. Whilst one-off extra funding is welcome, it does little to address the longer-term structural and demographic issues local authorities are facing.
We hope to see a strong preventative focus in the paper, encompassing housing and outlining closer links to other public sector partners. It is essential that local government has an enhanced role in shifting the focus from crisis care in acute settings to providing the conditions for people to live as independently and healthily as possible, for as long as possible.
We would also encourage the government’s green paper to be published in tandem with the NHS ten-year plan, to ensure a closer alignment of priorities over the next decade.
At last month’s County Councils Network conference, we launched our new campaign: A Fairer Future for Counties. We hope that the green paper is the first step in the direction of a fairer and sustainable future for local government care and support services.
David Williams (Con), spokesman for health and social care, County Councils Network, and leader, Hertfordshire CC