Efficiencies in adult care essential despite "highly positive" settlement

Local authorities and other organisations will need to make significant efficiency savings in the provision of adult care and ensure that decisions are made in a “fair and equitable” way, a senior health official has said.

In a letter to directors of adult social services, David Behan said the Comprehensive Spending Review had provided a stable base on which to build ahead of the recommendations of the Commission on the Funding of Care and Support.

Behan – Director General for Social Care, Local Government and Care Partnerships at the Department for Health – claimed the settlement for social care was “highly positive”, providing sufficient resources to protect people access to care and avoiding further restrictions to services.

He pointed to the additional £2bn funding for social care in the CSR, although he acknowledged that this came in the context of a reduction to overall local government funding and that difficult decisions would still have to be made.

“In order to maintain people’s access to care, local organisations will need to drive forward with reforming and redesigning services in order to make significant efficiency savings and transform the way that social care is delivered,” Behan argued.

In relation to social care, local authorities would therefore need to make efficiency savings by:

• Helping people “to stay independent for as long as possible, for example through re-ablement, reducing the need for care”
• Ensuring that people receive care and support in the most appropriate and cost effective way to meet their outcomes, “for example through assistive technology and driving forward with personal budgets”, and
• Maximising the spend on frontline services, “for example by reducing back office costs and making better use of the social care market”.

Behan outlined an expectation that the investment in social care would encourage improved integrated working between local authorities and their NHS partners.

The Department for Health will next month publish an ambitious programme for social care, he said, “where local authorities will be expected to put individuals in greater control of their care, foster a vibrant social care market, and make significant efficiency savings by focusing on prevention and delivering more cost-effective care”.

Behan added: “The upcoming years will provide an opportunity for us to move forward with pace to reform the system and to develop a genuinely personalised and preventative service.”

In a similar letter on social care sent to senior management of NHS bodies, NHS chief executive Sir David Nicholson said the settlement represented a “fantastic opportunity to support integration between health and social care services at the local level”.

Sir David said it was right to await the outcome of the consultation and Parliamentary approval for the government’s NHS reforms in Equity and Excellence, Liberating the NHS White Paper.

“However, there is no reason why NHS leaders should not be engaging meaningfully now with general practitioners and local authorities on how they can make the quality and productivity savings, within the current structural and legal framework,” he added.

Patients and users do not recognise a divide between health and social care, he argued, and so organisational boundaries should not be allowed to get in the way of high quality care.