Councils say they don't want to hand over control of social care to NHS or government

Tens of thousands of adults could live more independently at home each year if councils are able to retain control of social care instead of giving 'increased control to the NHS or the government', according to a new report.

This is the key finding of a report launched by County Councils Network (CCN), Newton and the Association of County Chief Executives (ACCE). It argues strongly that social care should remain being delivered by local authorities rather than giving increased control to the NHS or central government.

This would help deliver £1.6bn nationally in financial benefits per year from reducing care costs if councils are put in the driving seat to reform local services, it says.

The report outlines new ways of working and improved practices for local authorities, care providers and the NHS in what Newton terms an ‘optimised local delivery model’ to help transform services for many of the 1.4m people who approach councils each year for local authority arranged-care in England.

This can be achieved through a mix of interrelated improvements, including better long-term commissioning of residential and home care; greater collaboration between councils, the NHS and care providers; investment in reablement services; maximising the use of the voluntary and community sector; and embracing digital transformation.

Daniel Sperrin, director at Newton said: “Through our experience, we know delivering adult social care is complex and multi-faceted. Crucially, it must recognise the local place and communities in which it operates.

“To create the optimised model, we have engaged with over 150 individuals – including those working in the delivery of social care – but also health leaders; providers of care; policy colleagues, digital experts; and crucially those with lived experience of social care.

“Each of their valuable contributions has resulted in the model described in the report, which we hope will offer leaders both locally and nationally the opportunity to consider their role in creating a future for adult social care which enables all individuals to live their best lives.”

At least 90,000 additional older adults each year could benefit from greater access to short-term services, such as reablement, to reduce or prevent their need for long-term care. This, coupled with services being more effective, could reduce long-term care costs by £867m a year.

Around one fifth – 10,800 – of older adults who go into long-term residential care each year could be supported to live in a more independent setting, such as their own home. This could reduce long-term care costs by £178m a year.

Working-age adults with learning disabilities outside of residential care receiving formal support could be enabled to develop the skills they need to live more independently. In turn, they could have their level of required home care support hours reduced by eight per cent on average – delivering £261m in savings per year.

Greater collaboration between care providers and councils to tailor home care support around the individual, which maximises their potential for independence, could save £75m per year. At the same time, more use of voluntary and community sector services when adults approach social care could deliver a £95 million financial benefit per year.

'This year, we could see the government’s proposals for reforming care services in England'

But for service improvements to be realised, Newton outlines several ‘foundations’ that must be in place through the government’s long-awaited social care reforms. These include setting out plans for a long-term funding solution for adult social care. Parity of esteem with the NHS is also called for, with social care getting a more prominent voice in local decision-making, and more campaigning to raise the positive profile of the sector with the public.

The Local Government Association estimate by 2025 there will be a funding gap in adult social care of £3.6bn just to maintain services.

Cllr David Fothergill, health and social care spokesperson for the County Councils Network, said: “This year, we could finally see the government’s long-awaited proposals for reforming care services in England. This must set out a long-term funding solution but also be clear over who is best placed to deliver services for the most vulnerable in our communities.

“The evidence presented in this report is compelling: only councils, who know their populations and their providers, have the means to deliver improved social care services to keep people independent for longer. Social care is best delivered as a local service and local authorities have the connection to their communities to truly transform local care for the better.

“This report recognises if government finally delivers sustainable funding for councils, we can work with health partners and care providers to deliver improved commissioning and financial benefits which could be reinvested in local services.

“In exchange for more funding and local decision making over services, a new co-designed performance framework could also help provide reassurance to government that these improvements are being met.”