Social care should remain with local authorities rather than under NHS control, report says

A new ‘blueprint’ for delivering social care in England argues that social care should continue to be delivered by local authorities, rather than giving increased control to the NHS or central government.

The report, produced by the County Councils Network, Newton and the Association of County Chief Executives (ACCE), says tens of thousands of adults each year could live more independent lives if councils are given the ability to reshape services through the government’s long-awaited reforms.

The findings come after the Independent Review of Adult Social Care in Scotland recommended a National Care Service be set up with parity to the NHS. in January, former Health Secretary Andy Burnham, now Mayor of Greater Manchester, renewed calls for the NHS and social care to be more closely integrated in England.
Read more about the proposed National Care Service in Scotland: https://www.socialworktoday.co.uk/News/Review-of-Adult-Social-Care-in-Scotland-recommends-new-National-Care-Service

Based on engagement with over 150 individuals across the social care sector, the report concluded that only councils, working with their partners – including the NHS and providers – can deliver their new wide-ranging blueprint for services that supports individuals to live as independently as possible.

The report outlines new ways of working and improved practices for local authorities, care providers and the NHS in what it terms an ‘optimised local delivery model’. It says 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.

However, the report warns that this model can only be delivered if councils are given the clarity of a long-term funding model for care – due to be outlined in the government’s long-awaited green paper – and remain under local authority control. The Local Government Association estimates that by 2025 there will be a funding gap in adult social care of £3.6bn just to maintain services.

The ‘blueprint’ argues that these improvements could enable tens of thousands of individuals to live more independent lives every year – saving £1.6bn nationally per year from reducing care costs.
The report says savings could come from as many as 90,000 additional older adults each year benefitting from greater access to short-term services, such as reablement, to reduce or prevent their need for long-term-care. The report says this, coupled with services being more effective, could reduce long-term care costs by £867m a year.

More adults being supported to live in their own homes, instead of in long-term residential care, could reduce costs by £178m a year; while working age adults with learning disabilities receiving formal support outside of residential care could be enabled to live more independently, reducing their level of required home care by 8% on average delivering £261m in savings per year, the report says.

The report suggests reforms could also be underpinned by a new, outcomes-based performance framework. In exchange for more funding, the framework would make clear the impact of funding decisions, highlighting areas of good and poor practice, and give central government a new mechanism to monitor and support improvement.

Cllr David Fothergill, Health and Social Care Spokesperson for the County Councils Network, said: the evidence presented in the report was “compelling,” adding that “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.”

In 2019, Prime Minister Boris Johnson said he had "a clear plan" to fix the social care crisis, though he backtracked on his pre-election claims to have ready-to-go rescue package and warned action could take a full parliament to deliver in early 2020.

The Guardian reported in July last year that plans were being examined by David Cameron’s former policy chief Camilla Cavendish for the government to take responsibility for social care services away from councils in England, together with £22.5bn in annual funding, and hand it over to the NHS.

The Department of Health and Social Care confirmed at the time that Baroness Cavendish had been contracted to support the reform of the social care system, but said there was “no foundation” to the claims that the two public services could be merged.