Top line on today’s @1adass survey of #socialcare directors? Funding isn’t sufficient to meet increased DEMAND and increased COSTS. But if that sounds familiar, this year there are a few important, COVID-related twists. A thread. adass.org.uk/adass-spring-b…
Let’s look at DEMAND first. Partly, this is demographics - it’s a familiar story that there are more older people, living longer; more working age people with disability, including LD; and more mental health issues. Directors think these will add 4% to budgets this year.
Added to this, the report now suggests demand arising from problems in the HEALTH system. As the NHS struggles, directors are seeing more people needing #socialcare due to early discharge from hospital, lack of community support or failure to admit people to hospital at all. 
This is an important corollary to the often-related (and valid) concern that lack of #socialcare capacity is causing problems in the health system. The report is saying that the problems cut both ways. Something, you’d think, for ICSs to get their teeth into.
However, this year the top drivers of financial pressure relate not to demand but to COSTS. The three main issues are increasingly expensive care packages (a long-term but increasing issue, due to increased complexity), staffing and reduced care capacity.
Staff costs are being driven by the national living wage, which pushes up pay for lower paid workers, but also by the simple shortage of care staff, which forces employers to pay more for them. Directors say they’d need to pay on average £12.77/hour to fully compete.
(That recruitment crisis is driven by wider labour market issues. Unexpectedly, unemployment is low and, as a result, care vacancies have risen. It’s unfortunately the case that when other work is available, many people choose not to work in #socialcare .) kingsfund.org.uk/publications/s…
And now there’s another huge cost pressure - inflation. Nearly all directors see overheads like food and fuel as important drivers of residential care cost increases in particular. It’s now up there with staffing as a cause of cost increases.
How are councils responding? Again there’s a change. Last year, 75% relied on covid-related grants from government. But this year, as those grants dry up, it’s back to finding savings in other council areas. (So bad news if you were hoping for more frequent bin collections.)
But, worryingly, they are also still looking to make savings on #socialcare. Note here that efficiencies appear to be increasingly used up so the focus is cutting the number of people receiving care; reducing services, personal budgets and provider fees; and increasing charges.
Unsurprisingly, director have reduced confidence in their ability to meet their statutory duties, across a wide range of #socialcare areas. Overall, 17% have no confidence they can fully meet their statutory duties in 2022/23 and looking ahead to 2023/24 that figure rises to 32%.
They also have limited confidence in the wider financial state of their local health and care economies: 85% are pessimistic.
One caution: the report tells us what 152 #socialcare directors think and they may not always be right. It’s also only one perspective. But the findings are consistent with lots of other data. This is a familiar story told by lots of people, not just directors.
The overall message? #socialcare is not fixed, obviously. While there have been important changes in eligibility and in tackling catastrophic costs, the sector remains beset with problems for which there is currently limited or no government response. kingsfund.org.uk/blog/2022/05/r…
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