The Adult Social Care Activity and Finance Report published in 2017, draws together for the first time official data on local authority adult social care activity and finances.
Considering the upcoming Green Paper on social care for older people, this data shows clear areas where policy changes and funding increases may be particularly beneficial. The direct comparison between finance and activity will better support an understanding of current social care provision and challenges. Although not emphasised, challenges lurk ominously below the surface in three key areas.
Funding priorities
First, expenditure levels. Gross current expenditure on adult social care by local authorities rose by £556 million from 2015-16. While appearing positive, on closer look it isn’t much to shout about. Government funding priorities clearly do not lie with local authority social care provision, as that increase accounts for only a quarter of the additional £2 billion recently provided by the government to meet social care needs. It is also just a 1% increase in real terms, the only real term increase since the financial crash. Local authorities are spending less in real terms on adult social care than in 2006-07. Even if this is the beginning of a trend, annual 1% increases are unlikely to be enough to prepare for the demands of an ageing population.
Second, future challenges are revealed in the distribution of expenditure. The area of care with the largest increase in expenditure was long-term support: it increased by £539 million to £13.6 billion, counting for 77.6% of gross expenditure. Further details give rise to several concerns:
1. Those receiving long-term support are predominantly older: 58 in 1,000 adults aged 65 and older received long-term support, compared with nine in 1,000 aged 18-64. This raises concerns over future demands from our ageing population.
2. Despite the higher proportion of older people receiving long-term support, the expenditure is split almost equally between those aged under and over 65. This is because those aged 18-64 requiring long-term support typically have more complex needs, with data showing they predominantly have learning disabilities. Life expectancies for people with learning disabilities are lower than that of the general population but they are increasing. As more people with learning disabilities live to an older age, the resources required to support them adequately will increase.
3. Areas with higher income deprivation have higher rates of people receiving long-term support from local authorities. This increases pressure on local authorities with the highest concentrations of poverty, which research shows receive lower amounts of central government funding.
Increased costs
Finally, despite this increase in expenditure, levels of activity haven’t risen over the past year. Local authorities attributed this to increased costs in the provision of care, including the introduction
of the National Living Wage and higher numbers of people requiring support for complex needs. The cause for concern comes from other factors which are likely to further increase the cost of care provision. Although the final decision is currently delayed, the government plans to require care providers to pay minimum wage for sleep-in shifts.
Additionally, Brexit may impact staffing levels. EU workers make up 7% of the social care workforce, and this number had been consistently increasing until the referendum. With ongoing
staff shortages, any reduction or stagnation in the number of European social care workers is likely to result in the costly use of agency staff.
Overall, the report provides a lot of interesting data, which unfortunately highlights and adds to existing concerns. There are many issues to be tackled in the social care Green Paper and many
that will remain outstanding given the Green Paper will not focus on working age provision. The upside is that having this information should better equip us to deal with upcoming challenges. To end on a cliché: better the devil we know.
Annie Field is Policy & Research Officer at Campbell Tickell. For more information or to discuss this article, please contact: annie@campbelltickell.com
This article also appeared in the CT Brief, Issue 33: Care & Support edition.
