Councils struggling financially to meet people’s “higher-level” needs: ADASS
The Association of Directors of Adult Social Services (ADASS) has warned that an increase in complex and long-term care is pushing local councils to overspend.
Its 2024 Spring Survey, published last week (16 July), observes that people are needing “more complex care and support” due to illness and disability, but local councils are struggling financially to meet people’s higher-level needs.
Directors attributed the rise in complex care, in part, to an “ongoing push to discharge people from hospital more rapidly”.
The report notes: “The average size of care packages for people being discharged from hospital has increased in 76% of council areas over the past 12 months. This means that many older people and adults with a disability need more support from social care as they are more unwell following their hospital stay.”
Directors warned that increasing numbers of people whose care and support was covered by the NHS (Continuing Healthcare) or jointly funded, are now having to seek support from their local council or pay for it themselves.
The report found that directors’ confidence in delivering on their legal duties is “faltering”, with 90% indicating that they are either “partially confident” or have “no confidence” that their budgets will be sufficient to fully meet their statutory duties in 2024/25.
According to the ADASS’s research, adult social care budgets in 2023/24 were overspent by £586mn - the highest levels for at least a decade.
The survey revealed that directors ranked higher costs due to increased complexity of need as the “greatest concern” in relation to financial pressures on their budgets.
ADASS said: “As councils provide more hours of complex care and support, those people needing low-level, early support at home – which has gained cross-party support – are at risk of missing out or their needs escalating. This means that people are more likely to need to access emergency care and hospital treatment, which is bad for everyone and piles further pressure on the NHS”.
Further, eight in 10 directors observed that frontline adult social care staff are “increasingly” undertaking tasks that were previously delivered by NHS staff on an unfunded basis.
President of ADASS, Melanie Williams, said: “This report shows an unsustainable and worrying picture for the four out of five of us needing adult social care in the future and sends a clear message that we can’t keep doing more of the same. Instead of focussing on investment in hospitals and freeing up beds, the new Government must shift to investing in more social care, supporting unpaid carers, and providing healthcare in our local community to prevent people reaching crisis point and ending up in hospital in the first place.
“Without investment in early care and support at home or the community, spending more on the NHS is like pouring water down a sink with no plug in. This approach is also better for us all in terms of mental health, sense of independence and overall wellbeing.
“The next Government must have the courage to commit to a long-term, fully funded solution for social care and shift from short-term crisis management, especially during winter, to more care at home in the long term. Care at home is better for all involved, but also makes more financial sense.”
A spokesperson for the Department of Health and Social Care said: “We are determined to tackle head-on the significant challenges social care faces.
“We will undertake a deep-rooted programme of reform to create a National Care Service and make sure everyone gets the care they need.”
Lottie Winson
