News / Care funding gap to grow

The report, Social care for older people: home truths, said cuts in local authority funding were placing an ‘unacceptable toll’ on older people. Six years of cuts meant 26% fewer people had received help from social care. And delayed discharges from hospital – caused by pressure on both NHS and social care budgets – had imposed a significant cost on the health service.

The report said social care cuts should not be viewed in isolation. Pressures elsewhere in the NHS – in general practice, community nursing and the uneven distribution of intermediate care beds – had compounded the problem.

Social care providers were being squeezed by a combination of reduced fees or below-inflation increases, a shortage of care workers, the National Living Wage and higher regulatory standards. It was now a question of ‘when’ and not ‘if’ there would be large-scale provider failures, it said.

Nuffield Trust deputy policy director Ruth Thorlby said care providers are struggling on the low fees councils can afford. ‘Shortages of home care staff and affordable care home places mean older people are often stuck in hospital, putting both their lives and vital NHS processes on hold,’ she added.

HFMA director of policy Paul Briddock (right) said the report echoed many of the themes in the latest HFMA NHS financial temperature check.

‘Our members reported that spending on social care, particularly for older people, by local authorities has fallen by 25% in real terms in the last five years to 2015. This chimes with our findings and predictions that 56% of trusts believe the impact of social care to be one of the biggest risks to achieving planned savings,’ he added.

‘This week’s report highlights that support available from local authorities has been reduced and over 40% of money paid to care homes came from people paying for themselves. The lack of the right investment in social care places more pressure on an already stretched healthcare system, particularly when it comes to the discharge of elderly patients. It’s no secret that NHS finances are facing unprecedented challenges, but to overcome these, we do need health and social care to work better together. Even when the demand on services creates additional pressures across the board, collaboration in health and social care is vital in achieving high quality care for all.’

The report called on the government to, at the very least, bring forward better care fund money planned for 2018/19, accelerating the process for single, pooled health and social care budgets in all areas and developing a workforce strategy.

If it is unwilling to increase funding, the government should be explicit about what individuals can expect from social care, making it clear that the primary responsibility for funding social care will be on individuals and their families. Relying on private funding would be inequitable and unsustainable, it said, and called for a public debate on the future funding of health and social care.

Richard Humphries, King’s Fund assistant director of policy, said older people and their families had been left to ‘pick up the pieces’ following the failure of successive governments to reform social care. He added: ‘Putting this right will be a key test of the prime minister’s promise of a more equal country that works for everyone – there is no more burning injustice in Britain today than older people being denied the care they need to live with independence and dignity.’