Social care budget cuts damaging the NHS, latest quarterly monitoring report finds

Cuts in local authority social care budgets are adversely affecting health services, according to nearly 9 out of 10 (88 per cent) of NHS trust finance directors and 8 out of 10 (80 per cent) of clinical commissioning group finance leads surveyed for The King’s Fund’s latest quarterly monitoring report.

These findings are reinforced by NHS performance data analysed for the report. This shows that more than 5,000 patients experienced delays in being discharged from hospital at the end of August – the highest level at this time of year since 2007. Further analysis for the report reveals that nearly a third of these delays were caused by problems accessing social care services – an increase of 21 per cent in the past year.

With cuts in local authority budgets now having a significant impact on health and social care services, The King’s Fund is calling on the government to use the forthcoming Spending Review to protect social care from further budget cuts and reinvest the £6 billion previously earmarked to implement the Dilnot reforms (now delayed).

This quarter’s survey – which was carried out in September, two months after the period covered by recent reports from NHS regulators – also confirms that the NHS is now in serious financial crisis.

  • Almost two-thirds (64 per cent) of trust finance directors and 88 per cent of acute trusts are forecasting a deficit at the end of the financial year. These forecasts include additional in-year financial support for 75 per cent of finance directors in NHS trusts.
  • As measures to cap spending on agency staff come into force, a quarter (27 per cent) of NHS trust finance directors say this will affect their ability to ensure safe staffing levels.
  • Staff morale continues to top the list of concerns raised by trust finance directors.

As the NHS heads towards winter, the report shows that NHS continues to face significant performance issues. The most up-to-date figures show:

  • in August 5.7 per cent of patients spent longer than four hours in A&E – the first time the target has been missed in this month since monthly recording started in 2010  
  • the proportion of patients still waiting for treatment after 18 weeks – the main target measure for elective surgery waits – increased to 7.4 per cent in August, just within the 8 per cent target
  • the proportion of patients receiving cancer treatment within 62 days of an urgent referral from their GP fell to a record low of 82 per cent in the first quarter of 2015/16, well below the 85 per cent target and the lowest since the target was introduced in 2009.

Commenting on the report, John Appleby, Chief Economist at The King's Fund, said: ‘The quarterly monitoring report reveals the financial crisis engulfing the NHS and social care. With winter approaching, the NHS faces a toxic mix of widespread deficits, rising waiting times and low morale.

‘There is now clear evidence that cuts to social care budgets are affecting the NHS, as well as reducing services for people that need them. The government must use the Spending Review to protect the social care system from further cuts and reinvest the £6 billion previously earmarked to implement the Dilnot reforms.’

Notes to editors: 

How is the NHS performing? is the seventeenth quarterly monitoring report by The King’s Fund. It covers the second quarter of 2015/16 (July to September) (although time lags in the publication of data mean that reporting on some performance indicators covers different periods).

For further information or to request an interview, please contact the Press and Public Affairs team on 020 7307 2585 (07584 146 035 if calling out of hours).

The report details the latest survey of NHS finance directors and CCG finance leads, which was carried out from 10 to 28 September 2015. Of 240 NHS trust finance directors contacted, 90 responded. We also contacted 186 CCG finance leads, of whom 50 responded, covering 56 CCGs (27 per cent of CCGs).

The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.