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Social care funding and the NHS: an impending crisis

The impact of funding cuts to the NHS has been widely reported and discussed, but less attention has been given to social care – and, most importantly, to the inter-relationships of health and social care.

Social care funding has increased in real terms for the past decade, but there has been considerable variation in how that funding has been spent – in part because spending on social care is handled by local councils, whose circumstances vary. The wide geographical variations in cost and performance across a number of measures – for example, emergency hospital admissions, delayed transfers – reflect different relationships between health and social care. The government has pledged to facilitate closer integration so that people can receive a more joined-up service.

Social care funding and the NHS: an impending crisis? examines trends in spending on social care, looking at three scenarios arising from the 27 per cent real reduction in the central government grant to local authorities that between 2011/12 and 2014/15, social care spending will be fully cut, will receive some protection, or receive no protection. This suggests that there could be a funding gap of £1 billion by 2014 unless councils can achieve unprecedented efficiency savings. This would have a knock-on effect on the NHS, with cuts to frontline social care services leading to fewer people getting the help they need, causing more emergency admissions, delayed discharges and longer waiting times.

This paper provides evidence on the inter-dependency of health and social care, includes case studies of effective use of resources and recommends four areas for action to achieve better use of health and social resources:

  • adopting a more unified national policy framework, for example, replacing existing separate processes with a single strategic assessment of the funding needs of the NHS and social care

  • developing a better understanding of local patterns of need, spending and outcomes, with metrics to support shared-investment decisions

  • closer alignment of resources through pooled and place-based budgets

  • a wider role for local government in promoting health and well-being, thus reducing the need for NHS and social care services.