Why we undertook this project
Spending by local authorities on social care for older people is falling and fewer people are receiving publicly funded care. The NHS is also under intense financial pressure, with reductions in community health services such as community nursing. The National Audit Office has warned that ‘national and local government do not know whether the care and health systems can continue to absorb these cumulative pressures, and how long they can carry on doing so’.
The need for a better understanding of the current pressures facing care services and their implications has never been greater. Yet evidence about the relationship between changes in spending, how this feeds through to the quality and quantity of services, and the impact on the health and wellbeing of people who use them is extremely limited.
What we did
A joint project between the Nuffield Trust and The King’s Fund sought to shed light on these issues. In order to understand the impact on older people with care needs and their carers, the project followed four lines of enquiry:
- How are local authorities dealing with current pressures?
- How are social care providers responding?
- How have changes in NHS services – especially primary care, community nursing and acute services – affected the health, wellbeing and care needs of people?
- What is the impact on the quality of care being provided?
As well as describing what is happening at a local level, the project also sought to draw out the innovative practices and strategies commissioners and providers are using to mitigate current pressures.
The research took a case-study approach, looking in depth at a small number of local authorities. Although primarily qualitative in focus, the project explored quantitative data at both local and national level.