Building the Health and Social Care Bridge


By David Ayers, Property Networks Manager, CIPFA

It's been ten years since the Dilnot Commission reported to the Cameron-led coalition government and the infamous Barnet Graph of Doom first appeared. We were told that a social care white paper was imminent, but instead health and social care services have suffered from over a decade of austerity – leaving us woefully unprepared for the pandemic. Just over 100 years since the Spanish Flu pandemic of 1918, the world was once again brought to its knees.

Barnet predicted that, over a period of 20 years, spending on social care would squeeze out all other local government spending. He set out proposals to fund social care without the need for families to sell the homes of their loved ones to cover the costs. 

Fast forward ten years and you could be forgiven for having a feeling of déjà vu. We are still waiting for that social care white paper, and in the meantime have been treated to a sticking plaster approach – as if the current crisis was somehow a surprise to government. Unfortunately, when it comes to dealing with the inevitable demographic time-bomb the policy paralysis continues.

New analysis by the Local Government Association (LGA) shows that authorities providing social care are now spending more than 60% of their outgoings on these essential services, underlining the urgent need for action to address immediate pressures. However, no additional funding was announced in the spending review. Instead the government announced a new Health and Social Care Levy, but the majority of the funds raised through this will be used to address the pandemic backlog of elective surgery and treatment in the NHS. 

In addition, social care authorities can raise an additional 2% from council tax without the need for a referendum. The LGA says serious questions remain about whether the expected £5.4 billion from the new levy over the next three years will be enough to pay for recently-announced adult social care reforms.

While the controversy and paralysis continues, and uncertainty surrounding the sustainable funding of social care remains, a few care providers have started to put their own solutions in place. Well-designed intermediate care solutions can release much needed beds in the NHS while relieving pressure on existing social care services – saving financial resources in both the NHS and councils and relieving pressure on short-staffed services.

CIPFA's Property and Housing Conference on the 20 January, and forthcoming webinars in the New Year, will explore how collaboration between clinical commissioning groups, councils and housing providers combined with good planning and design can both improve services and reduce costs. 

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