By Sandra Beard, CIPFA FAN Advisor
That fact that the current social care system is in crisis is not news to anyone.
Despite this the question remains, how do you square increasing demand for publicly funded social care services with the problem of ever-reducing spending power for local authorities? Successive administrations have made numerous promises to solve the social care crisis and yet the long-awaited white paper remains consistently elusive. There is no disputing the fact that demand for social care was rising exponentially even before the onset of COVID-19.
The 2019 Performance Tracker, produced by CIPFA and the Institute for Government, indicated that requests for adult social care support have been mounting since 2015-16, yet fewer people are receiving publicly funded care. Similarly, in children’s services, despite persistent over-spending on budgets, service provision has not kept pace with demand.
The role of local government in protecting the most vulnerable during the pandemic has only served to compound this. The latest data release from MHCLG on the financial impact of the pandemic on local authorities shows that 55% of all COVID-19 cost pressures up until the end of August 2020 were in social care. A further survey by the Association of Directors of Adult Social Services (ADASS) showed that only 4% of adult social care directors were confident that they would have sufficient budget to be able to meet their statutory duties.
Planning to deliver good value in a demand-led service such as social care is an ever-increasing challenge. None the less, doing so is an essential part of service and financial planning to ensure that services not only remain within planned budgets, but also remain sustainable.
In recent years, CIPFA has been analysing the performance and spending of a group of authorities rated as good and outstanding for children’s services, and another group of authorities judged to offer good value and outcomes for adult social care. Our work with these authorities has informed a new three-step framework for councils to address the issue of planning to deliver good value in social care. The framework emphasises the importance of business partnering and of ensuring that plans reflect reality to enable improved operational and financial resilience.
Step 1 - assess how demand and costs are changing in reality
This is achieved by tracking changes in activity, price, costs and outcomes, ensuring that the authority gathers reliable information on trends as the basis for forecasting. Integrated financial and performance information provides an opportunity for service managers and others to present a full and realistic picture of need vs resource.
Reliable information is key to producing robust plans and making informed decisions.
Step 2 - identify what can be done to improve value
- The scope to bend the curve of demand - how can authorities benchmark themselves against their peers to identify opportunities to improve outcomes and value?
- The best way to develop robust business cases for change - how can councils estimate the costs and benefits of projects to bend the curve of demand and costs?
- Bending the curve involves acknowledging that no single council excels in everything. There is always scope to improve.
- Those councils that deliver good value consistently actively seek opportunities to learn from their counterparts to improve outcomes and develop robust business cases.
Having identified an area where there is scope for improvement, they will speak directly with the councils they have identified whose performance and value is better than their own and they will explore the reasons why.
Step 3 - making the right investment to deliver
Lack of capacity and investment often limits the ability of councils to ensure plans are based on robust evidence.
With year-on-year pressures to make savings, there is an increasing risk of improvement and transformation plans that have limited prospects of being realised. Even where plans are firmly grounded on a robust and realistic evidence base, they may still struggle to achieve their goals because of insufficient capacity to deliver. Yet in most cases, investment in extra capacity would not only make improvements in value more achievable, but would enhance the pace of delivery.
On 15 September, health minister Lord Bethell told the House of Lords that publication of the white paper, and therefore any reform of social care, will likely be further delayed beyond the end of this year.
CIPFA hopes that the provision of this framework will help enable councils to more successfully plan to deliver good value in social care.
>This article first appeared in Public Finance.
Find out more
Access Planning to Deliver Good Value in Demand-led Services (social care) here.