Tag Archives: personal budgets

Comprehensive spending review: little for social care

The months of rumours, leaks and speculation are over; the Comprehensive Spending Review has finally been announced. As expected, for social care, it does not make for fun reading.

Here are some of my immediate thoughts, based on Chancellor George Osborne’s speech and a (very) swift look at the spending review document. While the review obviously affects everyone in some way, I’m going to try to focus on the impact it could have on people with mental health issues and/or learning disabilities.

Firstly, it should be noted that there is very little geared specifically to people with learning disabilities and/or mental health issues. For instance, specific mentions of ‘learning disability’ (or disabilities) does not get one mention and ‘mental health’ only 2. I didn’t expect there to be; today is the day for grand statements, with the detail to come at a later date.

In terms of what was said, while Osborne promised an extra £2 billion for social care in the next five years, including £1 billion to aid joint working between health and social care, he mentioned that this would help older people – no mention of adults with disabilities.

Also, BBC health reporter Nick Triggle worries this could be more or less cancelled out by the increasing demand of the aging population.

Meanwhile, benefit reform will ensure that it “always pay to work”, according to Osborne. Benefits are to be capped at no more than the average net wage from 2013 – which will work out to about £500 per week for couple/lone parent household and £350 per week for single adult households – although people receiving Disability Living Allowance are exempt from this.

However, this may well hit people on incapacity benefit/Employment and Support Allowance and other benefits, especially those who are moved onto Jobseeker’s Allowance from ESA. The focus of the welfare reform is evidently on people getting jobs, with benefits cut to make it more of an incentive to work.

There is also a new 12-month time limit proposed for the one million people on ESA in the Work Related Activity Group to find work or face having their benefits cut.

But surely this will be dependent on the jobs being out there for people to take? Many people on ESA would like to take up jobs – part or full-time – but with many businesses not looking to take on employees, and the public sector set to shed 490,000 jobs, there are precious few available and competition for them will be fierce.

The reforms to housing benefit will also hit many people with learning disabilities and/or mental health issues, especially those living in London and the southeast, where property prices are generally higher than in the rest of the UK.

Potentially, the adverse impact of money worries on people with mental health issues or learning disabilities could be immense, as could the upheaval of having to move, if they now cannot afford the rent on their homes. For someone to have to move away from an area they know – including a network of informal support – to somewhere new could have a disastrous effect on a person.

Not all bad news

But the CSR wasn’t all bad for social care; there were a couple of positive notes from the Chancellor.

Firstly, personal budgets are to be extended to people with long-term health conditions, children with disabilities and special educational needs and adult social care. The commitment to personalisation is welcome and, for some people, personal budgets have made a tangible positive difference to their lives. Giving more people the option to do this is a good thing. Whether their budget will be enough to do this is another matter.

Likewise, the commitment to increase talking therapies for people with mental health issues is also to be welcomed.

The government is also going to take forward proposals to invest nationally in mental health liaison services at police stations and courts to intervene at an early stage, diverting mentally ill offenders away from the justice system and into treatment. However, it does carry the caveat ‘subject to business case approval’.

Nevertheless, this is a good move. Far too many people with mental health problems get stuck in the justice system and opportunities for them to access treatment are often lost.

Conclusion

From an initial assessment, people with learning disabilities and/or mental health issues do not fare well out of the CSR, especially in terms of welfare and housing reform. However, I don’t think anyone – regardless of who they are – fares well out of this review.

But there are some crumbs of comfort, especially with expanding personal budgets and talking therapies, although they are probably outweighed by the cuts.

However, to paraphrase Winston Churchill, this is not the end, it is not the beginning of the end, it is the end of the beginning. Next month, government departments will set out business plans to outline how they will implement cuts. This is where the real detailed information about cuts will come at a local level, and we will all find out which departments, services, projects, charities etc will retain funding, be closed, or face hard times.

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Filed under adult social care, learning disabilities, Mental health, Social care funding

Commissioners must be creative in face of budget cuts

After what seems like an eternity talking about potential cuts in local authority budgets, they are now with us – and are as bad as predicted.

Around the country, local authorities are publishing their budgets for 2010/11 and they do not make for happy reading. From what I have seen, no local authorities are increasing their budgets, and many have announced multi-million pound cuts.

Some local authorities are making cuts to adult social care services as a result. Councillors are keen to point out that frontline services will not be affected, saying they will mostly be made in back-office functions or through efficiency savings – conveniently opaque terms that do not reveal exactly where cuts will be made or to whom.

What this does do is make the job of the commissioner of adult social care services more important than ever; it is they who will decide which services are cut and which are bought.

Getting more from less is a difficult trick to pull off successfully, but they need to rise to the challenge. Fortunately, personalisation gives them the opportunity to do it.

With personalisation’s focus on the individual, it gives commissioners more flexibility to work with independent providers and the third sector to provide a range of services tailored to the local community, rather than the local community having to fit into the services commissioned.

This can mean that the services commissioned offer better value for money because they are the ones that people want – not what the local authority think they need. Also, services that do not provide value for money can be safely axed.

Personal budgets also give service users more choice and control. While it can be argued that they don’t get either if the budget isn’t enough to cover their needs, they often, anecdotally, get services in more cheaply than the local authority had done.

Budget cuts should focus the minds of commissioners and those that do innovate – and work fully with providers, the third sector and service users – should help their service users to achieve better outcomes.

Their role should be about shaping the market and enabling it to develop, rather than dictating it.

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Filed under adult social care, Social care funding