Tag Archives: personalisation

How will the Budget affect social care?

Tomorrow is probably the most crucial day for the UK since the general election; the emergency Budget is delivered.

This has been widely trailed for weeks, and we all know that cuts are coming and will be deep. Just how deep will be revealed tomorrow – and there are a lot of worried people out there, for many reasons.

For example, it is anticipated that the cuts will herald many job losses in the public sector –the Adam Smith Institute, a think tank, claimed that more than 250,000 employees could be cut without affecting frontline services.

But will the Budget effect services in social care? Yes, is the simple answer, because the Budget will affect every department of the public sector.

However, there have been few specifics given away so far – although we know that the grant for implementing the personalisation agenda in adult social care will be protected.

Elsewhere, there may be an announcement about provision for more respite care for carers, which would be warmly welcomed.

As for anything else, it is back to guesswork again. So here goes…

The London School of Economics and University of Kent, commissioned by Age UK, reckons the social care budget could be cut by £900 million over the next 2 years. That would inevitably mean cuts, and it could well be that local authorities ramp up the eligibility criteria for social care once again. This would take some people out of the system and as a result could seriously adversely impact on their – and their carers’ – lives and possibly hasten their move to more complex services or residential care.

Elsewhere, welfare benefits will be looked at, and any rise is unlikely at best. There is also the threat of changes to Incapacity Benefit and more stringent testing for eligibility, which could mean that some people are moved onto the (lower rate) Jobseeker’s Allowance who have little chance of gaining work.

There is also a lingering threat of a rise in VAT, which would hit everyone.

However, before the election at the Age UK conference, the Conservatives and Liberals said that social care funding levels would be maintained at least. But since then both have had a better look at the UK’s books and this hasn’t been reiterated since the coalition was formed – or if it has, I haven’t seen it; please correct me if I’m wrong.

So, tomorrow’s Budget could be painful for social care in terms of job losses for those employed in the sector, cuts to services and benefits. What effect this will have remains to be seen, but those involved in providing care will keep on going because they always do – that is the one certainty at this time.

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Social care possible victim of government cuts

Chancellor George Osborne announced the first wave of cuts to public spending yesterday, but it is still unclear what this will mean for social care – yet.

Most of the announcement dealt in headline terms – talking about millions of pounds worth of cuts to government departments, but not saying exactly where they will be made.

For instance, councils have been told that they will have to cut £500 million worth of services in the next 10 months. In the absence of concrete details, there is lots of speculation about where these cuts could come – such as in residential and home care for the elderly, according to a report in today’s Times.

This would seem likely – a recent poll for the BBC’s Panorama said that more than half of councils were considering making cuts to adult social care provision.

In practice, it may mean that eligibility criteria gets ramped up again, so that only those with ‘substantial’ or ‘critical’ needs will get services – which already happens in many council areas. Also, services such as day centres may be targeted for cuts, as will any service that struggles to demonstrate it provides value for money.

With budgets needing to be slashed other areas, such as the roll-out of the personalisation agenda, may be hit. There is the £237 million Social Care Reform grant scheduled for this year, and there is speculation that might be cut, according to a report in Community Care.

Meanwhile, children’s services were largely protected from the cuts, except for the abandonment of the Child Trust Fund, which wasn’t that popular anyway.

But this is just educated speculation. I assume the details of the cuts will gradually come out in the next few days and weeks, which should shed more light on what will happen and then councils – and service users – can start to plan for the future.

But what is certain is that these are only the first cuts – and not necessarily the deepest. June’s emergency Budget is expected to announce further spending cuts, while with the Comprehensive Spending Review – which sets out council budgets for the next 3 years – there are fears that council funding could fall off a cliff.

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What happened to social care in election debate?

After 3 weeks out of the country – I was one of those caught up in the volcanic ash crisis – I’m getting back up to speed with what’s been happening in social care and where the main parties stand on it before the election.

There was precious little mention of social care or older people in last night’s TV debate – well, the bit I watched before jet-lag caught up with me – but I haven’t seen much else about it in the news. I’m told there was not much talk about it while I was away either.

Considering that social care was supposed to be one of the main debating points in this election, everyone seems to have gone quiet on it since Labour announced its White Paper on the future of social care and plans for a National Care Service.

But while we know about Labour’s plans, you have to look hard to find the Conservative and Liberal Democrat policies on older people – social care as a category isn’t there, disappointingly.

More disappointing is the lack of concrete policies. For instance, the Conservatives pledge to introduce a ‘home protection scheme’ to ensure people don’t have to sell their homes to pay for care, but don’t say how it would work, or how it would be funded.

They do however advocate the extension of direct payments and individual budgets to give people more choice and control over their care. While this is a continuation of an existing policy, it does hint that if the Tories win, they may not make fundamental changes to the personalisation agenda.

Meanwhile, the Lib Dems say they would undertake a review of social care. It’s difficult not to be sarcastic about that pledge – hasn’t the sector had enough of those in recent years?

More promisingly, they talk about re-establishing the link between the basic state pension and earnings.

There has also been little mention of the future of social work, although there are fears among some social workers that cuts to frontline services may be made; there have been assurances that teachers, doctors and nurses will not be axed, but no such declarations made for social work.

So, the future of social care, one of the bigger issues facing the UK, has once again been swept under the carpet. In a way it is not surprising, because there are no easy answers or snappy soundbites and some of the solutions may not be vote-winners. But it should have been a key part of the debate because this will affect everyone in the UK at some point.


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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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Councils need to engage users over personal budgets

While scanning the newspapers yesterday, this report in the Guardian http://www.guardian.co.uk/society/2009/oct/28/personal-care-budgets-jamie-bartlett caught my eye. It says that 80% of service users still don’t understand what personal budgets and personalisation is.

The article shows that many councils have really got their work to cut out to get the message out to the community and engage with them about what personalisation means for them – and the problems that could lie ahead for them in implementing it.

Those that have embraced personalisation and driven the implementation of personal budgets will be well placed, but those that have dragged their heels – for whatever reason – could be in serious trouble and will need to look at their policies quickly if disaster is to be avoided.

The personalisation agenda is here to stay – whatever the result of the next general election – so councils really have to get out there and talk to the community, whether it is through their website, service user events, advertising or whatever. Otherwise they could find themselves overwhelmed with demands from confused service users who are suffering because they weren’t well enough informed about what a personal budget was and now don’t have the right care.

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