The world we’re in

Sustainable adult social care is one of the biggest challenges facing local public services.

In iMPOWER’s 2015 insight survey, ‘finding fresh efficiencies in adult social care’ was top of Directors’ and Chief Executives’ worry list.

“I do not believe it would be prudent for us to assume any additional NHS funding over the next several years, not least because I think there is a strong argument that, if there were extra funding to be available, frankly, we should be arguing that it should be going to social care…” – Simon Stevens, NHS England

The reasons for this are well documented and include demand and cost pressures (not merely demographic pressure).

The cracks are showing in a number of ways. For example, delayed transfers of care from hospital are hitting record highs and care homes going out of business are now being reported with increasing regularity. (See the LGA Adult social care funding: 2016 state of the nation report for further details).

Integrating with health is part of the solution, but it also adds a further layer of complexity to the problem.

There is an immediate pressure for councils to deliver savings both in the short term and with transformative savings targets in the medium term. Councils are being forced to answer a new exam question where only the exact percentage varies: How can I deliver sustainable adult social care with 20% less budget?

Our insight

The answer to the social care challenge is not more efficiencies. The unit cost of demand and the cost of processing that demand has in many cases been pushed to the limit. Demand-led change is the best option left.

Demand management is not about only helping some citizens and ignoring the rest. Managing demand means taking every opportunity, at every stage of the customer journey, to promote independence (a single, coherent narrative). A lot of avoidable demand is caused by the behaviours of citizens and organisations, and there is something you can do about it. In adult social care, practitioners assess that there is at least some potential to prevent, reduce or avoid up to 80% of demand* (*based on projects where iMPOWER have worked with social workers to review cases).

Behavioural insight is needed to deliver the behaviour and culture change demand management requires; a cultural change of the practice and behaviours of front line staff, citizens and partners.

How we help councils

We help councils to understand and manage demand in adult social care. Using behavioural insight and a variety of tools and techniques, we help councils to change culture, manage demand and therefore, reduce budget and improve outcomes.

In the last year we have worked with adult social care departments in Barnet, Birmingham, Bristol, Bromley, Ealing, Gloucestershire, Hertfordshire, Hull, Norfolk, Reading, Sheffield, Sutton, Tower Hamlets, Warrington and Wolverhampton.

We work with councils both as strategic partners to embed a demand management approach across the social care system, as well as on more targeted projects to deliver measurable savings and impact through trials of new approaches.

We have helped a range of councils build a Target Demand Model – a tool to help councils understand what demand is avoidable, and what level of demand is both genuine and affordable. By doing this councils can then design an adult social care system that is sustainable and improves outcomes. To do this we help councils to:

  • Understand the demand in the system ‘as is’
  • Understand what level of demand is avoidable
  • Establish what level of demand is affordable and realistic for the service to be sustainable
  • Using the Target Demand Model, design and implement a programme to deliver a reduction in demand

We work across the adults’ services system – from transition from children’s into adult services to frail elderly care. We also draw heavily on our experience and expertise in children’s transformation and health to help our clients join-up and integrate services.

Get in touch

For further information on our work in adult social care, please contact Jeremy Cooper at