Our top ten councils for adult social care analysis was the cover story of the MJ five weeks ago, and despite being somewhat nervous beforehand, I've been really pleased with the response.
Secretary of State for Health and Social Care, Matt Hancock, has announced an immediate £240 million cash injection for social care to help with pressure on hospitals. ADASS President Glen Garrod is right that this is only “a temporary and partial fix”. As County Councils Network’s David Williams says, this simply “perpetuates a trend in short termism”.
But it does offer an opportunity if we reframe the problem.
The £240 million covers 5 months worth of bed blocking at the current run rate (139,983 bed days per month), as the current cost of keeping someone in hospital is around £343 a day. This lends itself to a nice neat narrow-framing of the problem: the money should simply shift those people from hospital to home. Of course, all of those in the system understand it doesn’t work like that. And it doesn’t take into account what support the human being at the centre of social care really needs to lead as independent and happy life as possible. We need to take a wider view and tackle the whole system.
In our analysis on the first £1 billion of the additional money given to councils in the Improved Better Care Fund, we found that just 6% was spent on activities that might reduce hospital admissions, rather than just deal with demand. You might argue that this is 6% more for councils than if the money had been given to the NHS, but could local government not be bolder?
This £240 million of short-termism is not helpful either to solve the problem or to plan long term transformation. But it does give an opportunity to try something new and creative. My plea to councils is be bold and spend as much as you possibly can on avoiding admissions and, crucially, getting evidence of the impact. We need to reframe how the health and care crisis is understood. Let’s take this chance to start now.