I've visited eight adult social care departments this year, and talked with front line staff in all of them.
We recently set up a collaborative that is generating evidence on how to spend the initial extra £1bn for social care well. It has been fascinating to collate the insight from this exercise.
Our discussions have taken place amidst the continued Whitehall bunfight over the money. It is sad to see the lack of additional clarity since my reflections in the MJ in early April – but Councils could be forgiven for their paralysis when you consider the contradictory advice and lack of guidance they have received.
There is a potential catch-22 situation between having no formal guidance and yet a clear expectation to ‘get on with it’, with strong lobbying from national NHS figures on top. This is symbolised by the fact that all councils have to submit a report in three weeks’ time, with the only indicators being additional home care and residential care provided, when most councils have clear plans to do the opposite.
In light of this, I have been really impressed with the quality and proactiveness of planning that councils have carried out. After analysing these plans, and holding discussions with more than a dozen councils, there are some strong themes emerging. To pick out just a couple of insights:
- Analysing spending plans (split between the three grant conditions) shows significant differences between areas, with the largest overall focus on meeting ASC needs (44%), followed by stabilising the market (33%) and releasing NHS pressures (23%)
- There is no slavish implementation of the 8 High Impact Changes. Change 7 (Focus on Choice) is top of the pops, with change 2 (Patient Flow Systems) receiving the least attention
- The amount and type of engagement with Health partners so far varies enormously!