I've visited eight adult social care departments this year, and talked with front line staff in all of them.
September: Back to school, back from holidays and ready to take on the second half of the financial year. Reflecting on the discussions I’ve been having with Directors of Adult Social Care across the country, we are already seeing spiralling costs and the potential for a significant in-year overspend.
Many have nailed their colours to the ‘demand management’ mast in how they will deliver financial sustainability over the medium term (as backed up in iMPOWER’s insight survey). Despite demand management intentions, it is also evident that when facing in-year pressures, many councils continue to default to supply side savings as the short term fix – easier to see, easier to prove and easier to implement.
However, focusing on supply side efficiencies can actually end up costing councils more.
There are many great examples of supply side savings that clients are rightly proud of. For example, enabling people to self-serve through the front door or enabling social workers to carry out greater numbers of assessments/reviews. However, the reality of these supply side savings is that it can increase both the flow of demand into the system and/or the levels of support provided to clients. In effect the tap has been turned on further and the flow has increased. Less contact centre advisors or even social workers may be used but demand is processed more quickly, resulting in greater numbers of people in receipt of council-provided support.
Another client recently made simple supply side savings through reductions in agency staff. This resulted in them slowing down the flow of demand as they only had capacity to focus on more critical cases. However, it also meant they were no longer able to have early, preventative conversations with less critical clients to help avoid longer term care costs.
From iMPOWER’s experience we know that 30-40% of demand for council-provided support could be avoided. So unless supply side efficiencies are complemented with a focus on demand management, we risk increasing our overall costs. Introducing initiatives such as self-serve should only be done with demand management at the core of the solution design. In social care, this means moving away from assessing needs to focusing on what the individual can do to remain independent (the reality is that self-assessment may not be appropriate at all when we actually want to have a different conversation with potential clients).
In short, we can only make real savings in adult social care if we deploy a demand management approach. Implementing supply side savings in isolation of demand management are just not savings at all when you consider the impact on total cost.