Stuart Lindsay

The two billion pound question: Is there an opportunity to move from meeting to managing demand?

March 15, 2018
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We are delighted to launch our latest report: ‘The two billion pound question: Is there an opportunity to move from meeting to managing demand?’

It is a year since the 2017 Spring Budget, when Chancellor Philip Hammond announced an additional £2 billion of funding for social care for English councils.

With £1 billion of the funding almost spent, and another £1 billion to be invested by March 2020, this is a timely moment to assess what has been achieved so far and to reflect on how the rest of the funding could best be used.

The two billion pound question is therefore this – will the extra money promote a much-needed step-change at the health and care interface, enabling both systems to work better together in the interests of users, or will it have been just a temporary funding fix that ultimately changed very little?

The report argues that, whilst the funding has helped to meet demand within the system through reduced delayed transfers of care, sustainable change is only possible if more of the £2 billion is used to manage demand, not just meet it.

Our core argument is that the availability of additional funds gives councils and health providers an opportunity to move from coping with demand to managing it. However, this is only possible if leaders are brave and invest more of the money in enabling the NHS and local authorities to jointly address demand for adult social care. Our analysis shows that an estimated three-quarters of the money used or committed to date has been spent on supporting existing services; only 8.5% has been used to fund activities aimed at addressing demand in the health and adult social care systems.

Our report also shows that the funding has encouraged the NHS and local authorities to work closer together, and that this has helped to reduce Delayed Transfers of Care (DTOC) which fell by 26% between February 2017 and January 2018. This success has created a foundation for further joint working, which should address demand at a local level and tackle complex issues such as workforce challenges.

There is urgency around making this a reality. In two years’ time the money will have run out. If we’ve only used it as a sticking plaster, there will be no long-term impact. Only by addressing demand can we reduce pressure on the system sustainably and lessen the risk of any future crises.


This report shares findings from the iMPOWER Collaborative, a forum for leading local authorities and their health partners to share best practice around spending the £2 billion well.  Fifteen Councils were involved over the course of 2017/18, enabling iMPOWER to undertake detailed quantitative and qualitative analysis of £126 million-worth of spending plans (one-eighth of the national allocation).

Download the report

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