Adult Social Care cuts at a glance!

A summary of Council Business Plan and Budget 2016+ Consultation factsheets – Maximising the independence of adults (excluding cuts to school transport and public health)

The full document can be accessed here: http://www.birmingham.gov.uk/budgetviews 

Cuts and savings proposals ordered in descending value

1. Redesign and integrate services at scale across the health and social care economy
Saving in 16/17 £20m rising to £60m in 19/20

2. Step-up of savings re: Third Sector Commissioning and Supporting People
Saving in 16/17 £3.4m rising to £4.5m in 19/20

3. Internal Care Review – Home Care Enablement
Saving in 16/17 £1.5m rising to £3.7m in 19/20

4. Older Adults Offer
Cut in 18-19 £0.957m rising to £2.098m in 19/20

5. Assessment and Support Planning
Saving in 16/17 £.5m rising to £1.96m in 19/20

6. Introduce charges for Telecare and reducing spend on joint equipment contracts
Saving in 16/17 £1.6m continued to 19/20

7. Internal Care Services – Younger Adults Day Care
Cut £702k in 16-17 rising to £1.28m in 19/20.

8.Reductions in Adult Social Care Running Costs
Saving in 16/17 £1.111m continued to19/20

9. Internal Care Review – Older Adults Day Care
Saving in16/17 £218k rising to £510k by 19/20

10. Internal Care Review – Learning Disability Short Breaks
Saving in16/17 £192k rising to £364k by 19/20

11. Internal Care Review – Occupational Therapy
Saving in16/17 £20k carried over to 19/20

The bottom line
Maximising the Independence of Adults totals
16/17 Saving 32.587m
19/20 Saving £92.584m

Brief commentary

The following is a brief overview of the proposals:

1. 9 years of continuous cuts to Adult social care
Between 2011 and 2014 there has been a £100m cut to funding to Adult social care in Birmingham a cut of the order of 27%. Net expenditure on social care services was £379m in 2011 but four years later this had reduced to £276m. This financial year net savings of over £32 million are to be made. These latest proposals up to 2020 represent a further continuing cut to these services with £33m of cuts and savings proposed for 2016/17 rising to £92.584m in 2019/20.

2. Rising need for care and support
This further reduction to the Adult social care budget comes at a time when changes in population will lead to increasing numbers of individuals to need of formal support and possibly care. According to the Council’s own figures “it is estimated that there are 135,700 people aged 65 and older. Of these, some 30% are aged 80 and older. By 2025, the number of people aged over 65 is estimated to increase to 154,800 people, an increase of 14%. The older age group, those aged 80 and over, is predicted to increase by 23%, as people live longer.”

3. Better Integration of Health and Social care services
The largest single figure amongst these proposals is a vast £60m which is intended to be produce savings through the better integration of NHS and Adult social care services under the Better Care Fund strategy. The Council and local NHS has identified a ‘costly’ group of largely elderly people who place greatest demand upon NHS and Social Care services e.g. There are around 138,000 people over 65 in Birmingham. 110,347 of these (75%) were identified in both NHS and council data, and we are together spending £456m per year on their services. The aim of the integration of services is to prevent people entering hospital and thereby reduce the demand of this group of people upon Acute NHS services. Enabling people to retain their independence and to live well in their own homes is a good thing but the context here is everything. This is a cost led initiative and people needs are being framed as a costly problem. These savings are also a promise to the future!

4. Cutting preventative services
The largest single direct cut to a budget is to the funding to Third sector organisations which provides support to people below the Council’s eligibility criteria and to the supporting people programme which includes a range of housing support to people who have complex needs. These are identified by the Council as preventative services.

5. Promotion of Direct Payments
At present only 1,000 people out of a possible 7,000 eligible people in Birmingham receive Direct Payments to allow them buy their own packages of care and support. The intention is to significantly increase the number of people receiving direct payments. At present people cannot use their Direct payments to buy their services directly from the Council.

6. Council is withdrawing from providing Adult social care services
At present only 18% of Birmingham City Council’s care provision is directly provided and this figure will significantly reduce further under these proposals. The Council provides some excellent specialist care services such as the Enablement service. Overall the Council intends to retrench its position to become a commissioning authority as it withdraws from its role as a provider of a significant range of care services.

7. Externalisation and privatisation
In some service areas such as the Day Centres for older people and Younger adults day care they are raising the fluffy option of ‘spin off’ of these services to social enterprises or to service user organisations. For some services such as the Care Centres and Enablement Service there is a intension to find another provider to run these services.

8. Closing Council provided care services
In the short term the Council proposes to conduct a series of service reviews which will aim to rationalise and partially close some of the existing services such as Day Centre’s.

9. Care Act responsibilities

The Care Act 2014 has created important new duties for Local Authorities including the promotion of the wellbeing of adults and the provision of preventative services – that is services which help prevent or delay the development of care and support needs, or reduce care and support needs. The ability of Local Council’s such as Birmingham to meet these new duties is in contradiction with the financial climate of ‘austerity’ which is tending to ever greater rationing of services to individuals and upon strategies of reducing demand for services across the population.

These cuts in the Local authority funded Adult social care will actually reduce the resources available to enable the independence and wellbeing of people who have needs for support.

The following is a brief categorisation of the key proposal for each service:

Savings through service integration and efficiencies
1. Redesign and integrate services at scale across the health and social care economy
5. Assessment and Support Planning
11. Internal Care Review – Occupational Therapy

Increased service fees and charges:
6. Telecare
3. Enablement services after six weeks

Savings through restriction of access to services
6. Reduced spend on joint equipment contracts

Direct funding cuts through re-commissioning of services
2. Step-up of savings re: Third Sector Commissioning and Supporting People

Intended withdrawal by Council from provider role
3. Internal Care Review – Home Care Enablement
6. Internal Care Services – Care Centres

Externalisation and or spin off to social enterprise
3. Internal Care Review – Home Care Enablement
6. Internal Care Services – Care Centres
7. Internal Care Services – Younger Adults Day Care
9. Internal Care Review – Older Adults Day Care
10. Internal Care Review – Learning Disability Short Breaks

Initial partial closure of Council services
6. Internal Care Services – Care Centres
7. Internal Care Services – Younger Adults Day Care
9. Internal Care Review – Older Adults Day Care
10. Internal Care Review – Learning Disability Short Breaks

No detail of proposed saving
4. Older Adults Offer
8.Reductions in Adult Social Care Running Costs

 

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