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Balancing your adult social care budget

The opportunities for local authorities to make savings on long-term services within adult social care could have a positive impact on their overall spending performance.

Adult social care currently accounts for an average of 4640% of a council’s budget. The majority of this spend (96.2%) is on long-term services - those that last more than six months.

Short-term care, on the other hand, looks to provide targeted, intensive support to individuals to help them quickly regain or maintain a level of independence they achieved prior to a hospital episode or illness.

By reducing the need for costly longer-term care, a shift to relying on short-term care and other innovative approaches could reduce councils’ spend significantly.

Reducing overall spend

Local authorities across England saw an average increase of 0.39% in the proportion of spend on long-term services between 2015/16 and 2017/18. Due to the increasing demand on services, this is perhaps to be expected.

To assess how the cost of long-term services impacts on overall spend for adult social care, we looked at the sixteen authorities with the lowest and highest proportional spend on long-term services between 2015/16 and 2017/18.

Change in adult social care spend 2015/16 – 17/18. Local authorities with highest proportion of long-term spend.

Graph to show local authorities with highest proportion of long term spend

Source: NHS Digital

We found that those local authorities that spent the most on long-term care also had the highest increase in spend on adult social care as a whole, with an average increase of 8.76%.

Of the councils with the lowest proportional long-term services spend, there was only one authority with a significant increase in their total spend over the last three years. Except for anthat outlier, the authorities that relied on the increased provision of short-term services benefited from less spending overall, with an average increase of just 1.24%.

Change in Adult Social Care spend, 2015/16 – 17/18. Local authorities with greatest proportion of short-term spend.

Graph to show local authorities with greatest proportion of short-term spend

Source NHS Digital

This comparison supports the idea that authorities that have made an intentional shift towards relying on the increased provision of short-term services and alternative approaches have made significant reductions in costs, demand for ongoing services and increased cost effectiveness in the adult social care sector.

Delivering to budget

But does this reduction in spend on long-term services translate into a council being better able to deliver to its overall adult social care budget?

For this analysis we looked at the sixteen authorities that experienced the greatest increase and decrease in their proportion of long-term spend between 2015/16 and 2017/18.

For those councils with the greatest increase in proportion of long term spend, in 2015/16 one local authority was under budget. In 2017/18, three of these authorities (42%) are now under budget.

INSERT TABLE 1 HERE

Source: Gov

Despite some good performance for those with increased long term spend, this shows that the majority of council’s who have shifted more of their spending towards short-term services are characterised by a lower increase in their total spend and less likely to overspend their budgets.

Getting the right balance

This analysis highlights that a shift toward short-term services and innovative solutions can help local authorities better manage their adult social care budget, reducing demand and making significant savings.

References

  1. Adult Social Care Activity and Finance Report, England - 2017-18, NHS Digital, 2018
  2. Local authority revenue expenditure and financing England: 2017 to 2018 individual local authority data - outturn, Government, 2018

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