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Why the adult social care green paper may not deliver

The perspective of councils that provide adult social care could not be clearer. Nearly half of their expenditure is being spent on the rising demand for adult social care.

Councils are facing uncertainty because the current rate of demand growth is expected to continue for decades. But everyone could be forgiven for thinking that help is on its way. Much rests on the anticipated government green paper on adult social care to tackle these existential problems facing councils. But will it and the Budget in November provide the solutions?

Cost to the individual is government priority

The reality is that the government hasn’t much fiscal room for manoeuvre – and even less of a majority in parliament. More importantly, the question of council financial sustainability is of much less significance to the government than the question of how the average voter pays for social care. Citizens want to know that their wealth will not be unduly raided in the event of significant personal social care costs. This makes the thresholds and caps that might be put in place a green paper priority.

It can therefore be expected that the green paper will also deal with how new thresholds and caps might be funded, depending on the levels of policy generosity. But the policy goal here is about ensuring the distributional effect on individuals is seen to be broadly positive. Whether councils have more funding to pay for the care of the vulnerable and those without means is a secondary matter – or at worst the wrong question. There might be protests, but this is the reality.

The case for long-term investment in adult social care Find out more

Adult social care insights

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Time for councils to take the lead

The green paper may not provide all the answers, but probably a little short term relief. If that is so, then it is time to think hard about how to set a medium-term strategy at the council level that can work. Councils with social care responsibilities have been innovators in a number of respects – in managing demand processes, in reforming social work practices and in joining up with children’s services and the NHS. But there are new frontiers to be charted. Adult social care is a demand-led service that must hold three investments in balance:

  1. Investment in organisational process, data insight and capability to manage demand
  2. Investment in people to prevent, delay and avoid demand
  3. Investment in vibrant markets to service demand

The right question for councils is therefore about how to make those investments. They need to be at the game-changing scale, not at the level of experiments, often with partners in other counties, the NHS and the independent sector. Almost a decade of revenue poverty has made the task far greater to overcome. So we need to see boldness in building our care infrastructure for the future. These steps will include a more interventionist approach in the market to renew the crumbling social care estate; the conversion of warm words on disability independence into improved whole life pathways; and a revolution in the way data and technology is used to support people.

Councils with social care responsibilities are at their best when they use their scale and authority to tackle the issues government cannot or will not. For adult social care, that moment is surely here.