Cuts in social care ‘risk putting unsustainable pressure on NHS’

The National Audit Office (NAO) study finds around three-quarters of the reduction in spending on social care by local authorities has come from cuts to the amount of care provided, while a quarter has come through slashing costs.

It warned that cuts were increasing pressure on other parts of the system, such as the NHS and A&E, and yet Ministers remain unclear how these pressures will be absorbed.

It added: “Rising needs, reducing local authority spending and reductions in benefits may be putting unsustainable pressure on informal carers and acute health services.”

In the three years since April 2010, local authority spending on individual packages of home care, care homes and day care “has fallen significantly”, the report said.

“Our analysis shows that around three-quarters of the reduction in local authority spending has been through reducing the amount of care provided.”

While this could reflect some people needing less care due to earlier intervention, there have also been cuts to services and changes to eligibility criteria. This means fewer people qualify for care than before.

Spend on adult social care fell by eight per cent (£1.4bn) in real terms over the three years, the report said, despite the Government’s stated intention in 2010 that spending on social care should be protected.

The NAO warned that the increasing pressure was affecting carers as well as the NHS. “Informal carers are doing more hours of care per week and are, on average, getting older.

“Delayed discharges into, and avoidable admissions from, social care settings place increased demand on acute services.

“National and local government do not know whether the care and health systems can continue to absorb these cumulative pressures, and how long they can carry on doing so.”

The NAO concluded that while spending on social care was falling, demand for care was rising. Adults with long-term and multiple health conditions and disabilities were living longer, while the number of adults aged 85 or over – the age group most likely to need care – was rising faster than the population as a whole. This meant improvements were needed, including key contracts for care services.

“Contracts for services that local authorities commission from the private and voluntary sectors are frequently time or task based rather than outcomes based,” the study said. “They generally do not incentivise providers to rehabilitate or improve user independence.”

Labour MP Margaret Hodge, chairman of the cross-party public accounts committee, said: “The Department of Health and the Department for Communities and Local Government are changing the adult social care provision when it has no idea whether it will actually deliver savings.

“The result is unnecessary stress and an unfair financial burden on those who need care and the 5.4 million unofficial carers who already contribute £55bn worth of care every year.

“The fact the departments do not know how much longer the entire care system can cope under the mounting pressure makes for a worrying picture.”