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NHS faces year-round crisis over lack of social care, says council chief

Posted on 13/03/2018 by

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Comments come as chancellor warned that inaction on social care is no longer an option

The NHS could be plunged into a year-round crisis because of a lack of social care provision, the head of one of England’s biggest councils has warned.

The comments by Andrew Travers, the chief executive of Lambeth council in south London, were made as the chancellor, Philip Hammond, faces pressure to address funding shortages in his spring statement. They follow a warning by the Local Government Association (LGA) that a “tipping point” for adult social care was fast approaching and that inaction from ministers was no longer an option.

Labour said a £6.3bn in adult social care funding had been lost since 2010. Vince Cable, the Liberal Democrat leader, said the sector faced “a very critical situation”.

Travers said that without a long-term solution to funding social care, “it wouldn’t just be a winter NHS crisis – you might see it in the spring, and the autumn”.

The chancellor is expected to deliver a cautious, stripped-down spring statement on Tuesday with few new spending pledges and a modest upgrade to the independent economic forecasts prepared by the Office for Budget Responsibility (OBR).

Hospitals faced intense pressure over the winter as a lack of available social care places led to thousands of mainly older patients recovering from cold-related illnesses being stuck on wards, blocking beds for new arrivals.

Last month, the Conservative-run Northamptonshire council formally announced it was unable to meet its financial obligations, in part due to social care pressures.

Travers, whose Labour-run authority serves a population of almost 330,000 and spends more than £95m a year on adult social care, said he did not think many more councils would immediately follow Northamptonshire’s lead.

“The better way to look at it is to say that local authorities will, by and large, balance their budget, but at what cost?” he said. “If you or one of your nearest and dearest was in the system, at the health-social care interface, then you’d start to notice. Look what’s happened to the health service this winter – you might find that spreading out over more of the year, because of the extreme pressure.

“Part of the reason for that is that it’s difficult for hospitals to discharge people into the community because the social care packages are not there. So you might see an increase of difficulty for people who are caught up in the system and operations being delayed because wards are full of people who can’t be discharged.

When Travers was the head of finance for Barnet council in north London, following the first local government cuts in 2010, he created the “Barnet Graph of Doom” – a PowerPoint chart showing that if social care commitments continued to rise and budgets flatlined, councils would have no money to spend on anything else before long.

The National Audit Office found last week that English councils with social care obligations were routinely dipping into reserves to keep services running and that one in 10 would have exhausted these within the next three years if current spending continued.

Barbara Keeley, the shadow minister for social care, said the cuts had left a situation of “overworked and underpaid care staff with fewer care packages and worse quality”, adding: ”The Tories need to take action in the spring statement to avert the crisis which is gripping social care so that people get the care they so desperately need.”

The Department of Health and Social Care said: “We know the social care system is under pressure – that’s why we’ve provided an extra £2bn funding to the sector and recently announced a further £150m for the next year.”

Hammond is expected to confirm that the Treasury will provide more resources to boost NHS pay, as signalled last autumn, with unions and NHS management close to a deal, and he is expected to announce consultations on tax policy, including on single-use plastics.

The chancellor will also stress that while the day-to-day deficit has almost disappeared, the UK’s public debt remains historically high, so he will demand continued restraint.

The Treasury is wary of making fresh spending commitments when the potential economic impact of Brexit is unknown.

The OBR is expected to include the Brexit divorce bill agreed in December in its forecasts of the public finances, but will repeat its warning that it cannot provide a detailed projection of the economic impact.

In its autumn report, the OBR said: “Given the uncertainty regarding how the government will respond to the choices and trade-offs it faces during the negotiations, we still have no meaningful basis on which to form a judgment as to their final outcome and upon which we can then condition our forecast.”

The Labour MP Alison McGovern, a supporter of the Open Britain campaign, said: “This is a damning indictment of the government’s approach to Brexit. With just a year to go in the negotiations and after a series of highly-anticipated speeches from senior cabinet ministers and the prime minister, the OBR are still none the wiser about what the government actually wants.”

Shadow chancellor John McDonnell urged Hammond to end austerity. He said: “Today the chancellor has a choice. He can choose to act and end the misery faced by many, or he can do nothing and continue to favour a privilege a few.

“Our public services are at breaking point and many of our local councils are near bankruptcy. He needs to listen to the calls from across the political spectrum, including the Tory council leader in his own constituency – to end the financial crisis in our public sector.

On social care, Linda Thomas, the leader of Bolton council, who speaks on the issue for the LGA, said urgent action was needed now, otherwise “the adult social care tipping point, which we have long warned about, will be breached”.

Niall Dickson, the chief executive of the NHS Confederation, said there was a need for a fresh approach for both the NHS and social care. “We now need to hear from the chancellor that the government will work with all those involved in health and care to produce a plan for England for the next 15 years with a commitment to meet demands from changing demography and technology and with clear expectations of what these services should be able to provide.”

Source: TheGuardian