The number of people approaching their council for adult social care support has risen and council care costs have gone up for the fourth consecutive year, leading to an overspend of £715m, according to the latest annual survey from the Association of Directors of Adult Social Services (ADASS).
The increase has been attributed to councils being called on to support an increasing number of adults who have complex care needs.
Three-quarters of Directors reported an increase in the number people presenting to adult social care who were or would have previously been eligible for NHS Continuing Healthcare (CHC).
It follows promises by government to shift care from hospital to the community. But ADASS says its survey highlights a “disconnect” between these ambitions and the funding provided to deliver them.
Phil Holmes, President of ADASS, said: “Councils continue to be placed under huge financial pressure, with no signs of this abating. Behind every number there is person needing support, a family struggling or an unpaid carer taking on huge responsibility.
“There are areas that need particularly urgent attention. The ongoing reduction in the number of people receiving NHS Continuing Healthcare flies in the face of our ageing population. Increasingly frequent funding disputes are leaving people and families facing uncertainty about whether they will get the care they need, or whether their existing care will continue to be possible. This year’s ADASS survey provides even more evidence that NHS Continuing Healthcare urgently needs national reform.”
The ADASS survey also found that more than 400,000 people are waiting for assessment, care and support, a direct payment, or a review.
Meanwhile, councils are reporting that ICBs are failing to invest in services vital for supporting people in the community, including CHC.
Responding to the survey, the Local Government Association said: “After successful efforts in recent years to reduce the number of people waiting for a care assessment or support service, it’s concerning to see this number rise. This is another reminder of the difficult decisions councils are having to make and the real impact this has on their ability to meet their statutory responsibilities.
“Although overall overspend has decreased slightly this year, it remains high and, as a key issue for four out of five councils, is impacting spending on other council services. At the same time, councils’ capacity to spend on planned prevention is shrinking, with knock-on effects elsewhere in health and care services.”
Dr Jane Townson, CEO of the Homecare Association said: "Nowhere is the gap between need and funding clearer than in NHS Continuing Healthcare. ADASS's evidence confirms what our members experience daily: people with the most complex needs being reviewed out of NHS funding and pushed onto councils or left to pay for their own care, while funding disputes drag on around them - in the worst cases, almost to the point of death.
"We wrote to NHS England last month asking it to pause and engage with the sector before this programme proceeds: to establish first whether current rates are enough to fund safe, legal care, and to review the use of contingent-fee arrangements in NHS-funded care. ADASS's survey strengthens that case, and we fully support its call for a rights-based national framework for Continuing Healthcare, where eligibility follows a person's needs and legal entitlement, not the state of an ICB's finances.”