The Spending Review provides an opportunity to level up our communities and tackle health inequalities.
As we approach this year’s National Children and Adult Services Conference (NCASC), which is being held virtually for the second year, there is much to work towards and reflect upon given recent government announcements.
Senior councillors and council officers, as well as colleagues from the voluntary, community and private sector involved in children and adult services, will be gathering online to listen to high-profile speakers including Care and Mental Health Minister Gillian Keegan MP, Chief Medical Officer Professor Chris Whitty, and NHS England Chief Executive Amanda Pritchard, among many others.
“There is much to work towards and reflect upon”
What is certain to be at the heart of many discussions during the three-day conference is the recent publication of the Government’s highly anticipated and long-awaited health and social care plan.
Of the estimated £36 billion the new UK-wide health and social care levy announced in the plan will raise over three years, only £5.4 billion is to be ringfenced for social care in England.
Unlike for the NHS, none of this money appears to be allocated to help tackle the significant pressures facing social care now. The LGA says that addressing the NHS backlog and freeing up hospital beds cannot be done without also fixing social care, which will require additional support for those discharged into the community.
The lack of any itemised breakdown of how this share of the levy will be used for social care is creating concern for councils, while we also need urgent clarity on how much will go to adult social care beyond the three-year period – and an absolute guarantee that this will be delivered.
While it is important to protect people from paying ‘catastrophic costs’ for their care, the LGA says the introduction of the care cap is an enormous undertaking and councils should receive all the support they need to implement it.
The Government’s plan does have some potential promise on how care is paid for and the contributions people themselves make, but it has left open many more questions that need answering urgently.
As it stands, it will not improve access to – or the quality of – social care services; nor will it provide an uplift on care worker pay, or better support people to live the lives they want to lead and in turn strengthen our communities.
We have called for a cast-iron commitment from government that the planned white paper on wider adult social care reform, together with the Spending Review, will result in a long-term plan and a steady stream of investment into social care.
Related to this, we are calling for sustainable funding for local government mental health services, to put them on an equal footing with NHS clinical services and to meet current, future and new demand in the wake of COVID-19.
This will help provide appropriate support for those people who have vulnerabilities and investment in preventative mental wellbeing work at scale, including for suicide prevention.
We are also working to ensure councils have the resources they need to build on the work many are doing to implement the Government’s strategy to improve the lives of autistic people in their communities.
Supported housing can extend independent and safe living for older people and working age disabled people, including those with long-term health needs, helping to reduce demand on social care and health services.
We need to increase the supply of ‘extra care’ housing to keep pace with demand, and ensure that the housing and care support costs of people living in all types of supported housing are fully funded.
Timely home adaptations can also support older people and disabled people, their families and carers to manage wellbeing in the home.
We need to simplify the process by which people living in their own homes or who are renting privately can access financial support for adaptations, raise the accessibility standards for new builds, and increase the adoption of accessible design principles across the board.
When it comes to reform, the LGA broadly supports the aims of the Health and Care Bill, currently going through Parliament, to remove barriers to integrating care and support, to improve health outcomes and reduce health inequalities.
“The Government’s plan has left open many more questions that need answering urgently”
We also support the Government’s enabling approach to give local health and care leaders the flexibility to make their own arrangements for joining up services and setting their own strategies for improving the health of their communities.
There is little on the face of the bill to direct how integrated care systems and their two key components – integrated care boards and integrated care partnerships – will be set up and operate.
The LGA is working closely with councils, government and NHS England to ensure that the new arrangements build on existing partnerships.
Place-based partnerships, especially health and wellbeing boards, should have a leading role in driving health and care improvements.
The announcement of an integration white paper, to be published this autumn, came as a surprise to local government, especially as the Health and Care Bill will not come into force until April 2022 at the earliest. However, we will work with councils to ensure that their views help shape the future of integration.
COVID-19 has provided a stark reminder of the value of public health and of the deep health inequalities that exist in society.
Deprived and minority ethnic communities, and people with underlying health conditions such as obesity, have been disproportionately affected by severe illness, hospitalisations and deaths.
Councils, working with partners such as the NHS and the voluntary sector, can deliver good outcomes from frontline, cross-sector public health services like drug and alcohol treatment, sexual and reproductive health, physical activity, weight management, smoking cessation, health visiting and school nursing; and provide the necessary public health leadership to address the root causes of physical and mental ill health, such as poor housing, air quality, crime and poverty.
Councils are doing all they can to help keep people well throughout their lives and reduce pressure on the NHS and social care.
Investment in councils’ public health services now will reap benefits for everyone longer-term, including helping us prepare for the next public health threat and building a more prevention-focused health and social care system.
As all these issues and more are explored in greater detail at NCASC, we call on the Government to use its imminent Spending Review to realise our shared ambition to level up our communities, by delivering the investment needed to secure both the immediate and long-term future of our vital care, health and support services, as we build back better from the pandemic.
