Ahead of Wednesday's Comprehensive Spending Review, today we are publishing a report on the issues confronting those involved in planning and providing adult social care.
JRF commissioned Ipsos Mori to interview 15 local authority decision-makers with responsibility for adult social care across England, alongside five representatives from service user/carer organisations. This short, focused piece of qualitative research aimed to get a sense of how some key people are thinking, planning and preparing for the future.
The report indicates a wide range of responses, even across a small sample of local authorities. Some have already taken positive steps in a proactive fashion. Others simply feel unable to plan ahead until they know the outcome of Wednesday's announcement, until they have clarity about the scale of cuts (20%? 25%? 30%?), and clarity about changes such as the new GP Consortia.
Tellingly, everyone who took part had the same concerns about making the right decisions for the medium and longer term.
Everyone was worried about a dramatic reduction in funding for 'that bit of help': preventative and early intervention services which can reduce, delay or prevent the need for more costly services in future such as hospital admissions and respite services for carers. No one doubted the high value of these low-level support services. But they all doubted how they could justify spending on prevention if budget cuts were so severe that there was no option but to restrict entitlements to those with the most critical levels of need: the 'tip of the iceberg'.
For me, what emerges from Ipsos Mori's report is a sense of the variety of responses across even a small number of local authorities in England. It seems likely that we will see a widening gap between different places in how, and how well, they respond to Wednesday’s announcement, as social care has historically been under-funded compared with the NHS.
When we convened a meeting to discuss the Ipsos Mori findings, JRF asked how we – and others – might support decision-makers, activists and providers to steer the best possible course following the CSR, to do as little damage as possible, and to reshape services and support. We are now working with the Centre for Policy on Ageing to mine the existing evidence base on preventative services for older people.
What else do you think could support decision-makers to make the right decisions about adult social care?