When 50% of Adult Social Care Directors suggest current delivery models will lead to service shortages and financial difficulty, then the sector is clearly ripe for change. Couple this with the fact that the population aged 85 or above is set to double over the next 20 years, and the scale of the challenge is clear. We have selected five key challenges that councils must overcome. Yet against all odds, local government is starting to find its way, with innovative solutions being implemented across the country.
- Health & Social Care Integration
Health and social care integration can increase quality and reduce costs for both health and social care sectors.
Integration is already beginning to work. Calderdale’s ‘Gateway To Care’ is a positive example of a joined up NHS/LA approach. The service acts as a first point of contact for customers, and can divert people towards low-cost ‘preventative’ intervention. Of the 37,000 customers who entered the service, 97% received short-term support without the need for further care.
However, problems are emerging with integration. Some suggest that half the money being transferred from the NHS to councils has been used to protect care services from cuts, rather than driving integrated care. Quantifying the financial benefit of the Better Care Fund is also proving challenging.
Good data means good decision-making. The process within Local Authorities for compiling user data is cumbersome, with many different statutory returns filling the entire calendar. The data in many cases is difficult to interpret. However, ‘Big Data’ solutions are more readily available now than in previous years.
- Customer-focused services
Councils have thousands of stakeholders and are using new tools to understand their customers, such as customer journey mapping in Teignbridge Council. This enables councils to understand the expectations and needs of their customers. From this, councils have a clearer idea of what services should be provided, and the method by which staff and customers want them to be delivered. Customers want greater empowerment. In the most recent Adult Social Care Survey, only 32% of people suggested they had as much control over their lives as they wanted. Re-orienting services towards the customer is a key way in which satisfaction can be increased.
- Flexible working
Social care workers often find the sector inflexible. This can affect user satisfaction and productivity. 8% of social workers are considering leaving their jobs, with a significant proportion attributing stress as one of the primary reasons. However, some councils are making reforms in this area. Frontline social workers from Southend’s adult social services department were given laptops in order to enable them to administer support assessments at the service user’s home. This has significantly cut bureaucracy and duplication, and improved staff satisfaction.
- Commissioning & Procurement
Many councils are moving to being commissioners rather than providers of services, and Adult Social Care is no different. In the same ADASS survey mentioned above, 90% of those surveyed felt that an effective procurement strategy is necessary to make the service sustainable and achieve savings.
Commissioning on outcomes can maximise value and cut costs. For example, Wiltshire’s Help to Live at Home pays providers on an outcomes basis, with fines for missing customer-measured targets, and rewards for exceeding expectations. The scheme has saved £11.6 million, £4.6 million more than expected.
Evidently, the challenges are great but councils are showing that solutions do exist. The interdependencies between these issues means solving one goes some way to solving another: Integration will lead to better data, which will hopefully lead to more customer-focussed services, which entails better and more flexible methods of working, all of which are underpinned by a strong commissioning strategy. As is often the case local government is leading the way when it comes to reform.