Social care and the NHS effectively operate as a single sector, particularly as most people who have social care needs also have health needs. Adult social care is the responsibility of local government and provides non-medical care for the most vulnerable adults in our communities. Extreme financial pressures facing health and social care are leading to a crisis point in both these services.
This crisis is extremely worrying as many of the people who rely on those services are some of the most vulnerable in our society.
- The most frequent type of service is provided by care workers who visit people in their own homes to help them get out of bed, wash, eat & keep their home clean.
- If not living in their family home people with disabilities may live in small scale shared homes run by voluntary or private sector organisations.
- Extra care housing schemes provide care when required for older people.
- People recovering from mental ill health may need help with day to day living as part of their recovery.
- When people are very vulnerable a nursing care home can be the best alternative.
There are many different arrangements – packages of care are designed around the individual’s circumstances. Social care is means tested (unlike the NHS) and in Lambeth there are about 4,000 adults at any one time receiving some level of social care via the council. For those able to fund their own care the council can help with advice & information.
With a growing older population however, demand for care services is rising rapidly. Across England there are already 1.5million people over the age of 80 and we are heading towards having a million people living with dementia. By 2030, we will have 15 million people over the age of 65, up from 11 million today.
Unfortunately, while demand is rising, the stark truth is that there is just not enough money coming from central government. Simon Stevens, the Chief Executive of NHS England has called for extra funding urgently. In London there is an estimated £900 million shortfall in what we need to give our population adequate services.
In Lambeth, as in councils throughout the country, social care services are struggling because of these pressures. High housing and transport costs in London make it difficult to employ care workers meaning that the NHS, care agencies, care homes and other providers find it hard to recruit – so the public sector ends up with a high percentage of agency staff that cost more.
A cacophony of voices
The pressures on the system mean that these issues are finally getting the media coverage they deserve. And we are now seeing a cacophony of voices, from the care and health sectors to MPs and councillors of all parties calling on the government to act.
Sadly that pressure did not lead to any government action in the Autumn Statement last year. Instead the government solution has been to introduce a ‘precept’ option to add an extra 3% to council tax. While we, like most councils across the country, will take this option, we know it will only make a small dent in our overall savings target and the increased demand pressures.
It is time for a fully-funded, national solution to the adult social care crisis. We will continue to deliver our services in Lambeth by working more and more closely with local GPs and hospitals, as efficiently and effectively as possible. We will also continue to put pressure on the government to do the same.