A third of directors of Adults Social Services say they plan to cut services next year, and half say the quality of services has already declined.
The King’s Fund quarterly monitoring report, published yesterday, shows that the financial squeeze is ‘beginning to bite hard’ with adult social services.
The study shows that two-thirds of NHS finance directors and nearly three-quarters of directors of adult social services (DASSs) pessimistic about the financial outlook across their local health and social care system in 2013.
Cuts to services
36% of the directors said they were planning to reduce the volume of services that their council funded in the next year. They do not expect this to be with raise eligibility criteria but most already restrict help to those with ‘substantial’ needs, and some are planning to increase the charges faced by clients.
A third are predicting to overspend their budgets next year, and even though councils have a good track record of this, it is now much more difficult to make further savings without directly cutting services or affecting quality of services. The overspend is set to have a significant impact on access to social care services, with more than a third of DA SSs anticipating having to reduce services over the next year.
Growing concerns about the quality of care
Â„The report shows growing concerns about the quality of health and social care, with a third of finance directors report that the quality of NHS care in their area has deteriorated over the past 12 months, compared with only about one in six in the previous review.
46% of directors of adult social services thought that the quality of services they commissioned had worsened in the past year.
The findings are likely to increase concerns about councils’ capacity to maintain the quality and capacity of adult social care services amid rising demand pressures and cuts in their budgets. The government’s proposal to spend £1bn a year by 2020 limiting the costs of self-funders’ care was criticised by some campaigners as the wrong priority at a time when councils were struggling to meet the needs of existing service users.
Pressures on services
Â„Delayed transfers of care are a concern for many NHS organisations. The Kings Fund have said that investigation is needed of the difference between the impression that the official statistics give of a stable amount of delays, compared with the views that the finance directors have given which do not match.
Â„Â„There is also growing pressure on emergency care, with the proportion of patients waiting longer than four hours in accident and emergency departments at its highest level for this quarter since 2003/4 and a quarter of all providers recording breaches of the target in the quarter to December 2012. Two thirds of finance directors also said that delayed transfers of care in their area or trust had got worse over the past year.
Further cuts will only exacerbate the strain on key services, however the NHS has so far managed to maintain the massive reductions in waiting times it achieved by the middle of 2009, as well as continued reductions in health care-acquired infection rates
The Kings Fund conclude that the social services and local government in general, will face an even tougher financial situation as a result of the government’s deficit reduction strategy.