This article forms part of the LGA think piece series 'Towards a sustainable adult social care and support system'.
District councils operate at a level where we truly understand the health and wellbeing needs of our communities.
With people and place at the heart of Districts, our priorities are shaped by our engagement with local residents who can relate to the scale of help we provide and welcome the close democratic accountability that underpins that provision.
The delivery of planning, housing and health, sports and leisure services naturally place Districts at the forefront of our community’s health and wellbeing and cement an important and mutually reinforcing relationship with our adult social care and wider sector partners. Our frontline service areas significantly impact the wider determinants of health and are crucial to addressing the increased pressure on primary and social care, both in the short and long term.
With an increasing number of people living longer, and with more complex needs set to continue, it is vital that funding is spent keeping people well and safe in their own homes, and communities are empowered to care for themselves where they so wish, which can only be delivered at a local level.
The scale of district areas allows us to deliver locally tailored solutions to keep our residents healthy and happy. We have a place based approach to health and many of our more localised services, such as leisure and cultural activities, are key to inclusion, overcoming social isolation, loneliness and community engagement, which impacts significantly on mental and physical health. These services also support the wider prevention agenda, helping to mitigate demand pressures on social care through joint district-county initiatives.
Districts are the champions of cost-effective prevention. Through direct action (social prescribing and delivery of Disabled Facilities Grant) and also through wider determinants, such as housing and recreation, we can shape healthy communities where people thrive and don’t need to access primary services. When they do require such services, we are able to get them back living in the community as soon and safely as possible.
We are driving essential prevention work which reduces the burden on acute and social care, for example through the delivery of housing adaptations, which improves people’s independence and wellbeing and reduces the risk of falls. The delivery of adaptations is also crucial for ensuring people can return home after needing hospital care, in a familiar environment which is safe and conducive to their recovery, while freeing up much needed bed space. Our work is leading to reduced demand on services and lower health and social care costs.
More local funding for prevention work by Districts could save the wider sector millions of pounds. For example, further funding for districts to improve poor-quality homes with cold, damp and falls hazards can reduce NHS costs by £2 billion per year [King’s Fund and National Housing Federation Report on housing and health].
Furthermore Next Steps on The NHS’ Five Year Forward View said addressing the wider determinants of health, such as housing, can only be done if the NHS and local government worked closely together to improve health and make best use of available funding. This fits squarely with the local level that Districts operate in and yet there is still no statutory representation for District Councils on CCG and STP boards.
Districts’ role in place-based health and wellbeing is helping to protect and enhance quality of life and must be better recognised by government and sector partners. We are crucial to delivering a sustainable adult social care and support system; through improving housing, providing leisure and recreational facilities, offering debt advice, tackling homelessness, supporting troubled families and improving air quality, Districts are helping to reduce demand on social care and health services. This early intervention work is improving lives and saving money and resources further down the line.
We hope the Green Paper recognises how essential Districts are in effective prevention and demand reduction which has previously been ignored by government – we receive no direct funding for public health.
It’s impossible to discuss adult social care without mentioning funding. Our call for an additional 2 per cent prevention council tax precept could raise up to an extra £25 million for district councils which would help keep residents and their families from needing to access acute social care and NHS services by reducing demand for them. Considering that every £1 we spend saves £70 on health spending in the long term, this would mean the extra £25 million raised could save £1.5 billion over the longer term.
Ultimately, Districts work on a scale where it is possible to solve problems rather than simply manage caseloads. Key to driving down demand is using local knowledge to build healthy spaces and target funding on early intervention. Local investment will drive and lead to national improvement.
District councils, working closely and effectively with local partners, are a crucial part of the equation in supporting healthy and happy lives in our communities. National inputs clearly matter, but it is this inherently local work, backed up by democratic accountability, that really makes a difference.
Cllr Chris Saint
Lead Member on Enhancing Quality of Life, District Councils Network