Debate on the NHS’s performance in relation to its priority area targets; and the impact of adult social care pressures on patients of the National Health Service, and their safety, House of Lords, 6 February 2020

We are pleased that in the recent Spending Round, the Government has responded to our calls and provided desperately needed new money, including £1 billion for social care (children’s and adults), as well as confirming the continuation of existing grants. However, these one-off, piecemeal injections of funding hamper councils’ ability to plan for anything beyond a short-term horizon. Social care needs to be given long term funding certainty in the same way as the NHS, and we look forward to seeing the Government’s plans for long-term adult social care reform.

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Key messages

  • Adult social care and support is a vital service in its own right. It helps people of all ages to live the life they want to lead. It binds our communities, helps sustain the NHS and provides essential economic value to our country.
  • Following the Government’s delays to its green paper, we published our own, ‘The lives we want to lead: The LGA green paper for adult social care and wellbeing’, in the summer of 2018. This was a starting point for a public debate about how to fund care and how it can better support and improve people’s wellbeing. Our response to this consultation was published in November 2018 and sets out key findings, implications and recommendations, including on how to fund social care. In July 2019, to mark one year on from the launch of our own green paper, we produced a further report to set out the consequences of another year of delay and inaction.
  • We are pleased that in the recent Spending Round, the Government has responded to our calls and provided desperately needed new money, including £1 billion for social care (children’s and adults), as well as confirming the continuation of existing grants. However, these one-off, piecemeal injections of funding hamper councils’ ability to plan for anything beyond a short-term horizon. Social care needs to be given long term funding certainty in the same way as the NHS, and we look forward to seeing the Government’s plans for long-term adult social care reform.
  • NHS performance on its key target areas has deteriorated significantly over recent years. This has been driven by rising demand for NHS acute services, which is caused by a range of factors, including:
    • A lack of funding for and investment in adult social care, primary and community health care. This has meant that these services have been unable to keep pace with demand. It also means they are less able to help keep people out of acute settings in the first place.
    • A lack of investment in public health and preventative services.
    • An ageing population with more complex and multiple needs.
    • A national healthcare funding and operating model which is reactive and prioritises acute funding over community-based provision, treating the symptoms of pressures rather than their root cause.
  • There is a vital need to invest in primary and community health care, and wider community services. Local authorities’ public health grant funding has reduced by over £700 million in real terms between 2015/16 and 2019/20. To match the growth in overall NHS funding as part of the Long-Term Plan, the public health grant should increase to at least £3.9 billion by 2024/25. We are continuing our calls for the public health grant to be restored and placed on a long-term sustainable footing for the future, with the additional money used by local authorities to help avert the onset of disease and reduce the burden on NHS and social care
  • More needs to be done to make our model of health and care proactive, person-centred, holistic and preventative.

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Debate on the NHS’s performance in relation to its priority area targets; and the impact of adult social care pressures on patients of the National Health Service, and their safety, House of Lords, 6 February 2020