Councils across England saw spending on adult social care fall by 11% in real terms between 2009/10 and 2015/16, with newly published figures suggesting around six-in-seven councils made at least some cuts to their spend and one in 10 making cuts of more than a quarter.
Spending fell by most on average in London (18%) and metropolitan districts (16%) covering urban areas like Greater Manchester, Merseyside and Tyneside. More generally, cuts were larger in the north of England than the south.
Cuts were also larger, on average, in areas that in 2009/10 spent more on adult social care; had higher assessed spending needs and were more dependent on central government grants.
These are among the main findings of a new report by researchers at the Institute for Fiscal Studies (IFS), funded by the Health Foundation, which analyses official spending data on councils’ social care spending.
Other key findings include:
- There remains significant variation in councils’ social care spending across the country: spending was less than about £325 per adult resident in a tenth of council areas, while it was more than about £445 per adult resident in another tenth of council areas in 2015–16. That’s a difference of more than a third
- Councils where there are relatively more people over pension age (particularly those entitled to means-tested benefits), and where levels of disability benefit claims and deprivation are higher, tended to spend more on social care. Higher local earnings levels are also associated with higher levels of social care spending
- Even so these ‘spending needs factors’ only explain a small proportion of the variation in spending across councils. Indeed, councils’ ‘scores’ in the last official needs assessment in 2013–14 can only explain around 13% of the variation in what they actually spent on social care per person in 2015–16
- In part, this may reflect inaccuracies in that needs assessment, and the fact that by 2015–16, the assessment was two years out of date. But it will also reflect that given similar needs, different councils are likely to make different trade-offs between spending on adult social care and spending on other services. And they have different overall budgets (from council tax, business rates, and grants) from which to fund their service spending
- In addition to council spending, care recipients often contribute towards the cost of their care through fees and charges. These raise an average of £63 per adult resident, but the amount varies widely: one in 10 councils raise less than £35 per adult resident, while a further one in 10 raise £95 or more
- However, there is no clear relationship between local authorities’ own spending and fee income. It is not the case that all high spenders charge lower fees, nor that all low spenders rely on high income from co-payments to meet costs.
Polly Simpson, a research economist at the IFS and an author of the report, said: “The spending cuts analysed in our report have been accompanied by a substantial fall in the number of people receiving social care: down 25% across England, between 2009–10 and 2013–14 alone.
“Cuts have therefore been delivered, in part, by removing care from many people, with those still receiving care presumably those with the highest needs. What all this means for the quality of care received, the welfare of those no longer receiving care, and other services like the NHS requires further research to answer,” she said.
“One thing that stands out in these figures are the big differences in spending per adult on social care among councils assessed to have very similar spending needs by the government,” said David Phillips, an associate director at the IFS and a co-author of the report.
“Whether this means spending needs assessments are inaccurate, or reflects differences in available funding or the priority placed on social care relative to other services or council tax levels, is unclear.
“But it emphasises that the government has got its work cut out in its ‘Fair Funding Review’ of how to measure different councils’ spending needs from 2019 onwards – that debate could get quite fraught,” he said.
Responding to the research, Cllr Linda Thomas, vice chair of the Local Government Association’s Community Wellbeing Board, said the report reflected “historic and chronic” underfunding of adult social care by successive governments – which had forced councils to make tough decisions on their care budgets.
She said: “Councils have protected spending on adult social care as much as possible, but significant pressures of an ageing population, inflation and the National Living Wage are piling pressure onto our social care system.
“Councils are doing all they can to protect adult social care budgets and the £2bn for adult social care in the Spring Budget is a significant step towards protecting the services caring for the most vulnerable in our communities over the next few years.
“However, short-term pressures remain and we still desperately need a long-term solution to tackling the funding crisis to help provide care and support for people to enable them to live more independent, fulfilled lives.
“It is impossible to plan for the long-term without long-term funding. No matter what additional help is given to adult social care, if local government funding overall remains under pressure, adult social care faces further savings as it is the biggest budget within councils.
“It is also not appropriate to use an outdated formula that both government and councils agree is no longer fit for purpose as a measure of need to spend. Councils are closest to their citizens and will make spending decisions based on local need in the context of available resources.
“The government’s commitment in this year’s Budget to publish a Green Paper which explores options for a long-term solution to reform and fully fund our care system is a key opportunity to establish how, as a society, we should best support people of all ages with care and support needs in our communities both now and in the future.
“For the Green Paper to be successful, local government leaders must play a central role so that any solutions are workable, affordable, and support the spirit and letter of the Care Act, which councils are fully committed to.”