April sees the implementation of the Care Act, a widely supported and significant piece of legislation for the increasing numbers of us who will require care and support. Its aspirations are to improve the health and wellbeing of the people who need care and support (currently 1.3m) and family or friends who are also carers (5m in England).
It is a contradiction that despite everything being done to prioritise and protect adult social care (ASC) by councils, the cash invested in those services will have reduced by a further 1.9 per cent (£266m) in 2014-15 to £13.68 billion. This will be the third year of continuing cash reductions and the fifth year of real terms reductions in spending.
These five years of real terms reductions continue to contrast sharply with the health service, which has received real terms protection of its spending over this same period.
Despite everything being done, the cash invested in adult social care will be reduced in 2014-15.
The commitment to address this partially through the Better Care Fund for 2015-16 is very welcome. But the continuing scale of reductions in funding to local government, as augured by the 2014 Autumn Statement, continues to be a cause for extreme concern.
Since 2010 spending on adult social care has fallen by 12 per cent in real terms at a time when the number of people looking for support has increased by 14 per cent. Inevitably this has led to fewer people receiving support, with councils over the last four years making savings to their ASC budgets totalling £3.53 billion.
The ADASS budget survey for 2014/15 showed a 5.8 per cent reduction in the numbers of eligible adults receiving services during the previous year. The biggest decrease was directed towards older people supported in community settings which was reduced by 7.9 per cent compared to a 4.7 reduction in the number of older people in residential care
Dementia affects over 850,000 people in the UK. Some 23 million UK residents have a close friend or family member with dementia. As well as the huge personal cost dementia costs out economy some £26 billion annually. (Alzheimer’s Society, 2014).
Some 23 million UK residents have a close friend or family member with dementia.
Of these 773,502 were aged 65 years or over which represents one in every 79 (1.3%) of the entire UK population and one in every 14 of the population aged 65 years and over. In 2015, there will be 856,700 people with dementia in the UK at the current rate of prevalence. And if those trends continue the number of people with dementia in the UK is forecast to reach 1,142,677 by 2025 and 2,092,945 by 2051.
Frankly, applying the arithmetic suggested by our analysis of social care budgets to the demographics painted in our understanding of the growth in the number of people with dementia creates a serious worry. Within the current financial restraints, though, what can be done? And what is being done?
- Better, more streamlined and focused approaches to the provision of advice and information, assessment, treatment and care – helping people to live well. This of itself would not save considerable sums of money. But it would lay the foundation for closer, mutually supportive working which is much more likely to deliver the person-centred health, care and support that people need and tell us they want.
- A survey conducted by ADASS/Tunstall in September 2014 broadly concluded that where systematic investment in tele-care is made it demonstrably benefits older people and their carers, while simultaneously reducing care costs. The technological and medical revolution will continue and sits alongside efforts to improve what we do now. This must include more training for the people who seek to help and support people with dementia.
- The delivery of integrated personalised services, including the trialling of the use of integrated personal commissioning (personal budgets).
- The wide publicity and profile being given to dementia generally help to break down the fear and lack of knowledge which acts as a barrier to people seeking help, continuing to live in hope and gaining support from the communities we all live in.
Finally we have, as a nation, the choice whether or not to increase the level of spending devoted to adult social care from the current two per cent to a level where we can develop the care and support that only meets the needs of today, but the increasing needs of the next decade.