Councils will struggle to cope with the financial challenge posed by England's ageing population and may miss opportunities to innovate and save, says a new report from the Audit Commission.
Under Pressure, published today, says most councils do not know enough about the costs of their ageing population. They may also miss the savings that could flow from preventive services and better work with other organisations.
Michael O'Higgins, Chairman of the Audit Commission, said:
'Today's older people grew up with supermarkets and self-service, and tomorrow's will use iPhones and the internet. Older people don't want to become dependant, but councils need to help them help themselves.
'Most older people live at home, not in care homes. And the longer they do, the happier they are and the less they cost the taxpayer. Innovative, personalised services mean older people stay independent longer, saving public money.
'There are huge financial pressures on councils in the years ahead, but redesigning services and exploiting technology can make them better, more efficient and more personal. Some councils are showing the way, tackling the causes of ill-health and social isolation, reducing the need for expensive social care and helping people live well in later life.'
Local authorities already need to make billions of pounds of extra savings by 2013/14 because of inevitable cuts in public spending. But councils' costs will increase if they do not plan carefully as the number of older people increases each year.
The new report says councils need the right information to help make the right decisions. The needs of older people must be a central part of their plans for all local services, and they should involve the people themselves in developing services.
Some councils have been innovative, thoughtful and cost-effective in their services:
- In North Yorkshire, the council equipped a farmhouse to help a daughter and son-in-law look after a relative with dementia. This cost less than one month's residential care (see page 42).
- Flexicare housing in Hertfordshire allows people with fewer care needs to move into specialist housing, helping health and wellbeing. It saves about half of the annual average cost (£24,786) of someone living in residential care (see page 39).
- Essex County Council, like North Yorkshire (above) is one of many making use of Telecare (external link) (see notes). This technology has helped them save hundreds of thousands of pounds a year and fewer people need to be in residential or care homes (see page 44).
- Leeds has 'neighbourhood networks' which have nearly 18,000 members. It is run largely by 1,362 volunteers. There are 36 schemes which reflect the priorities of those involved: everything from travel and social activities to exercise (see page 41).
Councils currently spend about £9 billion a year on care services for older people, such as residential care and home care services. In 1982, 30 per cent of people were over the age of 50; in 2009 it was 34 per cent; and by 2026 it will be 40 per cent.
An ageing population also provides opportunities. Older people are often more involved with their local communities and more willing and able to volunteer. Sixty-five per cent of volunteers are aged 50 or over. Eighty-five per cent of older people do not use care services, but they do use general council services. And councils could do more to understand their needs and preferences.
The increase in the number of older people will affect all councils (not just those with social care responsibilities) and housing services, the NHS and the police. But there are steps councils and others can take to plan and make better use of public money.
Under Pressure includes recommendations, challenges and questions for councils, voluntary bodies, the NHS and others. These may help them focus on finance and strategy for an ageing population and acquire necessary information.
Case studies in the report show how some councils have collaborated to improve housing, health promotion and wellbeing. This can help prevent the need for social care. Case studies show how councils can get better value out of spending on care services through schemes like Telecare, which can lead to big savings.
Notes for editors
Telecare
Recommendations from the report Under Pressure:
All councils should:
- update their sustainable community and service strategies and medium-term financial plans to prepare for an ageing population;
- build older people's opinions and experiences into plans for services; and
- update commissioning strategies to prevent, reduce or delay the incidence of health and social care costs.
Councils with social care responsibilities should also:
- use unit cost data and benchmarks to identify priorities; aim to reduce residential care costs below the Department of Health's suggested target of 40 per cent of the budget for older people's care services; and develop an action plan to meet the financial challenge;
- work with the NHS, voluntary bodies and older people on area-wide approaches to later life that underpin value for money by integrating prevention, early intervention, and care services; and
- use delivery chain analysis to overcome obstacles to joint working aimed at cutting hospital admissions and high-level residential care support.
The Audit Commission
- The Audit Commission is an independent watchdog, driving economy, efficiency and effectiveness in local public services to deliver better outcomes for everyone.
- Our work across local government, health, housing, community safety and fire and rescue services means that we have a unique perspective. We promote value for money for taxpayers, auditing the £200 billion spent by 11,000 local public bodies.
- As a force for improvement, we work with others to assess local public services and make practical recommendations for promoting a better quality of life for local people.
Nigel Watts, Media Relations Manager: 020 7166 2129 or 07813 315538