Audit Commission

Councils are changing their approach to providing adult social care to make services more efficient, the Audit Commission briefing Improving value for money in adult social care has found.

As demographic change and financial pressures combine to create tough times for adult social care, councils have looked at many aspects of the service in order to provide better, more efficient services. Not only is the population ageing, but the pressure on services from people with learning disabilities is increasing as those people live longer.

Better procurement, improved back office arrangements, and a preference for community based rather than residential care where possible, are just some of the changes that local authorities have implemented to help them meet the challenges they face.

But the briefing finds that the pace and scale of change need to increase if councils want to release material savings, as well as improve care for people.

Andy McKeon, Managing Director Health, said:

‘Social care services have seen an increase in demand because of an ageing population and because people with learning disabilities are living longer. We are pleased to see that councils have reacted to these pressures and started to change the way they operate, by giving more people personal budgets and spending more on prevention.

‘But the pressures on councils are growing. They have many competing demands on their finances and, over time, more and more people will need their help. Small, tried and tested improvements will help to make savings in the short term and there are opportunities to do this. But councils also need to look more widely to deliver greater savings and make a real difference to peoples’ lives in the longer term.’

The briefing identifies nine areas in which councils can make changes to deliver efficiency savings. They are procurement; staffing; back office; assessment and care management; prevention; personalisation; changing the balance of care; partnership and charging. Most councils have addressed a combination of these factors, but no one council has made changes to all nine.

The briefing highlights examples of councils who have made substantial savings in these areas. The West London Alliance, made up of six London boroughs, predicted a combined saving of £4 million by jointly procuring personal home care. Hertfordshire County Council has reviewed its care packages for people with learning disabilities. By introducing individual budgets and negotiating cuts in fees for high-cost placements, it expects to make substantial savings while improving outcomes for service users.

All of the positive examples in the briefing bring savings and improvements for service users, but they are mostly transactional. Councils are seeking to redesign services and develop different approaches to care to provide a better quality of life - so called ‘transformational’ change. However, the briefing points out that although transforming services will help to deliver better quality support, it is a long and challenging process, and may not deliver savings.

One big opportunity for councils to do things differently in the coming years will be working more closely with the NHS. Working together they can make savings by commissioning or delivering services jointly, cutting duplication and avoiding simply transferring costs from one organisation to another.

Andy McKeon continues:

‘Social care is undergoing a radical change and we cannot predict what the service will look like in years to come. But we do know that like all public services, savings will need to be found in social care. This briefing presents a starting point for local authority decisions on adult social care spending over the next three years.’

This briefing is the first in a series from the Audit Commission, looking at value for money in social care.

Notes to editors

1. The Audit Commission is a public corporation set up in 1983 to protect the public purse.
2. The Commission appoints auditors to councils, NHS bodies (excluding NHS Foundation trusts), police authorities and other local public services in England, and oversees their work. The auditors we appoint are either Audit Commission employees (our in-house Audit Practice) or one of the private audit firms. Our Audit Practice also audits NHS foundation trusts under separate arrangements.
3. We also help public bodies manage the financial challenges they face by providing authoritative, unbiased, evidence-based analysis and advice.
4. The government has announced plans to disband the Audit Commission and put in place new arrangements for auditing England's local public bodies. It is consulting on proposals for the new regime. It is also considering with us the options for transferring the in-house work to the private sector, including the in-house audit practice becoming an employee-owned company.

For further information please contact:

Louise Neilan, Media Relations Manager
Tel: 020 7166 2132
Mob: 07766 697 801
Email : l-neilan@audit-commission.gov.uk