Tuesday 21 November 2017
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Personal social care budgets may be incompatible with cuts, PAC warns

Personal budgets for social care may result in worse outcomes for recipients as local authorities’ drive for savings is prioritised over good results for users, the Public Accounts Committee has warned.

In a report issued today, the committee said it had not been assured that councils could fully personalise care while seeking to save money.

Personal budgets are funds allocated by local authorities to individuals, who then use the money to meet their social care needs. The budget is either managed by the authority, a third party or is given as a direct payment to users themselves.

The aim is to give service users more choice and control over the services they receive and to tailor their care to personal circumstances and desired outcomes.

However, the PAC said it was concerned this was not happening and that local authorities do not provide the necessary support to help people get the most out of their budget.

The MPs highlighted that some groups, such as elderly people and those with learning disabilities, are less able to experiment with new and potentially risky approaches to care without this support.

PAC chair Meg Hillier said: “The need for adult social care is increasing but in recent years the amount spent on such care by English local authorities has fallen in real terms.

“Against this backdrop there are clearly risks in pursuing new approaches to providing care. Personal budgets have great potential but the interests of users are paramount and must be protected.

“It is vital people receiving care do so through the form of personal budget that best suits their circumstances. They should also be supported to make best use of it.”

The committee also added its voice to local authorities’ concerns that funding cuts and wage pressures will make it harder to fulfil obligations under the Care Act.

They dubbed the government’s response – to raise additional funds through giving councils the option to levy up to 2% higher council tax and allocate extra money to the Better Care Fund – “complacent”, because it is contingent on the area’s existing tax base.

Even with the additional funding, the Nuffield Trust, the Health Foundation and the King’s Fund all estimate there is likely to be a funding gap of £2-2.7bn by 2019/20. The Local Government Association puts this even higher, at £4.3bn.

Hillier pointed out providers are struggling to recruit and retain staff with the necessary qualifications due to financial pressures.

The committee also said that more evidence is needed to clarify how local authorities can maximise benefits of personal budgets to users and that the Department of Health needs to establish robust regimes to monitor their effectiveness, especially before they are rolled out in the health sector.

“The department and its partners must show they are learning from available evidence and data so that care users can be confident of getting best value from the resources available,” said Hillier.