Positively Together The current landscape in social care – a new future Denise Platt Chair NAT
Coalition agreement • “We share a conviction that the days of big government are over; that centralisation and top-down control have proved a failure. • We believe that the time has come to disperse power more widely in Britain … it is our ambition to distribute power and opportunity to people rather than hoarding authority within government. That way, we can build the free, fair and responsible society we want to see”.
David Cameron – February 2011 ‘The idea at the heart of this – the Big Society – is about rebuilding responsibility and giving people more control over their lives. But that doesn't just apply in areas like volunteering. It's as relevant when it comes to public services and the decentralisation of power. Indeed, I would argue that our plans to devolve power from Whitehall, and to modernise public services, are more significant aspects of our Big Society agenda than the work we're doing to boost social action.’
Redistribution of power from central state to individuals and local communities implies • Removing central requirements, lesscentral guidance & prescription • Public involvement not centrally required strategies • Public bodies becoming more accountable to public • Increasing role of voluntary organisations and social enterprises • Enabling public to hold local bodies to account - transparency & data
What decentralisation is the Coalition planning? • The Coalition’s programme for government sets out plans to decentralise to all levels: Individuals Local communities / neighbourhoods / civic society Front line professionals (such as police officers, nurses and teachers) Local institutions (such as schools and hospitals) Local government ...distribute power and opportunity to people... ...extend the roll-out of personal budgets in social care... ...the state should help parents, community groups and others come together to set up new schools... ...communities coming together to make lives better... ...create new trusts that will make it simpler for communities to provide homes for local people... ...give neighbourhoods the ability to determine the shape of the places in which their inhabitants live.... ...give heads and teachers the powers they need to ensure discipline... ...strengthen the power of GPs... …enable GPs to commission care on behalf of patients… …reduce red tape for police officers… ...all schools have greater freedom over the curriculum... ...stop the centrally dictated closure of A&E and maternity wards.... … enable employees to set up co-ops and mutuals to take over and run public services … …introduce mayors with additional powers… …create directly elected police ‘commissioners’… …directly elected individuals on the boards of their local primary care trust… ...give councils a general power of competence.... ...phase out the ring-fencing of grants... ...return decision-making powers to local councils... ...promote a radical devolution of power and greater financial autonomy...
Plurality of providers ‘the best way to raise quality and value for money is to allow different providers to offer services in an open and accountable way’ ‘Our public services desperately need an injection of openness, creativity and innovation’ ‘...instead of having to justify why it makes sense to introduce competition in some public services – ....– the state will have to justify why it should ever operate a monopoly’ David Cameron February 2011 • Social Enterprise • Mutuals • Self help • Co-operatives • Voluntary organisations • Private sector
Social Care Vision • Freedom - personal budgets for all those eligible, choice from a range of services. • Fairness – ‘how do we pay for social care?’ and a new legal framework • Responsibility – communities and civil society free to run innovative local schemes and build local networks of support
Seven Principles • Prevention – ‘empowered people and strong communities’ working together to promote independence • Personalisation – individuals control their care • Plurality • Protection – however ‘risk is not an excuse to limit people’s freedom’ • Productivity • People – a skilled workforce (Personal Assistant Strategy to be published in 2011)
Adult Social Care Reform • Spring 2011 – Law Commission review of adult social care legislation published • Summer 2011 – Commission on the funding of Care and Support services is published • End 2011 – Care and Support White Paper • Spring 2012 – Social Care Reform Bill
Standard for people living with HIV ‘All people with HIV should have access to social care services which are responsive, culturally appropriate and tailored to individual need. All people with HIV requiring multi-agency support should receive integrated health and social care.’ MedFASH 2005
Social care needs • Families • Employment • Mental health • Ageing • Housing/Poverty • Signposting through social care system • Better clinical/social care linkages
What does the ASG pay for? • 91% of local councils used the ASG to provide counselling services for people living with HIV • 82% used the ASG to provide peer support • 71% used the ASG to train staff (however very little information is available on the content of this training) • 67% used the ASG to provide support for adult carers • 63% used the ASG to provide personal care
What does the ASG pay for? • 58% used the ASG to provide HIV specific social workers (this was more common in councils with grants over £200,000) • 52% used the ASG to provide services to children and young people • 47% used the ASG to provide respite care • 29% used the ASG to provide residential care • 29% used the ASG to provide support for young carers
ASG and voluntary sector organisations • 93% of voluntary sector organisations who responded to the questionnaire received ASG funding as part of their income. • 14% of local councils gave 100% of their ASG to local voluntary sector organisations – these were generally councils receiving smaller ASGs, less than £100,000. • Over a third of local councils used annual contracts to fund voluntary sector.
NAT’s campaign The funding for ‘HIV/AIDS Support’ will increase from a total of £25.5 million in 2010/11 to £36.2 million in 2014/15. The allocations for each year are available on NAT’s website from the social care webpage: http://www.nat.org.uk/Our-thinking/Every-day-issues/Social-care.aspx
The future We are all in this together .............?