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Underfunded home care raising pressure on NHS

Experts calculate UK has £513m deficit for 2016-17

Adrian O'Dowd

Tuesday, 25 October 2016

Avoidable pressure is growing on the NHS and GP services because of falling funding of homecare services for older and disabled people from local authorities, according to a report* published today.

The United Kingdom Homecare Association (UKHCA)’s report estimates that around 90% of councils in the UK are not paying what it considers to be realistic prices for services that support older and disabled people in their own homes.

Collectively, there is a £513 million funding gap in state-funded homecare for 2016-17, said the UKHCA, which warned of the impact this was having on the more than half a million people who needed such help and knock-on effects for the NHS and community health services.

Although there is no national collection of data about the volume of privately purchased homecare in the UK, the UKHCA estimates that state-funded care accounts for around 80% of all homecare purchased, usually by local council social services departments, CCGs, or health and social care trusts in Northern Ireland.

For its report, the association analysed responses to its Freedom of Information Act enquiries sent to 208 local councils in Great Britain and the health and social care trusts in Northern Ireland.

It found that the total £513 million deficit for 2016-17 was distributed across the four UK nations as a deficit of £360 million in England; £72 million in Scotland, £58 million in Northern Ireland; and £23 million in Wales.

The association said that a fair minimum price for homecare of £16.70 per hour was being undercut by around £2 by most of the four countries’ local authorities.

In England, for example, the average price paid for older people’s homecare was £14.66 per hour and only £12.35 in Northern Ireland.  

This was happening despite the increasing recognition, said the UKHCA, that home-based care should be the solution to meeting people's care needs at home, rather than being treated in hospital.

People who relied on homecare services and those who supported them were being “short-changed” by councils, resulting in avoidable but growing pressures on hospitals and community-based health services.

Costs for homecare providers would continue to rise, warned the association, as the new statutory National Living Wage increased from its current £7.20 per hour to around £9.00 by 2018-19.

UKHCA's policy director Colin Angel, said: “We know that an ageing population is increasing demand for homecare services. Councils which decide to pay inadequate rates for homecare are taking major risks with people's wellbeing and the jobs of local people who provide care.

“We have already seen evidence of homecare providers leaving the state-funded care market, or closing their doors for good because they cannot afford to remain in business.”

The association called on the government and devolved administrations to make adequate funding available to councils and health and social care trusts in Northern Ireland to help the industry and to ease the pressures on an “over-stretched” NHS.

Izzi Seccombe, chairman of the Local Government Association’s community wellbeing board, said: “Councils, care providers, charities and the NHS are all united around the need for central government to fully fund adult social care. This is essential if we are to move away from just trying to keep people alive to ensuring they can live independent, fulfilling lives, as well as alleviating the pressure on the NHS.”

* The Homecare Deficit 2016. A report on the funding of older people’s homecare across the United Kingdom. United Kingdom Homecare Association, October 2016

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