The NHS’s failure to sufficiently fund the care costs of people with learning disabilities who are being transferred from long term health service placements has resulted in major overspends for many councils.
HSJ’s sister title Local Government Chronicle has learned there is a significant variation in the development of regional partnerships between councils and clinical commissioning groups to transform care in the aftermath of the Winterbourne View abuse scandal.
The number of people in long term units has remained broadly unchanged over the past year and still stands at 2,600.
The government pledged in 2015 to move people into community settings in the wake of the Winterbourne View revelations. Six carers were jailed after being filmed in 2011 abusing patients on NHS funded placements at the private hospital.
Last year, a funding package worth £75m over three years was promised to support the process. However, councils have said they have not received any extra funding.
Historically the long term care of people with complex needs in units was covered by a “dowry” provided by NHS specialised commissioners. Councils have said there is a lack of clarity over what the long term financial arrangements as people are moved into the community.
LGC reports that councils in Yorkshire are among the worst affected. Some of the region’s local authorities have reported projected overspends in adult social care budgets this year, due in part to the cost of supporting people with learning disabilities.
Sheffield city council in June forecast a £7m overspend in 2016-17, with £2.8m attributed to demand pressures on care and support for people with learning disabilities.
A further £500,000 was said to have arisen from clinical commissioning group “activity” in the learning disability service, “as the profile of demand has shifted to costs funded by the council and not the NHS”.
Sheffield adult services director Phil Holmes said the city council was exploring the possibility of pooling budgets with Sheffield Clinical Commissioning Group, but added: “Nationally we are awaiting clarity on the financial arrangements for transforming care.”
Barnsley metropolitan borough council has a projected overspend of £7.7m this year, including £1.2m due to an increase in the number of people with learning disabilities supported in the community.
Kirklees metropolitan council said a projected overspend of £9.7m in adult services included £4m as a result of individuals being moved out of NHS institutions.
In the south west, Somerset county council has projected a £22.6m overspend in 2016-17 largely due to “increased costs in care packages” for adults and children in social care, as well as those in receipt of learning disabilities services.
The Transforming Care programme’s national implementation plan, published in September 2015 by NHS England, the Local Government Association and the Association of Directors of Adult Social Services, said 30-50 per cent of inpatient beds for people with learning disabilities were likely to close by 2019.
NHS figures at the time showed there were 2,595 people with learning disabilities receiving inpatient care, three quarters of which had been admitted more than 12 months previously.
Figures released last month showed between 2,550 and 2,600 people still received such care.
Adass’ resources lead Simon Williams told LGC councils were committed to the Transforming Care agenda but added progress on forming plans had been “patchy” across the country.
He said there was “some anxiety” among councils about how new responsibilities would be funded in the absence of clarity from the government or NHS England.
Mr Williams, who is also Merton London borough council’s director of community and housing, said: “There is no national agreement that says the money will follow the patient as they close these facilities down.
“Local discussions are being driven by whether individuals meet the NHS criteria for continuing healthcare as there is no funding coming out of the centre.”
Nottinghamshire county council director of adult social care and health David Pearson said the partnership in his area had transferred 38 individuals at a cost to the council of £2m.
“We have another 40 to go and we don’t know how much that will cost, but it is likely to be more because some of the people still in hospital have the greatest need,” he said.
NHS England was approachef for comment.