What's on managers' minds this week

An adult social services director was at a meeting with a group of GPs a few weeks ago. None of the GPs was in a position to put their hand up to confirm they were earning less than£150,000 a year.

It is no surprise, then, that money, at a number of levels, is at the front of social care directors' minds.

'I find it inconceivable that the government isn't going to face up to appropriate funding of social care,' says one optimistic director post-Wanless. 'It has poured money into health ? too much, too quickly and poorly managed.'

Describing the situation in health as 'a bloody disaster', he is none too complimentary about the knock-on effect for social care.

'Health is under such pressure to get on budget, so there's closure of a lot of beds and people who would have been in those beds are more likely to need social care.'

In spite of the 'cost shunt' from health, the real trouble is that there is not more money in social care to deal with this, but less. And this means that, in spite of an emphasis on keeping people out of hospital, there is insufficient funding to meet that objective.

'We are totally overcommitted this year in terms of care packages and the impact of that is we are going to have to start cutting back again,' says another director. 'It's preventative and lower-level work that goes because there are so many people with large care packages.'

One region that overspent last year is moving to providing critical care only.

'It's a tough old world in social care,' says another director. 'Staff have to say no a great deal.'

But it is not just social care staff who are saying no. One director says measures are needed to prevent healthcare organisations from reneging on joint planning, budgeting and funding.

'The big issue is getting through this short-term extreme concern about the deficits to restabilise all the relationships between health and social care,' says another.

She stresses the importance of social care in trying to help 'stabilise footing' as quickly as possible so that health and social care can get on with the joint agenda.

'It's non-negotiable,' she says. 'It will happen because that's what good managers do.'