Better performance on delayed transfers of care attributable to social care during a spike in emergency hospital admissions in January has put local government in a strong position to challenge Simon Stevens over the role of councils in the health system, the chair of the Local Government Association has said.
The latest figures show system-wide performance on delayed transfers deteriorated by 1.4 per cent between December and January, at a time when the number of emergency admissions increased by 5,731.
However, analysis by Impower and Local Government Chronicle shows while delays attributable to the NHS increased by 4.7 per cent over this period, delays due to social care fell by 2.7 per cent.
LGA chair Lord Porter said the numbers provided a “stark realisation” for the government that social care and the “national unwell service” are “better affected” by councils.
Speaking following a speech by social care minister Caroline Dinenage last week at an LGA conference, Lord Porter referred to the delayed transfer targets imposed by the government on councils in July 2017, which included a threat of potentially losing control of funding.
He said: “The money we’ve been spending has delivered considerably more benefit and more bed space than spending money on the health service, so I think we are in the strongest position that I can recall being in.”
Speaking at the conference, Lord Porter added: “If there’s nothing else you do today, go back and thank your teams for all they have done because they have given us as an organisation the ability to start standing up to [Mr Stevens].
“I think Jeremy [Hunt] gets it about working together rather than Simon Stevens’ parochial bit about tanks on lawns.”
Speaking at the conference last year, soon after the targets had been imposed, Mr Stevens provoked anger when he said “laissez faire had not worked”.
The Impower analysis reveals 115 of 151 councils have improved their performance on social care attributable delays since February 2017, which was the baseline used by the government for targets set last July as part of the better care fund planning guidance.
After the target was set, the Department of Health and the Department of Communities and Local Government wrote to councils in December to say DTOCs performance would be judged on criteria including:
- whether councils hit their targets in September 2017;
- whether performance had improved since the corresponding month in the previous year;
- whether performance had improved since February last year; and
- whether the council is in the bottom quartile for delayed transfer rates per 100,000 of the population.
The letter also said areas would be judged on whether performance was below the government’s national target for delayed bed days attributable to social care at a rate of 2.6, which forms part of a target for reducing overall delayed transfer rates across the country, including those attributable to the NHS, to 9.4.
The analysis shows a total of 10 councils failed to meet any of these criteria, compared to 15 in the previous month.
Of the 10, six councils are part a health and social care system operating above the government’s national target rate for delayed transfers of 9.6 and therefore considered at the most risk of some form of intervention.
The six councils are:
- Warrington; and
- City of York.
City of York’s corporate director for health, housing and adult social care, Martin Farran, said delayed transfer figures fluctuate with performance deteriorating since October.
He added: “However, we put in additional support services and this has resulted in a significant improvement.
“Equally, the performance when viewed across the last 12 months demonstrates an improvement and positive trend overall.”
A Bristol spokesman said work was being done to improve the council’s offer to providers.
During her speech, Ms Dinenage said health and social care cannot be considered separate as they are “umbilically linked”.
She said “failings” in social care are driving people into hospital as well as preventing them from leaving. She said funding is “very much a live debate” within government.