Care packages for 20,000 older people could be funded if councils spent less on assessments and reviews, states report

Annual home care packages for nearly 20,000 older people could be funded if councils reduced their expenditure on social care assessments and reviews to that of the most efficient councils. This would enable over £300 million to be spent on the direct care for older people the Audit Commission has revealed today in a new report.

The number and cost of assessments and reviews have increased significantly in recent years, partly due to changes in policy including the move towards personalisation of care, but this does not explain the differences in unit cost across councils, the report finds.

The Commission found that the cheapest councils spend about half the amount of the most expensive councils on each assessment and review, while undertaking a similar volume of work and reaching the same quality standards. The Audit Commission’s report, ‘Reducing the cost of assessments and reviews’, states that many councils will be able to make significant savings by identifying and eliminating the causes of cost variation.

The report sets out a number of ways in which councils can reduce the costs of assessment and review, including:

• Redesigning the 'care pathway' from a client's first contact with the council through to possible provision of care;

• Reducing overheads by streamlining administrative support; • Matching staffing more closely to workload;

• Reviewing the grade mix of staff carrying out assessments and reviews; and

• Collaborating with other councils to share costs.

Andy McKeon, The Commission’s managing director, said: “Assessments and reviews are a crucial element of social care, enabling individuals' needs to be properly identified and met. However, our evidence suggests that councils can spend less and still do an excellent job in helping people receive the care that they need.

“As councils struggle to meet the needs of a growing older population with less cash, any opportunity to save money and redirect it into care should be pursued enthusiastically.”

The Association of Directors of Adult Social Services (ADASS) represents directors of adult social services in local authorities in England and says it gives a “cautious welcome” to the report.

ADASS vice-president, Sandie Keene cautioned against accepting uncritically the large amounts of savings the report says are possible. She said: “We need to welcome the continued focus on making assessment procedures as efficient as possible. But we cannot assume that the sorts of savings mentioned in the report are easily attained.

“Different local authorities vary enormously in the way they describe some of their functions when making their Referrals, Assessment and Packages of Care (RAP) returns to the DH – the data on which the Commission has based its research.

“This report gives very helpful benchmarking information which we should be encouraging all councils to consider in their planning for budget reductions over the coming year. It gives further opportunity for each authority to ask itself questions about the possibility of doing the assessment and care management functions differently while transforming services to ensure a more personalised approach.

“So, we welcome the report and the help it can give us in making the decisions that face us. But we cannot accept that it either could, or will, lead to the magnitude of savings that the Commission has suggested.”

Ms Keene explained that DASSs are now working on the next level of transaction efficiencies achievable by working more closely with health; developing single points of access and reducing duplication in care planning as well as examining the workforce skill mix on a wider scale.

She also pointed to the potential benefits arising from appropriate integration of health and social care management systems, saying: “Paying attention to skills-mix issues is crucial and essential in making sure our users get the right assessment by the right people in the right circumstances.” However she did not agree that pay rates should be re-examined in this context, “simply for the purpose of making savings.”

The Association, through its workforce and resources networks, will continue to consider ways this and other benchmarking reports can best benefit local authorities and adult social services departments. To read the Audit Commission report, ‘Reducing the cost of assessments and reviews’, visit: www.auditcommission.gov.uk/nationalstudies/localgov/Pages/assessmentsandreviews.aspx