Less than a quarter of local authority chief executives and social care directors regard their relationship with the NHS as good with data sharing being a particular problem, according to a survey by The MJ and BT.
The relationship with the NHS is key to both the health and care sectors. Yet asked how important closer working is with the NHS on a scale of one to five (with five being the most important) 43% of the respondents gave a score of five and 30% four, a pretty clear 73% between them.
The poll of council chief executives and social care directors however did not reveal any great enthusiasm for this working relationship. Only 22% regard their joint working with the NHS as good, 10% see it as poor while an overwhelming majority (68%) regard it as just ‘satisfactory’. One particular weakness is over data sharing with the NHS over social care with 19% regarding this sharing as poor, none as good and 80% as an underwhelming ‘satisfactory.’
The percentage of council budgets allocated to social care is substantial with a third of respondents spending over half their income on social care of whom 10% say their allocation is over 60%. Nearly a quarter of respondents (22.6%) are spending between 50%-60% of their council budget on social care, just over a third (35.5%) are spending between 40-50% while another third (32%) are spending 40%. The rest of the respondents (10%) are devoting over 60% of their budget on care.
It has already been well flagged up that there will be extra funding for social care coming down the line on top of the extra cash injection and council tax precept already announced. This helps to explain why the consensus from the survey is that the percentage of respondents’ budget on care is unlikely to change with 52% expecting little movement over the next three years while just over a quarter (26%) anticipate the costs increasing and 22%, unusually, expect them to reduce. The increase in some councils is partly a result of a reduction in the overall budget meaning adult care becomes a larger share although in some cases care could also be cut.
Of the 26% expecting their share of the council budget devoted to social care to increase, a third estimate the rise at 20% and above while half estimate a more modest 5%. Respondents were asked where this extra money would come from. The consensus was from higher council tax, savings elsewhere and income generation as well as closer integration with health though one answer was ‘we will very much struggle to fund.’ A typical answer was: ‘The only feasible way to fund the increased demand is to generate income from other parts of the council and by integrating health and social care as a system across the NHS, CCGs and all partners.’
Respondents were also asked to prioritise a list of areas which they felt could best deliver savings. Unsurprisingly promoting independence and wellbeing through the use of digital services and technology was a top priority by reducing the cost of hospital stays and supporting earlier intervention.
Next areas with the potential for savings were enabling users to interact with care services through digital channels and integrating commissioning through improved use of information. Enabling care professionals to work remotely was also cited along with more integration of services.
A key question is what technologies and innovation the respondents believe will best drive further savings. A clear majority cited sharing data with partners as a prime way of reducing costs. Other priorities named in the survey were automating processes, predictive analytics, business intelligence, the cloud, channel shift and remote working.
The survey drilled down to find out how respondents prioritised the above areas on a scale of one to five with five being the highest priority. These percentages give an idea of how important they regard the technology in helping them cut costs. On sharing data with partners 50% gave a four and 33% a five, a combined 83%, showing respondents regard this as a vital means of making further savings.
When it came to the question on automating processes, 45% gave it a score of four and another 26% a resounding five. On the respondents’ other priority, predictive analytics, which means being smarter about using data to predict demand, 22% gave a five, 38% gave a four and 35% a three, again an overall high score. For business intelligence, 26% gave a five, 35% a four (making a high 61% when both are added together), and 26% a three while on the cloud almost half gave a four score and 35% a three. Mobile and remote working are also clearly a priority with almost 60% regarding it as very important or critical. Channel shift, or offering different channels through which citizens can contact councils, is well established which explains the opportunity for more savings is less; 42% gave it a three, with 35% giving a four and 19% a five.
Respondents were asked to name other technologies that can help deliver savings and these included broadband and mobile coverage, digital inclusion and skills, Internet of Things, assistive technology for self-funders to promote independence, robotics and artificial intelligence.