Charteris

This is the first of two articles.

This first one challenges a well-worn assumption that the current level of expenditure on adult social care (ASC) is ‘a given’ and is thereby used as the basis for future forecasting.

We now have developed a very robust business case which promises to make savings well beyond traditional expectations. It now has credibility in the marketplace and with local authorities who are compelled through cuts in mainstream ASC funding to find further savings.

Savings on current expenditure

I’m using approximate figures here – from the Department of Health (DH) and my own estimates. In England, the 150+ councils with responsibility for adult social services (CASSRs) each spend annually £100 million on average. The total spend is therefore about £15 billion. There is another smaller slug of expenditure commissioned by the NHS for people with primary continuing health care (CHC) needs. In our work, I’ve directly tackled 10% of that spend which goes on ‘domiciliary care’ services as well as ‘supporting people’. This therefore is worth conservatively £1.5 billion. Our clients are now realising for themselves some of these hard savings promised in the business case, and what is also attracting industry attention is that we’ve got a comprehensive specification for a new service which gives better outcomes to social care customers and we’ve found a way to commission it which will drive out 25% savings. At the macro level that suggests there is £375 million worth of sustainable savings ‘out there’. That is the prize.

Who can help councils win these savings?

In the self-evident views of the Miinster of State and the Local Government Association (LGA), it will require outside help from consultancies.  In fact Paul Burstow has announced that his initial £300,000 fund for this has been expanded to £1,000,000.  John Bolton’s view is that Charteris are a leading consultancy in this area and are probably unique in really making possible the delivery of savings whilst also delivering better outcomes for social care customers and Wiltshire are the first council to put this into practice. At our suggestion he is now reviewing and writing up this Wiltshire case for a DH paper. So, in summary, we have a proven proposition capable of making savings of £375 million for the country which is building traction and of course is getting advocated by one of the biggest influencers in the industry.

How can consultancies help?

Last month the DH and the LGA  asked Professor John Bolton to lead their latest Adult Social Care Efficiency Programme (ASCEP) which is allocating  the £1 million (50 x £20K) to be spent on outside consultancy. He has explicitly said that though there is no more funding to come and each LA has, in a memorandum of understanding, signed up to 2 years work which will be evaluated twice during that time by him.

The duty of any consultancy is to make our first deliveries so compelling that our client LAs will continue to fund the rest of their efficiency programmes. Our double proposition of  ‘Hidden Value’ and ‘Supporting People Better for Less’ can do just this by finding immediately available savings which can then be used to fund the bigger programme of transformation and savings. The two main propositions are entirely complementary.

In addition the lessons learned thus far show that our propositions can be equally applied to other parts of the £15 billion market – particularly the larger institutional care market – which has proved extremely difficult thus far for LAs to make inroads into savings.

If this seems to make sense to you please look out for the next post which considers how Dilnot’s ideas on bridging the funding gap can be made much more sustainable and also cost less.