Implications of the Green Paper Jeni Bremner Programme Director

Context Demographics –1.6m people use social care –7bn spent on older peoples services –30% no contact with the authority Health Act 1999/Care Trusts Children Act Changes to Local Authority Structures Perception of local government

Funding Ring fencing of schools budgets £637m 05/06 only against estimated £1bn unfunded pressure £100m 05/06 social care Ongoing overspend on PSS Gershon Need for investment in workforce and IT Wanless Review only of older peoples services

PSS Survey – Interim Headlines 61% of authorities overspent 76% on children and families 38% on older people [although ? 27m underspend on older people FSS] Continuing Care 57% on physical and sensory disability 60% on learning disability – supporting people 43% on mental health

PSS Interim Headlines cont’d Fee increases for residential placements 5% Home care increase 5% 15% authorities increasing eligibility criteria Costs of implementing changes to children’s services

Performance 68% councils either 2 or 3 star - but 27% still only 1 star and 8 councils with no stars Only 23 councils with improved performance in adult services in 2004 Average of 143 clients receiving direct payments per authority – total 17,500! Numbers of older people helped to live at home not risen since 2001 – prevention no longer included

Personalised budgets/ Direct payments Expansion of direct payments into personalised budgets Local Gov slow to embrace this agenda Can people use direct payments to buy LA services? Workforce: care navigators/brokers Efficiency – individualised budgets vs block purchase.

Delivery Support for local authorities to be given the lead role in establishing partnerships to achieve change Possible extension of voluntary sector role – charities commission ruling that charities can provide statutory services. Substantial IT investment and workforce development needed Resources

Performance management/risk Person centred approaches will need new ways of measuring effectiveness of services – should the LGA lead this work? Will need new outcome measures Will need new approaches to risk around personalised budgets and individualised service delivery

All to play for? Scope of direct payments – NHS services Extra Care Housing Choice Vision has to be affordable

Progress to date Publication of Our Future in Our Hands Interagency Group – established, joint principles to be published? Direct payments – step change needed Resources – Wanless review

Implications for LGA Major area of risk for local government Performance issues Cultural change needs to be accelerated Major financial threat Substantial Workforce Issues Needs prioritising for resources?

Taking the Agenda forward Agree lobbying positions on key issues Seize the agenda Commission research [funding] Lead major campaign on independence and well being Support a broad focus for green paper Build coalitions Lead performance assessment for new agenda.