1. Essex County Council: Potential impact of the Care Act on demand for assessments/reviews and on eligibility for services

2. CARE ACT PROGRAMME ECC Governance Structure Steering Board (comprising Corporate Management Board & Partners) Integrated Health and Social Care Providers, Partnerships and Commissioning Consultation / Communications IT Systems - Case Management Corporate and Operational Policy and Guidance Information, Advice, Guidance & Advocacy Workforce / Change Management Core Work Streams Existing People Commissioning Workstream Finance Programme Board User Reference group Practitioner Reference group

3. Care Act ECC High Level Roadmap 3

4. ECC Care Act governance programme established Work to look at potential additional demand undertaken within the Finance workstream Will inform projections of capacity required; but we may be able to influence/mitigate this Potential cost ranges established Figures will be refined as more information is released Background of work undertaken

5. Limitations/ Caveats of modelling work No precedent Can’t predict people’s behaviour with certainty - will be influenced by publicity and other external factors Estimated demand in year one, peak may take longer to materialise Demography data projects on a simple, linear basis Estimates will be kept under review and updated as and when new details and regulations emerge 5

6. Background on the Essex population Higher than average % of people aged 65+ Approx. same % estimated to have a care need as national average BUT Essex is comparatively well off ….therefore likely to be higher than average numbers of self-funders who will request an assessment in future So taking a simple % of the national population share may be misleading 6

7. 7 Older People with Care Needs in Essex Bullet here

8. Summary of cost impacts considered 8 Impact Modelled Low Estimate of volume (a) High Estimate of volume (b) Recommended Estimate of additional volume in Year One (c) Estimated cost using DH assumptions of volume and price £m ECC Low Cost £m ECC High Cost £m (1) Revised Eligibility Criteria for people currently deemed ineligible - new packages n/a 0.8 0.9 (2) Revised Eligibility Criteria for existing Service Users - impact of increased packages n/a 13.0 14.1 (3) Additional Service User Assessments 4,750 to 6,00018,50012,000 1.9 to 3.0 5.4 7.2 (4) Additional Service User Reviews 8,94722,50013,780 2.3 to 3.5 2.8 5.9 (5) Additional Carer Assessments 2,5009,7506,150 0.6 1.9 (6) Demand for carers services 2,0005,000 2.7 to 3.4 5.0 11.2 Total Cost 18,197 to 19,447 55,75035,9307.5 to 10.517.6 41.2

9. 9 (3) Additional demand for assessments (excluding Carers) Source DataVolume estimate Unit cost estimate £ Total Cost Estimate £m Assumptions/Caveats DH Impact Assessment 4,750 to 6,000 400-5001.9 to 3.0 DH volume calculated using PSSRU aggregate model. ECC have approx 2.6% share of national total ECC recommended volume based on estimated self funder pop. in Essex Low unit cost based on DH analysis of LA costs High unit cost based average ECC cost of a “moderate” assessment ECC volume/ low cost estimate 12,0004505.4 Difference to DH6000 to 7,250 +/- 502.4 to 3.5 ECC volume/ high cost estimate 12,0005997.2 Difference to DH6000 to 7,250 99 to 1994.2 to 5.3 TOTAL COST5.4 to 7.2

10. Potential rise in assessment volumes over time 10 Significant increase in 2015-16 to reflect latent demand from care users already in the system, then drops off slightly before rising gradually over time – but overall volumes will increase

11. 11 (4) Additional demand for reviews Source DataVolume estimate Unit cost estimate £ Total Cost Estimate £m Assumptions/Caveats DH Impact Assessment 11,440 to 13,780 200 to 2502.3 to 3.5 DH national total calculated based on PSSRU aggregate model ECC share based on avg 2.6% share of DH total Low unit cost based on DH analysis of LA costs High unit cost based on average ECC cost of a review ECC volume/cost estimate (low)* 13,7802002.8 Difference0 to 2,340(50) to 0(0.7) to 0.5 ECC volume/cost estimate (high)* 13,7804285.9 Difference0 to 2,340178 to 2282.4 to 3.6 TOTAL COST2.8 to 5.9

12. 12 (5) Additional demand for Carer’s assessments Source DataVolume estimate Unit cost estimate £ Total Cost Estimate £m Assumptions/Caveats DH Impact Assessment 6,1501000.6 DH assumes 39% of service user assessments will also require a Carer Assessment; ECC have applied same % given the lack of a robust alternative methodology Low unit cost is based on DH/Surrey CC costings High unit cost is based on average ECC cost of a “simple” assessment ECC volume/cost estimate (low)* 6,1501000.6 Difference to DH000 ECC volume/cost estimate (high)* 6,1503121.9 Difference to DH02121.3 TOTAL COST0.6 to 1.9

13. 13 (6) Additional demand for Carers services Source DataVolume estimate Unit cost estimate £ Total Cost Estimate £m Assumptions/Caveats DH Impact Assessment 2,730 to 3,380 1,0002.7 to 3.4 DH assumes assessments resulting in service offered stays same as current % ECC assumes 80% of those carers assessed are offered a service based on same upper % conversion rate as service users Low cost based on avg. package cost of £1,000 (as per DH). High cost based on 3.5 hrs of dom care p.w. ECC volume/cost estimate (low)* 5,0001,0005.0 Difference to DH1,620 to 2,270 01.6 to 2.3 ECC volume/cost estimate (high)* 5,0002,23311.2 Difference to DH1,620 to 2,270 1,2337.8 to 8.5 TOTAL COST5.0 to 11.2

14. Questions? 14