Cash-strapped councils told to meet ‘undeliverable’ bed-blocking targets or have social care funding slashed

Councils ordered to reduce number of delayed transfers by up to 70 per cent before winter months or face losing social care funds next year

The Government has ordered councils to reduce the number of people remaining in hospital when they are fit to be discharged by as much as 70 per cent before winter, or see social care funding withdrawn from them in the Spring Budget next year (Getty)

English councils have been threatened with cuts to social care funding if they fail to meet “virtually undeliverable” targets to reduce bed-blocking.

The Government has ordered councils to reduce the number of people remaining in hospital when they are fit to be discharged by as much as 70 per cent before winter, or see social care funding withdrawn from them in the Spring Budget next year.

In a letter seen by The Independent delivered to all councils responsible for delivering social care, the Department of Health warns that NHS England will hold them “to account” for their role in delivering targets before the winter, and “take action” if they fail to meet them.

Council leaders warned that the threats from central Government leave them facing a “double whammy” of underfunding and prospective cuts to funds, which they said would see the elderly, vulnerable, and disabled suffer most.

Barbara Keeley, Labour’s Shadow Minister for Social Care, accused to Government of mounting an “overly simplistic and ill-judged” response to bed-blocking, and warned that the threats to councils were only likely to make current challenges in social care worse.

The rise in transfers of care – also known as bed-blocking – saw patients in England experience some 177,000 days worth of delays in April this year alone. A total of 55 per cent of these were down to issues in the NHS internally, while 38 per cent were attributable to social care, according to NHS England.

Analysis by the County Councils Network (CCN), which represents county councils in England, revealed that rural councils, all mostly Conservative controlled and representing more than 26 million people, were given the hardest targets, averaging at 43 per cent – double the target of London. Herefordshire County Council has a target of a 69 per cent reduction, while Suffolk has a target of 67 per cent, the analysis shows.

The CCN has written to Jeremy Hunt to urge the Department of Health to urgently reconsider the proposals, that county council leaders have called “undeliverable” and “arbitrary” tasks.

The letter from the Department of Health stated that through the Better Care Fund, Clinical Commissioning Groups were “agreeing targets for reducing delays” and that NHS England would “hold them to account for their role in delivering these,” adding: “NHS England will performance manage Clinical Commissioning Groups against the Better Care Fund metrics and take action where they do not meet them.”

It continued: “In November we will take stock of progress to date and will consider a review of 2018/19 allocations of the social care funding provided at Spring Budget 2017 for areas that remain poorly performing at the end of November.”

Council leaders are viewing this as a threat to their social care budgets next year. A spokesperson for the Department of Health confirmed that a review of 2018/19 allocations of the social care funding provided in the Spring Budget 2017 for areas that are “poorly performing” would take place, but urged that the funding would “remain with local government, to be used for adult social care”.

Councillor Colin Noble, CCN health and social care spokesman and leader of Suffolk County Council, said the targets were a “backwards step” in the Government’s attempt to ease pressures on social care, urging that county councils were being asked to meet “virtually undeliverable and arbitrary” targets.

“These targets are a backwards step. It is perverse that this money – designed to ease pressures – could be taken away if we cannot hit virtually undeliverable and arbitrary targets within a very short time period,” said Noble.

“Counties are the lowest funded councils for social care – they need a sustainable solution, not this double whammy of underfunding and the prospect of funds being withdrawn.

“We are confident we can put together a compelling care for an urgent rethink on this by the Government. If not, the elderly, vulnerable, and disabled people this money was supposed to support will be the ones who suffer.”

Chairman of the Local Government Association’s Community Wellbeing Board, Councillor Izzi Seccombe, said the targets were “counter-productive” and “ignored local need”, urging that councils are doing all they can to get people out of hospital and back into the community quickly and safely.

“The sudden and last-minute setting of unrealistic and unachievable targets for councils to reduce delayed transfers of care by Government is unlikely to be effective in relieving pressure on the NHS,” Councillor Seccombe added.

“The threat of reviewing councils’ funding allocations for social care if these are not met is unacceptable to local government because it takes resources from where they are most needed.

“This is why councils need to be given the freedom and flexibility to spend the additional funding for social care in the places where they feel it will be most effective. Targets on delayed transfers are hampering this approach.”

Responding to the concerns, Shadow Minister for Social Care Ms Keeley accused the Tories of mounting an “overly simplistic and ill-judged” response to the problem, saying: “Threatening councils with reductions in funding if they miss arbitrary targets for reducing delayed transfers is likely to make the crisis in social care worse.

“The rising number of people stuck in hospital and unable to get home is symptomatic of the mounting crisis in social care more generally. Tory Ministers are now pitting councils and the NHS against each other, just when we need them to be working together.

“The problem of delayed discharges will only be solved if the Government tackles the bigger problem of the mounting funding crisis in social care.”

It comes amid concerns of an impending crisis in the care sector, as residential homes struggle to cope with steadily rising costs and cuts to funding while being faced with a rapdily ageing population that is projected to see the number of elderly people requiring a place almost double within the next 20 years.

One in six care homes in the UK are showing signs they are at risk of failure, with the percentage of nursing homes displaying the hallmarks of financial distress having increased by about 5 per cent compared with the previous year as businesses in the sector are pushed “back to the brink”, according to a report by accountancy firm Moore Stephens last week.

A report by charity Age UK last month meanwhile revealed that thousands of care home residents were being wrongly charged fees of up to £100 a week, as one in four pensioners who are entitled to free care were being told to contribute towards their care costs to subsidise gaps in care home funding from councils.

Responding to the Government’s letter to councils, Caroline Abrahams, charity director at Age UK said: “We are all for any Government-backed initiative aimed at spreading good practice in managing the discharge of older people from hospital.

“But fining local authorities that are not performing well would be a ‘double whammy’ for older people in these areas as it would weaken local services still further, so it is not something Age UK would support.”

When contacted for comment, the Department of Health spokesperson reiterated that the Government had provided an additional £2bn to councils over the next three years for social care, and that £1bn of this would be provided in 2017-18 “so that councils could start to fund more care packages immediately and ease pressures on the NHS”.