Council overspend on social care highest in decade amid warning over NHS plan
The annual report from care leaders warned that due to the current state of the sector – which campaigners have long argued has not been prioritised or had adequate investment – the Government's aim to shift more care into the community could be undermined.
The Association of Directors of Adult Social Services (Adass) said the financial situation 'is as bad as it has been in recent history' with council overspend on adult social care budgets in the year to March hitting around £774 million.
This was up from £586 million in the previous year and is the highest level for at least a decade, Adass said.
Its survey – which had responses from 91% of directors of adult social services in England – also showed care leaders have reduced spending on prevention by 11% this year.
Just 5.6% of this year's total adult social care net budget is projected to be spent on prevention.
Adass said this lowest recorded spend is because overstretched budgets mean care leaders have had to prioritise immediate needs and people in crisis.
Earlier this month Prime Minister Sir Keir Starmer and Health and Social Care Secretary Wes Streeting unveiled their 10-year NHS plan which they vowed would 'fundamentally rewire' the health service and put care on people's doorsteps.
The plan set out how the NHS will move from treatment to prevention and from hospital to more care shifted into neighbourhoods and people's homes.
But Adass president Jess McGregor said: 'Without more investment to keep people well and independent at home, we risk undermining the shift towards prevention and neighbourhood health that Wes Streeting, the NHS and this Government are rightly championing.'
The overall overspend is 'likely to result in councils further tightening the eligibility criteria for social care, so they can deliver their legal obligations, leaving very little left for preventative measures that would likely save the state money in the longer term and most importantly, improve outcomes for people', Adass said.
Ms McGregor said: 'The maths simply doesn't add up – more people are coming to councils for help and their care is complex and costly, which means we don't have funds left to provide the early support and prevention that would stop people's health from deteriorating and help them avoid spiralling into crisis, where they frequently end up in hospital.'
The spending review published last month stated there would be an increase of more than £4 billion of funding available for adult social care in 2028-29, compared with 2025-26.
But Adass said there remains 'uncertainty' about what that figure covers, including whether it takes in the 'much-needed but costly fair pay agreement for care workers', which is yet to be set out by the Government.
Ms McGregor repeated a call for social care to be prioritised, saying: 'It's vital that adult social care leaders who are well versed in delivering support at the community level are meaningfully involved in decisions about where and how resources for neighbourhood health and care are spent.
'After all, acute hospitals are not best placed to deliver social care at the neighbourhood level – but councils are.'
The Local Government Association (LGA) said the survey results show 'councils are caught in the impossible position' of choosing between meeting people's complex care needs and supporting other's wellbeing to prevent needs escalating.
The LGA added: 'Local government is best placed to lead this shift and deliver neighbourhood-level care, but it cannot do so with one hand tied behind its back by underfunding.'
Mr Streeting has previously said social care 'has to be part' of neighbourhood health, adding: 'In the context of this plan, social care features because it has a role to play on admission avoidance and speeding up delayed discharges.'
The Casey Commission, launched earlier this year, aims to set out a plan to implement a national care service, but social care leaders have previously raised concerns over the potential timeline of 2036 for some recommended reforms to be introduced.
The first phase is expected to report in 2026, although recommendations from the initial probe will be implemented in phases over the course of 10 years.
The second phase of the commission, setting out longer-term reforms, is due to report by 2028.
A Department of Health and Social Care spokesperson said: 'We inherited a social care system in crisis but in our first year of government we have taken immediate action to improve this.
'The spending review will allow for increased funding for social care by £4 billion, we have legislated for the first ever fair pay agreement for care workers, and Baroness Casey has begun her work on the independent commission into adult social care to build a National Care Service that is fair and affordable for all.
'We have also invested £172 million extra in the Disabled Facilities Grant to deliver around an extra 15,000 home adaptations and given unpaid carers a £2,000 uplift to their allowance.'
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