Social care bosses in East Renfrewshire have said there is “no choice” but to prioritise support to those in substantial or critical need due to a “very dire financial situation”. The move means people deemed to be at low or moderate risk could miss out on care, and comes as the area’s Integration Joint Board [IJB] tries to save over £3 million.
A ‘supporting people framework’ — which involves assessing and categorising people’s needs — was brought in earlier this year to save money. Initially, it was decided support would no longer be provided where needs were considered ‘low’, but that is now being extended to include ‘moderate’.
Moderate, substantial and critical categories of risk
Moderate has been described as “some risks to an individual’s independence or health and wellbeing” which “may call for provision of some social care services”. Community and voluntary support will be used to mitigate the impact.
Focusing on those in the ‘substantial’ and ‘critical’ categories involves providing care where there are “very immediate risks to individuals”. Lesley Bairden, chief financial officer of East Renfrewshire’s Health and Social Care Partnership [HSCP], said: “I think we have no choice now, we will need to move to substantial and critical levels of need. It was something we had hoped to avoid. “However, I think it is also important to note that will bring us on a par with other partnerships across GGC [Greater Glasgow and Clyde] and beyond.”
Funding of the area’s IJB
Funding for the area’s IJB, which directs the HSCP, is provided by its two partners: the council and NHS. It needed to find around £7m of cuts this financial year [2023/24] due to a budget shortfall, and board members heard last week that “just over £3m” is still needed.
The majority of that is expected to come from the supporting people framework, but reviews of the care being provided are “delivering less savings than we had hoped”. The policy applies to adults and children with a disability accessing social care, but not to children and young people where there are “care/welfare concerns”.
Alongside the supporting people framework, the cost of prescribing is “causing the most concern”. It is “roughly running around £200,000 a month over budget”, which would “take us up to at least £2.4m for the year”. Talks are ongoing across GGC about how to deal with prescribing pressures.
A “number of offers have been made” following a “voluntary severance and early retirement exercise”, which will deliver savings, but this could be revisited to save more money.
History of underfunding
Extra support of around £700,000 has been provided by East Renfrewshire Council and, according to Ms Bairden, is “not yet reflected in the projections”. She said a “relatively positive” meeting was also held with NHS GGC, where the “reason and the rationale behind our pressures was clearly recognised”. No support has been agreed at this point, she added.
Julie Murray, chief officer of East Renfrewshire HSCP, said they would be “signalling to Scottish Government colleagues that we are at this point”.
Cllr Katie Pragnell, Labour, said the change to the supporting people framework was made “with a heavy heart” while Anne-Marie Monaghan, who chairs the IJB, said there has been “a history of underfunding” of social care.
Ms Monaghan added: “This isn’t about poor financial management on the part of this IJB, or indeed of any of our finance and executive colleagues. It’s because we’ve got high demand for support and we frankly don’t have enough money.”
She said there is a “very difficult and very dire financial situation”.
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