The National Audit Office has published a report on the financial sustainability of the NHS
Key aspects related to social care:
National bodies have not assessed the impact of all the wider cost pressures faced by local NHS organisations in plans for achieving financial sustainability. The Department, NHS England and NHS Improvement expect trusts and commissioners to invest in transformation programmes. But they do not yet know what level of investment is required or whether local bodies will be able to make the changes at the scale and pace needed. Furthermore, the government has made a commitment that the health and social care system in England will be fully joined together by 2020. We have previously reported that local authority spending on adult social care fell by 10% in real terms between 2009-10 (£16.3 billion) and 2014-15 (£14.6 billion). The accounting officer for NHS England told the Committee of Public Accounts that “over the next two or three years, there is likely to be a widening gap between the availability of adult social care and the need for social care. That, will, inevitably show up as delayed discharges and extra pressure on hospitals.” However, in our review of the plans for financial sustainability, we did not see any estimate of the impact of pressures on social care spending on NHS bodies (paragraphs 2.6 to 2.13). (pg. 11)
The Department, NHS England and NHS Improvement should analyse the impact to the NHS of pressures on social care funding, and the cost of implementing seven-day services. Local bodies are faced with wider cost pressures in addition to the need to achieve financial sustainability. However, not all of these have been taken into account in national plans for financial sustainability. (pg. 13)
The Committee of Public Accounts raised concerns that funding cuts and wage pressures will make it harder for local authorities to fulfil their Care Act obligations at a time when demand for social care is rising. We have previously reported that local authority spending on adult social care fell by 10% in real terms between 2009-10 (£16.3 billion) and 2014-15 (£14.6 billion).23 The accounting officer for NHS England told the Committee of Public Accounts that “over the next two or three years, there is likely to be a widening gap between the availability of adult social care and the need for social care. That, will, inevitably show up as delayed discharges and extra pressure on hospitals.” We did not see in our review of the shared plan to achieve financial sustainability any estimate of the impact of pressures on social care spending on the NHS budget. The accounting officer for NHS England acknowledged that the effect of social care pressures “is not costed into the NHS funding envelope for the next five years” (pg. 34)