quarta-feira, 21 de setembro de 2011

Coping with Cuts to Disability Services

Coping with Cuts to Disability Services by Claudia Wood

In October 2010, Demos published Destination Unknown, exploring the impact of the welfare benefit cuts announced in the Spending Review on disabled people. Our analysis of DWP caseloads revealed that, overall, the 3.5 million disabled people currently claiming disability-related benefits would lose about £9.2 billion of financial support by 2015 as a result of the Government’s announced changes.

But after publishing this report, we realised we knew little of what was going on ‘on the ground’ with local services. Disabled people are disproportionately reliant both on welfare benefits and public services – so we were only looking at one half of the coin when it came to the impact on disabled people of the government’s reforms. Because the fact was, in the very same Spending Review that saw such radical reforms to benefits, the government also announced budgetary cuts to local authorities that were truly game changing. A 28 per cent cut over a four year period. Councils were facing tough decisions – sacrifices had to be made, and many were placed in the unenviable position of choosing between refuse collection and library maintenance, play groups and elderly care.

Coping with the Cuts, has therefore attempted to throw light on how the government cuts to local authority budgets are affecting disabled people’s services across the country. We undertook the ambitious task of collating a range of data regarding front line care and support services from every local authority in England and Wales, sending out hundreds of FOI requests to gather the necessary information.

Once we had this to hand, we realised that there were disparities between the level of budgetary cuts local authorities were making to their social care budgets, and the changes being made to the front line of care and support. Some councils had very large care cuts – up to 22 per cent - but were not raising service user charges, or tightening eligibility criteria. They weren’t closing any services either. On the other hand, some councils were increasing care funding by up to 10 per cent, but reported closures, restrictions in eligibility and large increases in charges for things like meals on wheels and respite.

And it is this disparity which is at the heart of today’s report. We found that when it comes to coping with the cuts, it’s not always how much you have, but what you do with it that counts. We combined this front line information and created a ‘coping score’ to demonstrate this.

The results, published today and presented graphically at http://disability-cuts-map.demos.co.uk/, shows that local authorities are each coping with budgetary constraints in very different ways, and some better than others. By looking beyond how much funding councils had, to how this was affecting their front lines, we were able to avoid the very common criticism levelled at councils with big budget cuts. Some councils wielding large cuts are actually doing well in protecting disabled people's services – this measure acknowledges their hard work.

We were, for the first time, able to compare local authorities based on a set of objective and comparable data and present the information as a national picture. And it is a phenomenally complex picture, one which the government would do well to consider when assessing the impact of its local authority budget cuts.

But the key finding of this report is, perhaps, that there is no ‘magic bullet’ when it comes to coping with the cuts. We report how many local authorities are trying new things – from citizenship-based commissioning, to coproduction with disability user groups, to integrating their health and care systems – to get more for less. Each are at a different stage in the process, some were encountering greater obstacles than others, but it is still early days. Hopefully, local authorities will consider today’s coping score as a baseline – and take it as a challenge to improve and learn from the range of coping strategies already being pioneered across the country.

The information on North Yorkshire suggests:
1). -9.04 per cent budget change to disabled children and families' care and support
2). 0.26 per cent budget change to adult care and support
3). -4.15 per cent budget change to older people's care and support
It states that North Yorkshire has increased the cost of specialist transport by 10 per cent and is no longer offering community meals services. We are rated as 'OK'

I have to query the data and the suppositions in your methodology. Some statements are plainly untrue... e.g. we are seeing an increase in the uptake of meals through our social enterprise models with WRVS and Age Concern in North Yorkshire. The fact that we have organised things differently and we are being more efficient does not then mean a reduction in front line services.
Likewise you rightly use the word 'change' when you refer to % in adult social care. However we are offering more people support and with a wider transformed range of services. Your headline 'Coping with Cuts' gives little credit to the successful efforts of Local Government to modernise and transform thus achieving greater efficiencies while producing better outcomes for people.

PS we continue to offer services at all levels of the FACs criteria.

Seamus - we based our analysis on FOI responses from individual councils. All information we used came directly from them.

North Yorkshire told us "Meals on wheels - No longer provided. Number of people who accessed the service: 1,051". The FOI request allowed councils to give us additional information, but the response gave us no further details on this particular issue.

However - and more importantly - whilst closures and cessations of services was mentioned as "additional information" on the Disability Cuts website, closures are NOT included in the calculation of the council's coping score. We explain this on the website here http://disability-cuts-map.modernactivity.co.uk/how-we-made-the-coping-index/ and in the full report. We did not include closures and cessations for the very reason you imply here - it is too subjective an issue, and we are not in a position to judge whether the end of a service is done for a "good" or "bad" reason.

Therefore, the end (or not) of community meals in North Yorkshire does not affect North Yorkshire's score at all.

The increases in user charges in North Yorkshire in hourly home care, transport, day centre meals and older people's respite charges are taken into account, and DOES affect North Yorkshire's score.

However, the fact that eligibility criteria is (again according to the FOI response) "moderate, with the aim of meeting lower need where the risk to independence may be significant" counts in North Yorkshire's favour, as does the fact it does not apply an efficiency saving on personal budget allocations. Hence the overall placing of 67 out of 152 - above average.

Hope this clarifies. I would also suggest you read the full report, which very much focuses on the innovations of some councils in the list (not just the top copers) and distils some key things they have in common that other authorities could take on board.

The full report can be dowloaded here:http://www.demos.co.uk/publications/copingwiththecuts

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