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Dear Colleague,
Since our last Bulletin, the Government published its much-anticipated Autumn Statement. The LGA has produced a thorough briefing on the statement. We were pleased that this announced extra funding for adult social care and that the Government accepted our ask of allocating funding previously earmarked for the now delayed charging reforms into the system itself. The additional investment set out in the Autumn Statement will likely address some, but not all, of the pressures facing adult social care over the coming period. And, of course, it contrasts with the £13 billion we previously called for to address the full range and severity of pressures facing the service, including rising demand, and ensure councils can meet all of their statutory duties under the Care Act. We remain of the view that an investment of this scale is needed for adult social care to support our national infrastructure, our economy and our prosperity. People who draw on social care and support will remain concerned about the services they access to live the lives they want to lead.
Some components of the new funding have a strong focus on delayed discharge, which – as we head firmly into winter – becomes an ever-greater priority for Ministers. We understand this but continue to press Government and officials on the need to ensure that adult social care is seen as a vital service in its own right and not simply an extension service of the NHS to reduce pressures on acute hospitals. A case in point is the component of the new Autumn Statement funding that will be routed through the Better Care Fund (BCF). While we welcome the Government’s commitment to continuing this support and the much-needed medium-term certainty this will give social care and health partners, we continue to remind Government that the purpose of the BCF is not limited to freeing up hospital beds; it supports people through adult social care to remain independent and in their own homes, helping to prevent admission to hospital in the first place.
Many of the issues we have campaigned on in adult social care in recent years are reflected in an important new report on the future of care and support by the House of Lords Committee on Adult Social Care. I was delighted to give oral evidence to the Committee several weeks ago and I am pleased to see the report reframe adult social care in a far more positive light and take, as its starting point, people who draw on social care. We could not agree more with the Committee’s view that adult social care needs to be seen as a “national imperative”. There is real synergy between what the LGA has been saying about the future of adult social care and the Committee’s final report.
As I reflect back on the last 12 months as Chair of the LGA’s Community Wellbeing Board, I am struck again by the enormous – and often daunting – volume of work that councils have had to contend with across adult social care, public health, health integration and wider wellbeing. The dedicated work that you and your colleagues continue to do in councils across the country is inspiring and deeply valued, making a real and lasting difference to people’s lives. I do hope you are able to take some time off over the festive break to relax and enjoy time with friends and family. I wish you a happy and healthy Christmas and greatly look forward to continuing to represent your interests at a national level in 2023.
Yours,
Cllr David Fothergill
Chairman
LGA Community Wellbeing Board
Stories
Celebrating 175 years of the role of the Director of Public Health
In 1847, Liverpool became the first city in the world to appoint a Medical Officer of Health when it appointed Dr William Henry Duncan. The Association of Directors of Public Health and the LGA are commemorating this special anniversary by publishing a series of eight interviews with current Directors of Public Health.
Hewitt Review of Integrated Care Systems
Patricia Hewitt, Chair of Norfolk and Waveney Integrated Care Board, has been asked by the Department of Health and Social Care (DHSC) to undertake a review of the autonomy and accountability of Hewitt Review of Integrated Care Systems (ICSs). She will be submitting her interim report to DHSC by 16 December 2022, with a final report by 15 March 2022. DHSC will be publishing details of the call for evidence shortly. View the Review's terms of reference.
We understand that the deadline for evidence will be 9 January 2023. The LGA will be submitting its own written evidence and we encourage councils to draft their own response. Please contact the DHSC Review Team if you require any further information: hewittreview@dhsc.gov.uk .
Cllr David Fothergill has been invited to join the informal partnership group to advise Ms Hewitt. We will seek to ensure the local government perspective is considered in the Review. Please contact alyson.morley@local.gov.uk if you would like to know more about the LGA’s response.
Guidance on preparation of Integrated Care Strategies
Guidance on the preparation of integrated care strategies, published by DHSC, recommends that Integrated Care Partnerships (ICPs) may wish to publish their interim Integrated Care Strategy by the end of December 2022 if they wish to influence the Integrated Care Boards' first Five Year Forward Plan. The guidance recognises that this is a transition year, and therefore, this timeline is not a requirement and there is no legal duty to submit their strategy to NHS England (NHSE). Where it sets out how NHSE should exercise its functions to deliver the strategy, ICPs should engage us on the relevant sections ahead of publication and share the strategy when it’s published.
Health and wellbeing boards: guidance
The Government has published Health and wellbeing boards (HWBs) guidance which the LGA has played a key role in shaping. We support its key messages, particularly that HWBs are and will continue to be important place-based forums, bringing together health and local government, NHS and community leaders, to agree on priorities for improvement in the health and wellbeing of their communities.
ADASS Autumn Survey 2022
In the Association of Directors of Adult Social Services (ADASS) Autumn Survey 2022, fewer than one in 10 directors think they could manage with existing resources over the next few months. In our response to the survey, Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board, said it added to the growing and consistent evidence that social care is already in crisis. He called for immediate investment to address unmet and under-met need.
Adult Social Care Discharge Fund
The Government has unveiled a £500 million Adult Social Care Discharge Fund to free up hospital beds, and address care workforce challenges this winter. £200 million will be distributed to councils based on the adult social care relative needs formula and £300 million will be distributed to Integrated Care Boards (ICBs), targeted at those areas experiencing the greatest discharge delays. Councils and ICBs are asked to work together to plan how to spend the funding locally.
Carers’ costs
Carers Trust has published a report highlighting that unpaid family carers are experiencing unprecedented financial hardship with many now using food banks. The report found one in seven unpaid carers have had to use a food bank and almost two-thirds of carers are worried about being able to afford energy bills. We have said the Government must ensure that unpaid carers are supported through the cost-of-living crisis and work with councils to develop long-term solution for the funding of social care.
Oliver McGowan Mandatory training on Learning Disability and Autism
Health Education England and partners at DHSC, NHS England and Skills for Care have launched the The Oliver McGowan Mandatory Training on Learning Disability and Autism elearning which is free for social care staff to complete. Read the LGA briefing on mandatory training about learning disability and autism
Toolkit to help eliminate veterans’ homelessness
The No Homeless Veterans toolkit contains a self-audit for local authorities and housing providers to assess how well they’re meeting the housing needs of veterans. It also provides information on requirements and examples of best practice. Tailored versions have been created for England, Scotland and Wales.
Armed Forces Covenant Duty Statutory Guidance
The Government has published the Armed Forces Covenant Duty Statutory Guidance to assist specified bodies, including local authorities, comply with their legal obligations by providing information about the Duty and those people within the Armed Forces community who are beneficiaries of the Duty.
Office for National Statistics (ONS) publish Veterans Census data and launch Veterans Survey
The ONS has published the first-ever England and Wales census data on UK Armed Forces veterans. It has also launched the first-ever Veterans’ Survey to collect feedback from the veterans’ community across the UK. The ONS online survey went live on 10 November 2022 and will be open for up to 12 weeks.
Dental Care Access Measures
The Government has introduced a new package of measures to improve patient access to dental care. Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board, welcomed the step to address the lack of access to affordable dental care and called for the Government to commit to a comprehensive dental workforce strategy and provide a real terms increase to councils’ public health grant, so they can offer vital oral health improvement programmes to prevent longer-term health problems. Previous LGA analysis found that no area in the country has more than 1 NHS dentist per 1000 of the population.
Sexual health services
The LGA's new report, Breaking point, warns of the pressures facing local sexual health services and highlights that there were over 4 million consultations at sexual health services in 2021, a 16 per cent increase compared to 2020 and an increase of 36 per cent since 2013. At the same time, over £1 billion has been cut from councils’ public health grant over the last seven years, resulting in a 17 per cent reduction in spending on STI testing, contraception and treatment.
Healthy Start Vouchers
Urgent action is needed to tackle low take up of the Government’s Healthy Start Voucher scheme, as LGA analysis reveals that nearly 150,000 eligible families a month are currently missing out on them. The LGA 's five-point plan to increase take-up and improve the scheme includes a call for the Government to ensure that the value of the vouchers reflects the rate of inflation for food and non-alcoholic drinks.
Cold weather plan
The UK Health Security Agency has updated the action cards on how different organisations need to respond to cold weather alert levels 0 through to 4. Further guidance from GOV.UK, The Met Office and the National Institute for Health and Care Excellence (NICE) can be found on our cold weather plan page.
Autumn Statement 2022: LGA briefing
LGA
Developing integrated care strategies: tips for successful partnership working
LGA and NHS Confederation
Breaking point: Securing the future of sexual health services
LGA
Integrated workforce thinking guide: Practical solutions to support integrated care systems
LGA
Top tips for retention guide
LGA, ADASS and Skills for Care
Top tips for successful partnership working in integrated care partnerships
LGA and NHS Confederation
ADASS autumn survey report 2022
Association of Directors of Adult Social Services (ADASS)
Statutory guidance for integrated care boards, NHS trusts and foundation trusts
NHS England
Navigating the system: experiences of accessing adult social care information and advice for people in later life
Independent Age
Events
Midlands Political Leadership Masterclass: Health and Wellbeing in the Integrated Care System
11 January 2023 | Birmingham
Smith Square Debate: The future of adult social care (Hybrid event)
26 January 2023 | London
Let’s talk about… encouraging diversity in recruitment
19 January 2023 | Webinar
Handling online abuse and intimidation
1 February 2023
Personal safety for councillors
21 February 2023
Let’s talk about… supporting inclusive leadership
2 March 2023 | Webinar
LGA Annual Conference and Exhibition 2023 (4-6 July)
4 July 2023 - 6 July 2023 | Bournemouth
National Children and Adult Services Conference and Exhibition 2023
29 November 2023 - 1 December 2023 | Bournemouth
Media
Winter is coming: Councils prepare for deep freeze with 1.4 million tonnes of salt at the ready
6 December 2022
Social workers seeing record numbers of children with mental health problems
14 November 2022
NHS “dental deserts” persist in rural and deprived communities – LGA analysis
1 October 2022
Parliamentary
Autumn Statement
The Chancellor delivered his Autumn Statement on 17 November 2022, setting out the Government’s spending plans by setting budgets for each central government department. The LGA has produced a briefing detailing our response to the announcements which can be found on our website.
In our media statement, we noted that it was good that the Government has used the Statement to act on the LGA’s call to stabilise local services from spiralling inflation, demand, and cost pressures. The Chancellor announced additional flexibility for local authorities to set council tax by increasing the referendum limit to 3 per cent per year from April 2023. The Government is also giving local authorities with social care responsibilities the ability to increase the adult social care precept by up to 2 per cent per year. However, we have been clear that council tax has never been the solution to meeting the long-term pressures facing essential public services as it raises different money in different areas, unrelated to need.
In meetings with Ministers and Parliamentarians, our Chairman Cllr James Jamieson, highlighted the contribution of councils as leaders of place and called for the Government to provide councils with sustainable long-term funding, which we continue to advocate for.
Integrated Care Systems
Councillor David Fothergill, Chairman of the LGA's Community Wellbeing Board gave evidence to the Health and Social Care Committee on 8 November 2022 as part of its inquiry into Integrated Care Systems (ICSs): autonomy and accountability.
Councillor Fothergill said councils continue to emphasise the need for ICSs to have the freedom and space to agree and action their own priorities, adding that they should not bypass or duplicate place-based leadership but to work with them and build from the bottom up.
He also called on the Government and NHS England to reduce the number of targets and priorities for ICSs, in recognition that ICS leaders need to be able to focus on local system priorities.
Health and Social Care Questions
At Health and Social Care questions on 1 November 2022, Mark Fletcher MP (Conservative, Bolsover) used NHS “dental deserts” persist in rural and deprived communities – LGA analysis to highlight his constituency has some of the worst dentist provision in the UK. He asked the Minister for a meeting to discuss this and what can be done to increase provision for his residents.
In response, the Minister, Neil O'Brien MP, said Seven Derbyshire dental providers have been commissioned to deliver extra weekend activity to improve access this winter and, nationally, we are exploring how to incentivise dentists to work in areas where getting an NHS dentist is proving challenging. Oher topics of interest to local government included community care; care worker pay; Integrated Care Systems; impact of cost of living on health and mental health.
Supporting asylum seekers
On 15 November 2022, Lord Howarth of Newport (Labour) asked what steps the Government is taking to ensure the provision of appropriate accommodation for asylum seekers after their departure from the Manston immigration centre. The Minister, Lord Murray of Bildworth, stated that the Government are committed to working closely with communities and stakeholders to ensure that asylum seekers are housed in safe, secure and suitable accommodation. Lord Howarth went onto note that councils are already struggling to house people in need, leaving asylum seekers in limbo in hotels. Lord Dubs (Labour) and the Bishop of St Albans questioned the Minister on the Government’s commitment to informing local authorities ahead of asylum seekers arriving in their local areas. The Minister assured the House that the Home Office intends to improve notification.
The following day the Shadow Home Secretary Yvette Cooper MP asked the Home Secretary to make a statement on migration. The Minister for Immigration, Robert Jenrick MP, responded and noted that the Government has agreed a new multi-year strategic and operational plan with France that will be supported by UK investment of up to €72 million in 2022-23. He emphasised that the Government is “determined to get a grip of this problem”. During the Urgent Question, Ben Bradley MP (Conservative, Mansfield) asked the Government to ensure councils were able to get the information they need to urgently put in place the support they need at local level. While Rachael Maskell MP (Labour, York Central) asked the Minister to ensure local authorities have the funding to support people seeking asylum. The Minister emphasised that he was in contact with local authorities across the country to see how best they can be supported.
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