£3bn a year to develop seamless health and social care

Social care Poor community care can led to patients remaining in hospital

The NHS budget in England has been protected again - but the health service has been told it must do more to help councils with social care.

Chancellor George Osborne said he wanted to see £3bn set aside in 2015-16 for integrated services.

He said this was to stop vulnerable elderly patients from falling into "the cracks" between the two sectors.

It comes after he announced local government would get a 10% cut.

The NHS is already committed to spending £1bn a year on joint projects with local government so this represents an extra £2bn.

The chancellor told the House of Commons: "Many older people do not just use the NHS they also use the social care system and if we're honest they often fall between the cracks of the two, being pushed form pillar to post and not getting the care they want."

He said this money would be spent on services that would be jointly commissioned between the health and social care - although it would come from the NHS pot.

"Let's stop the tragedy of people being dropped in A&E on a Friday night to spend the weekend in hospital because we can't look after them properly in social care," he added.

Analysis

It is easy to understand why ministers want to encourage a better working relationship between health and social care.

As budgets have been squeezed, the two sectors have drifted further apart. Not only has that been bad for vulnerable elderly people, but it has not made economic sense either.

A recent analysis by Age UK showed that hospital patients were waiting for more than 30 days on average for a care home place - 13% longer than three years ago. A similar rise in waits has been seen for those needing care packages at home.

That is costly. A hospital bed costs £250 a day on average, while a week in a care home costs just over £500 and home help even less.

Creating a joint budget like this is also convenient politically. It allows the government to say it is keeping its commitment that the NHS budget would be protected, while also enabling it to say it is giving more money to social care.

Council cuts

Councils currently spend about £16bn on social care so in theory the £3bn joint fund represents a significant sum.

However, councils have had to trim the amount they spend in recent years because of the cuts that have already taken place.

And with another tranche announced for local government in this spending review some question the impact it will have.

Sandie Keene, president of the Association of Directors of Social Services, said: "The benefits gained from closer integration with the services provided by our health colleagues will be rendered less valuable if the intricate relationship with other services is threatened by severe downward pressures on local government as a whole."

Sir Merrick Cockell, chairman of the Local Government Association, said the chancellor had made a "positive, practical move" to help deliver services which keep people independent and out of hospital.

"Today's announcement is a start towards addressing the very real crisis in providing care to some of the most vulnerable members of society. It will ultimately save taxpayers money and improve the quality of care people receive.

"However, this transfer does not disguise the fact that council funding will have been cut by the equivalent of four times this amount across the life of this Parliament. This cut is having a severe impact on local services, including those this money is designed to support."

Overall, the NHS budget will be £110.4bn in 2015-16, which represents an annual rise of 0.1%.

Before the last election the Tories had promised to increase the NHS budget during the parliament.

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