3. An approach which places maximising individuals’ independence at its heart, including long-term planning with providers and with families, to ensure that over-provision of support is minimised . Innovation and investment is needed to take a more forward-looking, preventative approach and improve longer-term outcomes. Such an approach requires more effective transition planning from an earlier stage, as well as more joined up working with a wider range of partners, in particular schools. An in-depth understanding of different cohorts’ needs (as illustrated in this report) will also be important for effective targeting of appropriate preventative interventions, for example identifying key points in people’s life journeys where timely and appropriate support can prevent needs from escalating. 4. A specific focus and investment on the 18–25 transitions cohort to ensure a proactive and joined up approach to meeting the needs of young people, both those who transition to adult services, and those previously in receipt of an EHCP who are not eligible for adult social care but still have needs. Modelling for this report estimates that there will be at least 25% more 18–19-year-olds transitioning to adult social care by 2030, and the support for 18–24-year-olds will cost at least 40% more for adult social care services by the same year. There will also be increasing demand from individuals who previously had an EHCP but will not be eligible for adult social care. All these individuals are likely to require support from, if not adult social care, other local authority departments and a new approach will be needed to ensure that increased future need is managed and prevented. Specifically, a review may be required of the ongoing model of support from local authorities and partners for individuals with autism only, or social, emotional and mental health difficulties.
Support for working age and lifelong disabled adults made up 63 % of the net adult social care commissioned spend in England in the financial year 2022/23. Expenditure is increasing due to the type of care which working age and lifelong disabled adults are receiving. Forecast overall expenditure on support for working age and lifelong disabled adults will be 50 % more per year – or It is expected that expenditure on support for 18–24-year-olds will grow by at least 40 % by 2030 as a consequence of increases in SEND and population growth. £6bn more – for England by 2030.
Priorities for change at a local level 1. Whole system change for working age and lifelong disabled adults based on their specific needs, not based on an older adults’ model. Stakeholders engaged through this research programme argued that the current delivery model for working age and lifelong disabled adults is out of date and needs redesigning, in close conjunction with people with lived experience and with a wide range of system partners. They agreed that this must continue to be a social model of care and support, not a medical model, and be more strengths-based. The role of local partners should be prioritised, for example maximising the role of education partners. Nationally, the Department for Work and Pensions (DWP) is an example of a partner who could play a different role by supporting better employment outcomes for working age and lifelong disabled adults. Clarifying shared and measurable objectives across partners will help to improve alignment and reduce current fragmentation.
2. A more effective approach to influencing and managing the market, ensuring that commissioning best practice is implemented, and working with providers to develop a jointly beneficial arrangement. Several authorities engaged in this programme reported needing to increase their use of more expensive out of area placements to meet local needs or feeling ‘at the mercy’ of the provider market. There were also reports of ‘handbacks’ from providers happening more frequently, negatively affecting individuals and often increasing package costs. More widespread use of commissioning best practice could help to address this issue. For example, through more long-term, strategic planning; more rigorous use of local population data to inform commissioning decisions; working with and responding to variation in local provider set-ups; and a more rigorous and consistent approach to managing local markets. In addition, there is potential for commissioning best practice to be shared and implemented more widely across adult social care nationally, so that local authorities are managing their local providers and markets to best effect.
12
HOME
HOME 13
Made with FlippingBook - Online catalogs