09: The future for working age and lifelong adults
The model assumes a conservative flat rate of inflation of 2% CPI every year for the future forecast horizon. This provides an average growth of 6.8% each year. This also excludes any additional cost pressure that may arise from potential changes in joint funding with health partners, particularly Continuing Healthcare. As shown in Section 4, any increase in the minimum wage above inflation is expected to create further growth in expenditure, and this too would need to be factored into further pressures, for example if the proposed wage increase to social care workers by the new Government were to be enacted. Interim recommendations To achieve a substantial improvement in outcomes and the financial sustainability of these services, a greater focus on working age and lifelong disabled adults is vital, involving a more prominent and transparent national debate as to how to optimise outcomes and improve financial sustainability. This greater focus also needs to be supported by significant reform at both a local and national level. There is no doubt that reform on this scale will be challenging – local authorities engaged through this programme described having grappled with the issues identified in this report for many years with varying degrees of success. Nonetheless, based on the analysis conducted for this programme, several priorities exist at both a local and a national level.
This report has outlined the case for why outcomes need to and can be improved for working age and lifelong disabled adults. Based on the engagement undertaken for this programme, there is broad consensus across the system that there is potential for a scale of progress to be achieved in the next 5–10 years that has historically taken nearer 30 years to achieve. Forecast cost pressures for adult social care Although this report has focused on making the case for improving outcomes, there is also a financial imperative for change. With the significant rise in support expenditure for this cohort now above inflation and minimum wage, if this trend continues (without national reform) it will likely result in an escalating cost pressure on adult social care services. If the current trend for spend growth in adult social care support continues, including the additional forecast pressures from transitions, this will lead to a total increased cost to local authorities of at least 50% more – or £6bn more per year – for England by 2030 , as shown in Figure 16. This forecast has been developed by taking the increase in expenditure over the last five years and using the average rate of above- inflationary growth.
Figure 16: Current and forecast annual gross commissioned spend on working age and lifelong disabled adults
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