The future for Adults and Community Services

Birmingham City Council today published a green paper looking at the future of Adults and Community Services across the city.

The council is facing a big challenge, having to cut the budget we can control by half over seven years. In the past we have often made changes to improve our services and get better value for money. But we now face cuts in government funding on a scale that has never been seen before.

We will need to make big changes to balance the books in the years ahead. These changes will have an impact on everyone in the city, so we want to discuss them with you before going ahead.

The key question we are seeking to answer is: How can we continue to provide essential services to residents and guide the city through such difficult times, whilst supporting greater fairness and future prosperity?

Key points

  • Adult care accounts for one of every three pounds spent by Birmingham City Council. It’s the council's largest area of direct spend;
  • If we put that spend in a bubble, the consequences of that for the rest of the council are dramatic. A reduction in community services would mean that people using care services would suffer by having fewer alternatives to residential care;
  • The scale of the cuts before us is unprecedented;
  • We have no choice but to address the cuts head on. If we don't, we would leave people with dementia, the frail and the elderly, the mentally ill and those with multiple, complex disability in a downward spiral of poorer care and outcomes;
  • We think the answer lies in reducing demand for high cost, high end care. All the data shows that we make more use than other local authorities of residential and hospital care;
  • We want to develop services for children with disability that span their lifetime. We cannot accept that dependence is an outcome for so many young people;
  • This is why we have reviewed adult care thoroughly, including independent challenge to our spending and activity. We have an understanding of what we need to do to meet the enormous challenge that lies ahead, but need to develop this through dialogue with users, carers and the public.

Background

The city council supports people who have substantial or critical needs. This means that they need a lot of help with five daily tasks – washing, eating, dressing, going to the toilet and getting in and out of bed;

We have given a commitment to work to protect the most vulnerable. We will honour that commitment, but that also means facing up to how hard that is going to be;

Over the last three years, Birmingham's social care for adults has met reductions of £115m, £52m of which has covered the demographic pressure and £63m has been cash cut from budgets;

We have met this challenge with innovative ideas: the Enablement service (helping people who have been in hospital, had falls etc); www.mycareinbirmingham.org.uk, Birmingham Telecare and the Community Navigators scheme (pilot in Ladywood and Kingstanding to build community capacity). These are all good examples of how we are changing the way we meet need, but the scale of the cuts before us is unprecedented;

The changes that we have already put into place mean that more older people get a service from the council than when we spending more money – 7,500 people got telecare in its first year, 3,000 people each month buy services through mycareinbirmingham. Just these numbers alone are bigger than the number of older people who got social care services in 2009.

The initial proposals arising from the review

  • We are considering developing services for children with disabilities which span their lifetime. We will look at incentives to providers to promote earlier planning and independence. This plan will include identifying employment opportunities and creative thinking about removing barriers to living in their own home;
  • We want to improve the care management of frail elderly people, across health and care. This looks like better planning for very frail people already in care homes, so that increasing needs at the end of life can be met in the care home, not by transfer to hospital. This plan will set pave the way for better multi agency working for people outside hospital. It will give older people and their families the confidence that they will be cared for appropriately, in their own home. It will also look at providing a more coordinated response to a whole range of events from falls, to strokes, to intermediate care and end of life;
  • We are considering a radical new approach by establishing a social enterprise to enable specialist care services to trade outside the council. There are potential gains from this operating model and could save the council around £2.5m in three years;
  • We are considering ceasing council owned residential provision for short breaks for people with disabilities and their carers because the alternative of offering individual budgets would provide more choice and a more effective use of resources.

Send us your Comments

Email: servicereviews@birmingham.gov.uk

Text: 07786 200 403 – Simply start a new message with the word 'Budget' followed by a space (if you miss out a space your message will be lost), then add your comment. Please note you will not get a receipt for this message. Mesages sent via this service will cost your usual network rate per message and are anonymous unless you put your name in the message.

Write to: Service Reviews, Room 221, Council House, B1 1BB.

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