The separate and combined meetings of the CIPFA/ADASS Social Care & Welfare Reform and Health panels on 18 December 2015 revolved largely around three forward looks: at the likely consequences of the spending and settlement announcements made in late November and just before Christmas; at the health and social care products to be launched in 2016; and at the plans for further development of CIPFA’s new Health and Integration Faculty.
Social Care & Welfare Reform Panel members noted CIPFA’s settlement responses to date, agreeing that the settlement went only part of the way towards dealing with the pressures, and emphasised:
- the claimed certainty of a four year settlement is of limited value when council tax and business rate proceeds are very uncertain
- concern about the distributional effects of the settlement – eg might northern mets lose spending power disproportionately, even after the mitigation afforded by BCG growth allocations? The potential transfer of attendance allowance to local government has some logic but also high risk
- the 2% social care exemption from council tax referendum requirement was mis-described as additional funding – it is a change in the rules which apply to councils raising funds themselves
- the public health settlement is concerning and needs further consideration, so the panels will return to that.
The Health Panel also picked up on public health in concluding that, although the settlement looks good, and it is a good deal better than might have been the case, it benefits the NHS rather than health as a whole, and even in the NHS some caution is in order:
- NHS England spending rises by £7.6bn in real terms over the settlement period, but other health spending falls by £3m.
- Those £3m reductions (as well as unresolved pressures on social care) will have knock-on effects on the NHS.
- The addition to NHS budgets in 2016/17 will in large part be needed to deal with deficits seen in 2015/16.
- 2016/17 therefore represents something of a pragmatic ‘firebreak year’ to get the NHS’s finances in order, but that leaves minimal scope to respond to new demands to invest up front in preventative measures for the long term.
- Use of capital to revenue flexibilities removes a significant backstop in the form of capital slippage, so putting more emphasis on the need for a prioritised capital strategy and good financial management generally.
- The tariff will be a net inflator, not a deflator as in recent years: good news for providers, but potentially shifting pressure points around the system and adding to the sense in moving towards place-based joint system accountability.
Reports were received on several forthcoming products:
- the pre-Christmas launch of the Social Care Risk Tool
- the New Year roll-out of integration training
- Excellent Finance Business Partner for Health publication planned for March 2016
- proposals to expand the reach of benchmarking in adult social care for 2016/17 data.
Both panels approved the forward strategy for the Health & Integration Faculty, which seeks to balance the triple aims of growing CIPFA membership, raising its profile and voice, and growing the revenue contributed via the faculty’s work. Areas flagged to explore further included:
- accounting for integration
- building Better Care Fund and 2% social care council tax issues into the forthcoming budget survey; and
- options for post-settlement updating of 2015’s The Health of Health Finances publication.