Newcastle City Council: offering a multi-disciplinary triage at the first point of contact in social care

Newcastle City Council’s approach to the front door of adult social care services has led costs of over £5m per annum being avoided and improved outcomes for residents. The council uses a multi-disciplinary team to explore different ways to meet people’s needs without the need for a social worker, bringing together voluntary, community and social enterprise, enablement, physiotherapy and more.

As CIPFA explored in Managing rising demand in adult and children’s social care (2024), requests to councils for adult social care from new clients increased by almost 10% between 2018/19 and 2023/24. Councils need to ensure that their processes to connect people to support are effective and lead to improved outcomes and value for money.

The challenge

This case study pertains to adult social care at Newcastle City Council. Newcastle is a core city in the North East of England. Newcastle is a vibrant city with a mix of ethnicities, ages and cultures. The city is rich in communities of place, people, interests, action and practice, yet we know there are some longstanding health and social inequalities that impact on the lives of local people.

Figure 1 is an infographic showing the composition of the city and the demographic growth experienced and forecasted. It also shows the volume of work that comes through adult social care.

Figure 1

Adult social care must deliver the statutory duties outlined in the Care Act 2014 in a challenging financial landscape where purchase of care services from the market is more expensive due to cost of living increases and changes to National Insurance, as well as ensuring that the workforce is paid the real living wage.

Local government has seen a reduction in core funding from central government, with a reliance on raising income through council tax and business rates alongside traded services. This has meant that over the last decade, councils have faced significant funding gaps in maintaining core services, and services within councils have been required to find efficiency savings year on year to enable a balanced budget.

Figure 2 shows the savings required of and delivered by adult social care since 2014/2015

Figure 2

Year on year	£m
2014/15	5,984,140
2015/16	6,174,980
2016/17	6,316,547
2017/18	4,681,000
2018/19	4,623,800
2019/20	5,906,000
2020/21	9,440,000
2021/22	8,416,000
2022/23	4,450,000
2023/24	4,982,000
2024/25	6,034,800
Total	67,009,267

To achieve these savings, the service has focused on transforming service delivery to reduce or delay people’s need for costed services rather than cutting service.

The savings ask from the directorate for 2025/26 is circa £9m.

The action

A decision was taken to look at presenting issues in a different way. There was a cohort of 160 people who had presented at the front door who were waiting for a social work assessment under the Care Act 2014. Using this cohort, we took an approach that allowed experienced rehabilitation staff to undertake a home visit and understand the nature of the issues the person was facing to determine if there was a different way of managing the situation. In 76% of cases, we quickly identified that a social worker was not needed, and significant functional improvement for the individual could be achieved with some immediate and prompt practical support.

We also identified that access to therapy services was difficult for some people and that improvement in function and wellbeing was adversely affected by lengthy hand-offs to other services.

We enhanced the multi-disciplinary team to include physiotherapy, occupational therapy, falls expertise, moving and handling expertise, learning disability and autism expertise, and a carers’ worker.

This was a key change to the way the service operates and how people in the city experience social care. A multi-disciplinary team ‘huddle’ happens each morning to discuss the presenting needs of the people who have made contact. This allows a plan to be put in place for who is best placed to undertake a visit, some of which are joint visits to ensure professionals with the right skill set are understanding needs.

Referral processes have been streamlined, so that if visiting professionals feel another service is needed, it can be quickly arranged. We have trained our social care assessment officers to be able to assess people for small pieces of equipment, and we are rolling this training out to the wider workforce. If the scale or scope of presenting needs is not immediately clear, our reablement team provide some responsive visits to work with the individual to better understand what is needed. Our local carers centre also joins the multi-disciplinary team weekly to ensure that carers’ needs are identified and addressed.

The council invests £314,000 per annum for additional therapy staff using funding from the Better Care Fund (BCF).

The aim is to resolve presenting issues and give advice, information and signposting at the earliest opportunity to prevent and delay the need for care and support.

The outcome

Since 2 December 2024, 1,549 people have been seen. Most of those were seen the same day or next day and are receiving timely and comprehensive rehabilitation interventions, advice and support.

In 49% of cases, transfer to another service has been prevented, avoiding waiting times and reducing the work for partner agencies.

77% of people have seen a reduction in their needs. 50% have seen a reduction in their dependency on services. 59 hospital admissions and 29 admissions to residential care have been avoided.

In 12 cases, the need for two members of staff has been avoided and there’s evidence of providing the least restrictive care.

We have been tracking the costs of anticipated care packages at the point of presenting and then recording the actual care required at the end of the intervention from the multi-disciplinary team. Full-year effect costs are demonstrating an avoidance in spend of £5,094,613.74.

Staff are enjoying the work and feeling that they are making a difference.

Reflection

This can be replicated elsewhere. We have been delighted with the results and are applying this approach now not only at the first point of contact but at any point where a person’s needs have changed, and at planned and unplanned reviews.

We are also using the skills of the multi-disciplinary team to work with people in short-term care home placements to ensure they stay functionally able and reduce the number of bed days needed before someone is able to go home.

The change in working is positive for our staff, who feel like they are making a real difference to people; our customers, who are evaluating the service very positively; and our system partners, who feel that our change in working is effectively helping to reduce pressure on the acute hospital landscape.

7 July 2025