Some local authorities trying to cope with public spending cuts are actually costing the public purse more by delaying decisions about individual cases and forcing people to remain funded by the NHS for longer than they should be, the Disabilities Trust has warned.
The Trust, which provides residential and community-based support for people with autism, brain injury, and physical disabilities, says that “bed-blocking” has proved to be an unintended consequence of the cuts to local authority budgets, occurring when people are in transition from one funding stream to another.
The Trust gets most of its £46.9m income from local authority supported-care budgets, though its brain injury rehabilitation services are generally funded by primary care trusts (PCTs).
Director of finance Sindy Fortescue told CivilSociety.co.uk that people with brain injuries tend to require a great deal of intensive and expensive treatment in the early stages, which is funded by their PCT, but as their condition improves they can be shifted to less intensive, community-based care, funded by local authority social care budgets.
But at present, because local authorities are in such disarray trying to make savings to cope with the spending cuts, they are putting off making decisions about where to put people. "So the person continues to be funded by the PCT when they actually need to be out in the community funded by social care," she said.
“Each case goes to a panel who decides who is going to fund their care, but at the moment we are finding they tend to go backwards and forwards for anything up to six or seven months before it’s decided. They don’t want to make a decision because all the time they are delaying, they don’t have to pay the fee themselves.
“So the NHS gets stuck with a £3,000-a-week bill to keep people in rehab when they should be out in the community on a package that costs maybe half that.
“We have several instances where people are paying far too much.”
Fortescue said that evidence shows that if a patient is given the right brain injury rehabilitation support in the first year after the injury, and reaches a stage where they are back in the community or even in employment, that can save up to £1m in the lifetime of that person in terms of cost to the public purse. “Apart from the moral aspect,” Fortescue said, “if you give the right service initially, that person is able to live a much more economically contributory life.”
She stopped short of saying the councils are deliberately delaying decisions in order to save themselves money, stating that “all sorts of factors” could be contributing to the situation. “But it is certainly taking far longer now than it ever did before.”
Fortescue wondered whether other charities that receive funding from both local authorities and NHS budgets were seeing the same thing.
