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The Budget 2017: Key reaction to social care bung and A&E support

Bruce Potter of Blake Morgan

“The Chancellor has, in amongst everything else in the budget, signalled he knows all is not well in the health and social care space, but he has little headroom (in his opinion) to do much more than alleviate the symptoms – not pay for cures.

“He would have been pilloried if he had made no supporting gesture to relieve the social care funding gap. £2bn is quite a gesture, but it is quite an issue, and could be seen as an expensive sticking plaster not a cure.

“The other gestures towards supporting A&E with £ 100m to support GP triage (acting as a first stage filter), and supporting those rare beasts, robust STPs, with a £325m capital fund, will not promote a radical and rapid recovery. Mr Hammond (and Mr Hunt) no doubt hope these financial painkillers will bat these issues down the road until the larger wide-ranging review kicks off.”

Dr Chris Moulton, Vice President of the Royal College of Emergency Medicine

“We, along with other Colleges, have called for an increase in social care funding and the budget delivered £2bn for this purpose over the next three years. While it is unlikely that this will be enough to rescue a failing health and social care system, it will help to improve the safe and timely discharge of patients from hospital and thus free-up much needed beds.

“However, social care is only part of the problem and this is only a short-term solution; more will need to be done to ensure the longevity of a health service facing the huge challenge of treating an ageing and expanding population.

“We need more beds and more doctors; this budget does not address these key issues. While an acknowledgement that implementing sustainability and transformation plans will require additional funding is welcome, the plans themselves aim to cut the overall number of beds available – a step in completely the wrong direction.

“RCEM cautiously welcomes the extra £100m to be spent on A&E triage schemes in time for next winter, provided it is used appropriately. For some time, RCEM has called for co-location of urgent care services around major A&E departments and having primary care on site will undoubtedly benefit patients.

“The College would like to see this as the first step to co-locating more services, including frailty teams and out-of-hours mental health teams, around the A&E department. By creating a hub of services, patients can be swiftly directed to the treatment or service most appropriate for their needs, without the need to travel elsewhere or book another appointment.

“The devil will be in the details but the money from the budget will hopefully help to ease winter pressures. However, with enormous system pressures all year round, more will be needed to halt the long-term decline in performance that our departments are experiencing and keep our patients safe.”

Quentin Cole of PwC

“The Chancellor’s announcement shows the Government realises that the pressures on the health and social care systems are interrelated, and the answer lies not just in efficiency savings.

“The £2 billion injection of cash over the next three years, announced for social care, is welcome as are the additional commitments for capital expenditure, but this is not a long term solution.

“Today’s system was designed to deal with yesterday’s problems. Instead of just looking for quick solutions, the system itself needs to be reshaped to deliver improved outcomes, optimise resources and empower patients.

“PwC research shows that, in the long term, the balance of power needs to be shifted to local areas so they assume greater accountability for financing and control of services – passing down funds to a local level which can be spent in a tailored way by leaders who understand the problems facing their own areas.”

Dr Mark Porter, BMA council chair

“This budget does nothing to address the gaping hole in NHS finances. There is a £30bn gap to fill and we should be increasing the UK’s health spending by at least £10.3bn to match that of other leading European economies. The NHS and social care are at breaking point and have been failed by party politics for too long. We need politicians from all sides to come together to agree a long-term solution to the challenges facing health and social care.

“We have a crisis in social care happening right now, so any funding to help provide the care patients so clearly need is a help. Failures within the social care system hugely affect an already stretched, overworked and underfunded NHS – most NHS trust finance directors have said that cuts in local authority social care budgets are adversely affecting NHS services. For doctors to look after patients well, social care needs to be well-funded and adequately staffed.

“The crisis in the NHS doesn’t stop at the hospital door – our A&E’s are struggling because of an overstretched system. Having GPs in A&E won’t reduce admissions – if anything this could have the effect of attracting more patients to hospitals. The government also needs to explain how it will fund and recruit GPs to work on site at hospitals when there already aren’t enough to meet the needs of the public. Many are already working in practices with permanent vacancies which they are unable to fill, despite government promises at the last election to recruit 5,000 more doctors into general practice.

“The chancellor’s announcement of £325m of funding for some STPs is unlikely to go far enough, and we know that the plans need at least £9.5bn of total capital funding to be delivered successfully.

“Our health service is one of the best in the world, but is, increasingly, failing too many people for too much of the time. Put simply, the budget does not go far enough to address this.”

Chris Ham, Chief Executive of The King’s Fund

“The additional money announced today is welcome recognition of the huge pressures facing social care. It will provide some short-term relief for older and disabled people, families and carers who are being let down by the current system.

“The plan to publish a green paper on the future of social care funding is encouraging, but we have been here before. This time, the government must break the mould and deliver the radical reforms that are so badly needed.

“A starting point for this should be the report of the Barker Commission, which recommends a new settlement for health and social care and a single budget to put them both on a sustainable footing for the future. This will need to be funded by reforms to existing benefits paid to older people, increases in national insurance and changes to taxation.

“Our recent report highlighted lack of capital funding as a significant barrier to the success of STPs so on the face of it the decision to make money available to invest in the most promising plans is a step in the right direction.

“This winter the NHS has been buckling under the strain of meeting rising demand for services and maintaining standards of care. The Chancellor must address this in his autumn Budget or be honest with the public about the standards of care they can expect with the funding the NHS has been given.”

Niall Dickson, Chief Executive of the NHS Confederation

“This is good news – on social care the Government has finally woken up to what many of us have been saying for some time – that hospitals and community services are desperately struggling, and that huge numbers of vulnerable older people are receiving inadequate or non-existent care.

“The extra funding will definitely help, but we await the details. We also welcome the announcement of a Green Paper on the long-term funding of social care – let us hope this time it results in action and not more words.

“The promise of additional capital funding to support local transformation plans is also welcome, but again we await the detail. Without this money it will be impossible to develop the new services that are so desperately needed.

“We now urge the Chancellor to continue listening. While the social care review is important we believe there is a need for a wider cross-party consensus based on objective evidence about what funding is needed for both health and social care over the longer term and how this should be paid for.

“The NHS and local government need to find new ways of working and of working together, which embrace prevention and help to keep people healthy for longer, thereby reducing pressure on overstretched services. The current system is not fit for purpose and it is time we all admitted it.”

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