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We have good-quality social care provision in Bury, and have been ranked among those at the top in Greater Manchester for a number of years. The clinical commissioning group and the local authority work hard with external providers, with a supportive approach to quality assurance. This ensures that CQC ratings for our provider market continue to be good, and have focused on building positive relationships with them. This quality approach impacts positively on the health system too, as Bury has the second lowest admissions to hospital of older people in Greater Manchester. That means admissions are avoided, which is better for both the person and the public purse.
The integration of health and social care in terms of both delivery and commissioning is being embraced in Bury, and is really important to provide a holistic approach to people, their carers and families. Bury has created a local care organisation, with £19.2 million of Government money. Integrated neighbourhood teams are a key part of delivery for people in neighbourhoods, bringing together social care, community health and primary care. This approach avoids duplication and gives streamlined services to people. This, coupled with a preventive approach, along with population health improvement priorities, is the long-term answer to demand in the NHS, in my opinion.
Greater Manchester devolution brings together local authorities and the NHS in terms of community leadership and frontline delivery. This is very different from the rest of the country, where CCGs are merging to create strategic transformation partnerships on huge footprints. This local approach in Greater Manchester recognises the significance of the wider determinants of health in managing long-term health issues. However, in my opinion, the lack of a long-term funding solution for social care is the Achilles heel. Council tax solutions are not the answer. For example, places such as Bury, which has a faster-growing older population than the rest of Greater Manchester and therefore greater health needs in the long term, are unable to raise the amount of funding needed locally.
The national living wage—an excellent concept, if unfunded—puts additional pressure on councils’ social care budgets, since they have to pass on uplifts that reflect the pay rates of the people delivering care. This does create significant financial issues in the social care system, in what is already a pressurised set of services, due to the demands from the numbers of people and the ageing population, which, as I say, is growing faster in Bury than in the rest of Greater Manchester.
As we have heard, the workforce is as big an issue, if not bigger, for social care as for the national health service. Although the news about the increasing number of nurses is welcome across the health and care economy as a whole, those working in the private provider sector of social care have been overlooked in recent announcements, and recruitment and retention may therefore be even more difficult than they are already.
The final point I wish to make is that temporary funding, even when relatively long term through the better care fund and the improved better care fund—this year, it has provided £18.5 million of funding to my local authority—is not helpful for a system that is demand-led and has to ensure that it provides value for money wherever possible. A more certain and improved settlement for social care would ensure that longer-term planning can be put in place.