by Robert Armour
Cost comes before quality says report
VOLUNTARY organisations should be more involved in the delivery of social care after a report blamed the public sector for poorly organising and badly planning care services across the country.
An Audit Scotland report says councils and NHS boards must improve the planning and organisation of care services if they are to achieve better quality care.
The report says voluntary and private organisations provide a substantial amount of social care to people in Scotland, and councils and their partners should be working more closely with them.
Audit Scotland found that councils spend too much on people with intensive needs at the expense of those who needed less intensive support.
Councils currently spend £3 billion a year on social care services but with social care planning becoming more complex because of rising demand and reduced budgets, the public sector needs to take a different approach to commissioning care services, says the report.
It states: “Councils…have been slow to develop strategic commissioning. Only 11 of 32 council areas had commissioning strategies covering all social care services. Most…did not include an analysis of local needs.”
The report adds: “There is a risk that councils focus too much on reducing costs when procuring services and give insufficient regard to the range and quality of services and their impact on individuals.”
It found that none of the commissioning strategies analysed explained how information about quality or cost was used to make decisions about allocating services either in-house or externally.
The report lends weight to calls made by the Coalition of Care and Providers Support Scotland (CCPS) for more robust government action on commissioning, as Audit Scotland found “little evidence of significant improvements” since a series of Social Work Inspection Agency performance inspections began more than eight years ago.
Annie Gunner Logan, director of CCPS, said the report bears out the long-standing concerns of voluntary organisations over shortcomings of commissioning and procurement.
“Councils have the key responsibility of ensuring that care and support services meet local needs, are of good quality and make a positive difference to people’s lives. This report makes it clear that they cannot do this without a robust commissioning strategy in place, otherwise decision-making will be dominated by the need to cut costs.
“Voluntary organisations have borne the brunt of this failure to take a strategic approach to commissioning, as they have been placed under severe pressure from councils to cut costs without adequate consideration of the impact that this will have on the quality of care, the range of support available and the impact on the individuals and families who rely on it. This report helpfully highlights the risks of continuing with this approach, and contains important recommendations for urgently-needed improvements.”
Auditor General for Scotland Robert Black said the plans for bringing health and social care closer together mean that major changes lie ahead for these services.
“The self-directed support legislation should give people greater choice and control over their care packages.
“However, if these changes are to work well, it is essential that councils and health boards improve the planning and commissioning of care services.”
A Scottish government spokesman said: “We recognise that we must always strive to continually improve the delivery of care and that we need to make better use of the resources we commit to health and social care in Scotland.”