Adult Social Care Activity and Finance Report, England - 2019-20

This is the fourth year in which the adult social care activity and finance data have been brought together in an official statistics report.

Activity data is sourced from the Short and Long Term (SALT) return, while finance data is taken from the Adult Social Care Finance Return (ASC-FR). In previous years, the report included analysis of the Deferred Payments Agreement (DPA) collection. This is now a separate publication which is due for release in the new year.  

This report presents the main themes only, based on mandatory data, at England level. Regional and local analysis can be found in the publication reference tables.. The full data collected including voluntary elements of the data are available in both Excel and CSV format is available.  

Further information around the data collections is available. 

NHS Digital plans to continue to develop and release user friendly outputs relating to this data.

Adult social care activity provided or arranged by local authorities covers a wide range of services including long term and short-term care, plus support to carers. Clients may take a variety of different pathways through the system, according to their needs.

This report will look in detail at the breakdown of expenditure by local authorities on adult social care, and the activity that is provided or arranged by the local authorities. As such, it does not cover adult social care activity and expenditure that is provided or funded elsewhere, for example, if the care is arranged and funded by the client without any involvement from the local authority.

While the two collections have been designed to be as complementary as possible, there are some differences in how data is categorised and so direct comparisons between the two sources should be made with care.

It is possible however, to consider broader similarities and differences in the trends shown in the data. For more information see the “How can the data be used?” section below.

Where there are differences in the definitions used between the collections these will be clearly pointed out in this document, and you can also find further information in the Equalities and Classifications standard (EQ-CL) which sets out the definitions for each of the collections, as well as within the guidance documents for each collection. If you require any further information about how the data used in this report can be compared, please contact us at [email protected].

The finance elements of this report focus primarily on gross current expenditure. This is defined as the total expenditure less capital charges, and less all income except for client contributions.

Finance data within the commentary of this report is rounded to the nearest million. Figures in billions are reported to one decimal place.

Activity data within the commentary of this report is rounded to the nearest five.

Percentages are rounded to one decimal place.

All data is collected from Councils with Adult Social Services Responsibilities (CASSRs) in England, however for ease of reading CASSRs will be referred to as local authorities throughout this report.

This is an annual publication and the next release with 2020-21 data is planned for autumn 2021.

For the 2019-20 collections NHS Digital used inbuilt validation checks within the data templates and post-submission data quality reports for each collection to identify logical inconsistencies in the data, and where the data submitted is an outlier against either local and national data or against submissions from previous years. Local authorities could then review and resubmit data ahead of the deadline or provide explanations for any identified issues.

Both the SALT and ASC-FR data returns contain complex elements and this, combined with the aggregate nature of the collections, means that some data quality issues are not always immediately apparent. Furthermore, the annual nature of the collections means that any issues with the submitted data can sometimes take a while to be identified and worked through with local authorities.

Through the respective collection Working Groups, NHS Digital work with local authorities and other stakeholders to continually develop the data template and the accompanying guidance documents to improve clarity and ease of completion. A DHSC project to convert the current aggregate return for social care activity to client level is currently underway. The envisaged benefits are increased value from the data collected, both through wider and more flexible availability of social care data together with the health links; a simpler return leading to reduced burden; and greater flexibility for future developments than aggregate returns such as SALT allow. DHSC and NHS Digital have engaged with all parts of the system, including all system suppliers, LGA, ADASS, NHS England and a range of individual LAs. Further information is available here https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2020#letters-to-social-services

This year, we were advised:

• Although deadlines were extended to support local authority colleagues, quality assurance to the same extent as previous years was not possible.
• In some authorities, locally introduced changes to methodology meant that 2019-20 data was more accurate but that year on year changes were no longer comparable.
• Some authorities advised that they were unable to make all contacts to check whether clients were still at home 91 days after discharge (affecting table STS004).

Users should be aware of the following data quality issues when reading this report, which are frequently raised by local authorities:

• Limitations with case management systems for reporting of some data items, particularly around full cost clients.
• Several local authorities have mentioned difficulties obtaining and/or quality assuring data from third party organisations such as mental health or carer data.
• Allocating expenditure by Primary Support Reason (PSR) in the ASC-FR can be challenging as many finance systems are not configured to collect this data.

Throughout the report we will identify data quality issues where appropriate to aid user interpretation. Further detail on the data quality of both collections can be found in the accompanying data quality summary.