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Publication, Part of

Adult Social Care Activity and Finance Report, England - 2020-21

National statistics, Official statistics

National Statistics

Current Chapter

Adult Social Care Activity and Finance Report, England - 2020-21


Summary

This publication contains data taken from the Adult Social Care Finance Return (ASC-FR) and Short and Long Term (SALT) collection to provide information regarding adult social care activity and finance on local authorities in England for 2020-21.

This is the seventh year of the SALT and ASC-FR collections, and the fifth year in which the adult social care activity and finance data have been brought together in an official statistics report.

This report contains aggregate information submitted by 151 Councils with Adult Social Services Responsibilities (CASSRs) in England, to provide insight into adult social care activity and expenditure for the period 1 April 2020 to 31 March 2021.

Adult Social Care, like many public services, has been impacted considerably by the coronavirus (COVID-19) pandemic. Operationally, local authorities will have responded to these challenges differently; some services may have been paused due to restrictions, or to support other activities, and the associated spend and activity may have been captured locally in different ways. As such, even though NHS Digital is collecting the same data, the pandemic is affecting trends and making comparisons over time difficult.

Many year on year changes have been influenced by the pandemic, for example by the increased funding made available, and as local authorities worked out the best response in their area, 2020-21 data is also likely to be subject to more local variation than in previous years. NHS Digital have worked closely with local authorities throughout, gathering extra context on how the pandemic has impacted both provision and reporting.

Some of the known strengths and limitations associated with this year’s data, directly as a result of COVID-19, are listed below so that users of the data can consider this as they read through the key findings and analysis. Further detail will be referenced alongside the relevant analysis and where local authorities have made us aware of specific issues affecting their provision/data, these are listed in the accompanying data quality outputs. There may be other issues which have impacted a local authority’s data which we have not been aware of, so this should also be taken into consideration.

• From 19 March to 31 August 2020 the government, via the NHS, paid for new or extensions of existing packages of care and support for patients discharged from hospital or who would otherwise have been admitted to hospital. Although the SALT collection does not typically capture clients supported by the NHS, a decision was taken to include activity funded under these COVID-19 hospital discharge arrangements, so long as it met the definition of care provided under the Care Act and was commissioned by the LA. This may mean that more clients were included in the collection over the reporting period; local authorities also told us that some of these clients would have been supported by the local authority anyway so the impact of this may vary from authority to authority.

• Local authorities told us that resource was reallocated to focus on the most appropriate support. As the SALT collection does not cover a complete picture of activity, this means that reductions against one service line would not necessarily be offset by an increase elsewhere in the collection.

• Lockdown restrictions meant that some services e.g. day centres had to close. In many cases, local authorities told us that online support and contact was still available but not everyone may have accessed it. This means that clients are still included in the SALT figures as they continue to be supported by the LA however the support may be through a different means than usual.

• All adult social care COVID-19 related costs should be captured in ASC-FR. Whilst separate lines have been added to the RO return for new COVID-19 associated categories, these could not be added to the ASC-FR data collection at short notice due to the associated timescales required by the change process without impacting the timeliness of this published data. It is acknowledged that some of the spending (for example, on activity funded under COVID-19 hospital discharge arrangements, or where grant funding is passported directly to a care provider) may not directly relate to people whose care is supported by the local authority however a decision was taken that given the increased funding, these costs should be included for completeness, reported under Commissioning and Service Delivery, as this is Adult Social Care sector support, through local authorities. This means that year on year overall totals are not directly comparable.

• Some local authorities told us they were supporting care homes through payments based on care plans, or block bookings, rather than the actual weeks of care delivered. This means that some weekly costs of care (Unit costs) in ASC-FR could be distorted as a result of this sector support.


The England-level statistics for 2020-21 have been estimated as one local authority was not able to submit for SALT and two for ASC-FR.

In 2020-21:

Gross current expenditure

Gross current expenditure on adult social care by local authorities was £21.2 billion. This represents an increase of £1.6 billion from the previous year, a 8.1% increase in cash terms and a 1.3% increase in real terms, although as noted above, some of the spending in 2020-21 does not directly relate to people whose care is supported by the local authority and so overall totals are not directly comparable. This is influenced by an increase in government funding in 2020-21 specifically to support the adult social care sector during the COVID-19 pandemic; reported income from Specific and Special Grants increased by £1.5 billion over the same time period.

Expenditure on long term support

Almost three quarters (73.6% or £15.6 billion) of total gross current expenditure is spent on long term support, and this is the first year more money has been spent on clients aged 18-64 receiving long term support, rather than those aged 65 and over,  since the collection began in 2014-15.

Long term support

2020-21 saw the first year-on-year increase in clients supported, up 2,715 to a total of 841,245 clients. This may be influenced by the inclusion of activity funded under COVID-19 hospital discharge arrangements, as mentioned above.

 

Overall, the number of clients receiving long term care has been decreasing each year since 2015-16. This downward trend has been mainly driven by a decrease in clients aged 65 and over receiving long term care, down 35,945 to 551,550 since 2015-16.

Requests for support

1.9 million requests for adult social care support from 1.3 million new clients, for which an outcome was determined in the year, were received by local authorities in 2020-21. This is equivalent to 5,250 requests for support received per day by local authorities.



Last edited: 20 October 2021 1:23 pm