Select Committee on Health Memoranda

MEMORANDUM BY THE DEPARTMENT OF HEALTH (CONT.)

(iii)   Could the Department provide figures on how many people were removed from waiting lists for day case treatment and for in-patient treatment (a) because of admission for treatment and (b) for reasons other than treatment? How many people were self-deferred in each six-month period since September 1988? What rules apply to ensure consistent interpretation of these figures? Has the Department made any assessment of the extent to which people removed for reasons other than treatment in that hospital had either been admitted, died, treated in another hospital, or no longer required treatment?

  6.  Table 4.15.10 shows the total number of admissions and removals at six-monthly intervals from September 1998 to March 2000. Information on admissions and removals in 1997-98 is only available for the 12-month period between April 1997 and March 1998. The information collected centrally does not differentiate between the reasons for removal. It is therefore not possible to assess the extent to which patients have been removed for any particular reason.

  7.  Table 4.15.11 shows the number of patients who had self-deferred at six-monthly intervals from September 1988 to March 2000.

  8.  The NHS Data Manual has included the following definitions since November 1996:

(i)  Removals other than admissions

"A count of Elective Admission List Entries removed from the Elective Admission List during the period, for reasons other than admission. These are identified as entries that were removed on an Elective Admission List removal Date within the reporting period having an Elective Admission List Removal Reason of Patient admitted as an emergency for the same condition, Patient died or Patient removed for other reasons. It does not include suspended patients as they have not been removed from the Elective Admission List."

(ii)  Deferred admission

"A count of all Patients on an Elective Admission List at the census date who have had an Offer of Admission during the period who are self-deferred and who are still waiting for admission. The figures are split into those intended to be treated as ordinary admissions and those intended to be treated as day case admissions . . . Patient who have self-deferred a planned admission are excluded from this return.".

  Information on the extent to which people who are removed from waiting lists for reasons other than treatment, such as death, treatment in another hospital or no longer requiring treatment, is not available. However, anecdotal evidence suggests that the most frequent reason for removal was because the patient no longer wanted or required surgery.

Table 4.15.10

NUMBERS OF ADMISSIONS AND REMOVALS

England by specialty
	Ordinary		Day Case
6 months to:	Admitted	Removed	Admitted	Removed
Sep-88	941,363	72,131	359,213	18,419
Mar-89	938,864	86,256	392,646	23,871
Sep-89	959,516	92,715	420,536	26,784
Mar-90	934,164	109,963	454,266	31,041
Sep-90	910,557	101,572	465,603	36,409
Mar-91	888,291	125,408	496,554	43,510
Sep-91	918,376	115,338	534,998	47,616
Mar-92	938,842	157,759	601,316	67,267
Sep-92	901,687	124,675	638,905	67,044
Mar-93	879,834	139,707	691,201	80,873
Sep-93	829,580	131,708	712,016	85,040
Mar-94	800,632	137,604	768,249	97,207
Sep-94	796,780	136,907	849,379	111,295
Mar-95	804,411	143,757	925,446	129,361
Sep-95	763,117	128,408	943,405	131,830
Mar-96	767,412	139,901	1,026,419	147,724
Sep-96	761,967	132,833	1,056,084	154,879
Mar-97	683,421	117,203	1,047,602	147,084
Sep-97	*	*	*	*
Mar-98	*	*	*	*
Sep-98	687,330	134,836	1,189,074	194,417
Mar-99	682,511	136,383	1,267,592	206,796
Sep-99	662,461	120,560	1,175,154	175,132
Mar-00	628,114	130,814	1,216,451	196,281
In the year 1997-98, information was collected annually only. Source: KH06. NHS Trust-based figures.

Table 4.15.11

NUMBER OF SELF-DEFERRALS

Number at:	Ordinary	Ordinary Day Case
Sep-88	40,753	8,433
Mar-89	37,098	8,769
Sep-89	38,224	9,905
Mar-90	36,441	9,735
Sep-90	39,274	11,865
Mar-91	36,115	11,998
Sep-91	33,868	12,469
Mar-92	30,965	13,151
Sep-92	35,992	18,134
Mar-93	35,800	19,095
Sep-93	41,550	24,142
Mar-94	39,189	25,185
Sep-94	43,538	34,946
Mar-95	42,188	37,152
Sep-95	45,004	42,650
Mar-96	45,112	44,908
Sep-96	46,876	49,632
Mar-97	46,022	49,390
Sep-97	(2)	(2)
Mar-98	56,633	64,522
Sep-98	42,330	52,928
Mar-99	40,098	50,667
Sep-99	38,955	50,398
Mar-00	36,270	44,771
Source: KH07A. NHS Trust-based figures.

Footnotes:

1.  The numbers above relate to the position on the last day of the six month period and do not represent the total number throughout the period.

2.  In the year 1997-98, information was collected annually only.

(iv)   Could the Department provide charts and figures showing how trends in emergency and waiting list, booked and planned activity have moved with waiting lists sizes since June 1991? Could the Department provide both indices and actual numbers in each case?

  9.  Tables 4.15.12(a) and 4.15.12(b) and Figure 4.15.2 show growth in non-emergency (waiting list, booked and planned) and emergency activity (FFCEs), and change in waiting list size, since the quarter ending 30 June 1992, the first quarter for which data are available. Table 4.15.12(a) provides indices and table 4.15.12(b) provides actual numbers.

  10.  Hospital Episode Statistics (HES) are the only data source that is broken down by age. The routine data returns for waiting list figures used in the rest of this report are not. Table 4.15.13 shows the numbers of emergency and elective admissions distributed by age on a quarterly basis between the quarter ending June 1988 and the quarter ending December 1999 (the latest quarter for which data are available).

Table 4.15.12(a)

TRENDS IN NON-EMERGENCY AND EMERGENCY ACTIVITY AND WAITING LISTS

(Indices)

Quarter ended:	Non Emergency Activity (3)	Emergency Activity(2)	Waiting Lists
30-Jun-92	100	100	100
30-Sep-92	103.94	101.26	100.29
31-Dec-92	103.64	101.33	104.28
31-Mar-93	100.36	104	106.18
30-Jun-93	103.87	102.48	108.78
30-Sep-93	107.13	104.27	110.14
31-Dec-93	102.66	111.95	113.74
31-Mar-94	118.6	111.18	113.69
30-Jun-94	111.38	107.74	114.99
30-Sep-94	115.74	110.03	114.31
31-Dec-94	120.2	113.04	114.24
31-Mar-95	122.31	117.28	111.42
30-Jun-95	118.41	113.58	112.37
30-Sep-95	122.71	115.46	111
31-Dec-95	127.2	119.76	112.58
31-Mar-96	128.88	120.29	111.84
30-Jun-96	123.51	118.32	112.71
30-Sep-96	128.1	119.24	113.29
31-Dec-96	127.72	124.1	117.92
31-Mar-97	123.87	128.7	123.58
30-Jun-97	127.89	125.23	126.99
30-Sep-97	128.14	124.26	128.86
31-Dec-97	128.58	128.58	134.67
31-Mar-98	128.46	130.19	138.48
30-Jun-98	134.05	130.28	137.4
30-Sep-98	138.18	131.42	129.54
31-Dec-98	143.09	134.52	125.24
31-Mar-99	140.05	131.69	114.49
30-Jun-99	139.8	128.18	116.78
30-Sep-99	138.37	137.5	115.7
31-Dec-99	140.24	132.51	118.24
31-Mar-2000(1)	138.82	135.21	110.67

  Footnotes:

  (1)  Activity figures for this quarter are provisional.

  (2)  From 30 June 1998, Activity Growth is calculated on an FFCE basis.

  (3)  Non-emergency activity includes waiting list, booked and planned cases.

  (4)  Non-emergency activity is General and Acute data and does not include mental illness, learning disabilities or maternity services.

  Source: KH07. NHS Trust-based figures.

Table 4.15.12(b)

TRENDS IN NON-EMERGENCY AND EMERGENCY ACTIVITY AND WAITING LISTS

(Numbers)

Quarter ended:	Non Emergency Activity(b)(3)	Emergency Activity(b)	Waiting Lists
30-Jun-92	981,957	872,708	937,054
30-Sep-92	1,020,636	883,690	939,740
31-Dec-92	1,017,679	884,309	977,189
31-Mar-93	985,497	907,634	994,974
30-Jun-93	1,019,957	894,331	1,019,341
30-Sep-93	1,051,939	910,002	1,032,038
31-Dec-93	1,008,035	977,025	1,065,782
31-Mar-94	1,164,645	970,297	1,065,369
30-Jun-94	1,093,753	940,268	1,077,497
30-Sep-94	1,136,546	960,246	1,071,101
31-Dec-94	1,180,335	986,505	1,070,492
31-Mar-95	1,201,065	1,023,507	1,044,051
30-Jun-95	1,162,722	991,240	1,052,958
30-Sep-95	1,205,006	1,077,671	1,040,152
31-Dec-95	1,249,028	1,045,154	1,054,948
31-Mar-96	1,265,566	1,049,798	1,048,029
30-Jun-96	1,212,800	1,032,586	1,056,122
30-Sep-96	1,257,872	1,040,616	1,061,557
31-Dec-96	1,254,142	1,083,026	1,104,983
31-Mar-97	1,216,321	1,123,184	1,158,004
30-Jun-97	1,255,793	1,092,854	1,189,962
30-Sep-97	1,258,232	1,084,452	1,207,515
31-Dec-97	1,262,579	1,122,136	1,261,915
31-Mar-98	1,261,398	1,136,207	1,297,662
30-Jun-98	1,287,139	955,677	1,287,543
30-Sep-98	1,326,860	964,083	1,213,839
31-Dec-98	1,373,930	986,805	1,173,598
31-Mar-99	1,344,775	966,029	1,072,860
30-Jun-99	1,342,389	940,257	1,094,251
30-Sep-99	1,328,651	1,008,663	1,084,157
31-Dec-99	1,346,609	972,042	1,108,006
31-Mar-2000(1)	1,332,952	991,864	1,037,066

  Footnotes:

  (1)  Activity figures for this quarter are provisional.

  (2)  From 30 June 1998, Activity is measured on an FFCE basis. Prior to that it was measured on an FCE basis.

  (3)  Non-emergency activity includes waiting list, booked and planned cases.

  (4)  Non-emergency activity is General and Acute data and does not include mental illness, learning disabilities or maternity services.

  Source: KH07. NHS Trust-based figures.

Table 4.15.13

DISTRIBUTION OF ELECTIVE AND EMERGENCY ADMISSIONS BY AGE

Quarter	Number of Admissions Age 0-18		Number of Admissions Age 19-64		Number of Admissions Age 65 and over		Number of Admissions Age Not Known		Number of Admissions All Ages
	Elective	Emergency	Elective	Emergency	Elective	Emergency	Elective	Emergency	Elective	Emergency
Q1 1989-90	121,427	154,907	531,904	313,526	226,491	266,432	2,276	2,433	882,099	737,301
Q2 1989-90	120,475	154,082	501,924	327,918	223,348	262,101	2,150	2,543	847,897	746,645
Q3 1989-90	113,161	177,293	514,515	330,653	219,667	306,424	2,116	3,398	849,458	817,769
Q4 1989-90	122,789	149,380	550,167	297,634	221,154	236,239	719	1,552	894,829	684,806
Q1 1990-91	124,474	164,599	558,510	346,584	245,162	293,165	613	1,222	928,759	805,570
Q2 1990-91	122,169	158,110	523,995	340,759	238,951	273,810	586	1,078	885,701	773,757
Q3 1990-91	117,124	159,972	522,452	329,088	238,576	290,854	690	1,440	878,843	781,354
Q4 1990-91	116,584	142,226	501,639	285,950	215,177	244,355	645	2,179	834,044	674,710
Q1 1991-92	127,759	150,926	568,397	330,307	258,666	285,652	1,046	2,315	955,868	769,200
Q2 1991-92	134,584	157,046	573,245	345,473	268,039	279,625	1,165	2,361	977,034	784,505
Q3 1991-92	128,034	173,962	578,584	342,186	265,935	307,072	1,107	2,515	973,659	825,736
Q4 1991-92	135,570	149,262	612,288	309,501	266,144	264,466	862	2,095	1,014,871	725,354
Q1 1992-93	136,431	157,654	595,314	348,183	282,832	302,464	792	1,549	1,015,382	809,911
Q2 1992-93	140,679	150,341	600,983	358,884	292,521	297,541	813	1,527	1,035,012	808,343
Q4 1992-93	133,211	158,133	600,135	349,255	290,543	321,557	688	1,662	1,024,589	830,674
Q1 1993-94	133,568	167,740	622,114	326,621	287,856	284,664	564	1,535	1,044,113	780,622
Q2 1993-94	132,725	155,817	617,993	359,533	301,433	319,234	421	961	1,052,572	835,545
Q3 1993-94	139,688	156,254	635,406	371,276	317,736	317,032	479	985	1,093,309	845,548
Q4 1993-94	131,165	178,445	630,514	365,202	309,393	357,581	532	1,556	1,071,605	902,784
Q1 1994-95	141,398	163,277	681,702	336,856	319,843	295,989	404	860	1,143,347	796,982
Q2 1994-95	136,880	163,707	666,647	362,466	329,307	326,314	835	659	1,133,670	853,146
Q3 1994-95	144,513	157,082	689,135	374,774	345,903	321,793	163	302	1,179,714	853,951
Q4 1994-95	138,680	176,119	692,574	372,767	346,367	342,078	143	280	1,177,764	891,244
Q1 1995-96	142,110	164,686	732,194	341,163	349,564	304,162	131	191	1,223,999	810,202
Q2 1995-96	139,890	170,774	706,519	372,869	345,021	334,320	304	644	1,200,733	878,608
Q3 1995-96	144,458	165,440	716,404	394,590	370,561	330,479	308	735	1,231,732	891,243
Q4 1995-96	136,595	190,195	717,395	384,804	366,933	368,978	236	701	1,221,158	944,679
Q1 1996-97	142,708	165,081	755,300	348,394	371,228	314,233	226	673	1,269,468	828,403
Q2 1996-97	140,010	169,273	728,891	372,995	377,556	342,434	570	1,041	1,247,044	885,809
Q3 1996-97	144,976	162,558	728,280	384,516	397,285	340,631	586	1,033	1,271,142	888,801
Q4 1996-97	134,453	177,599	718,344	382,176	387,904	373,654	627	1,045	1,241,344	934,540
Q1 1997-98	129,613	170,246	686,603	348,589	360,368	327,546	647	749	1,177,240	847,177
Q2 1997-98	137,789	175,244	740,554	385,369	412,086	354,167	1,723	756	1,292,152	915,516
Q3 1997-98	139,088	167,698	723,608	394,137	416,931	350,093	2,282	721	1,281,909	912,649
Q4 1997-98	128,395	184,974	697,500	382,935	399,500	365,031	2,598	867	1,227,993	933,807
Q1 1998-99	132,134	176,555	718,354	361,707	397,560	335,501	2,721	1,159	1,250,769	874,922
Q2 1998-99	134,614	172,362	734,438	393,052	409,339	362,381	3,091	949	1,281,482	928,744
Q3 1998-99	145,295	164,513	783,642	403,168	443,348	354,797	3,692	1,058	1,375,977	923,536
Q3 1998-99	135,747	189,994	775,578	398,649	436,867	389,757	3,284	969	1,351,476	979,369
Q4 1998-99	138,471	176,545	801,883	366,511	438,141	338,533	3,664	1,005	1,382,159	882,594
Q1 1999-2000	113,045	140,153	630,892	314,513	357,074	269,916	3,326	1,273	1,104,337	725,855
Q2 1999-2000	109,085	125,009	588,744	299,910	335,896	245,352	2,706	1,194	1,036,431	671,465
Q3 1999-2000	107,603	146,323	616,810	308,140	353,073	275,318	5,246	2,426	1,082,732	732,207

  Source: Department of Health Hospital Episode Statistics.

(v)   Can the Department provide a comparison of total numbers of people waiting for outpatient appointments for each year for which figures are available, separately identifying trends in the average wait for an outpatient appointment?

  11.  Table 4.15.14 shows the average waiting times for first outpatient appointments at each quarter since the quarter ending 30 March 1995 and the number of attendances for the same period. Data on total numbers of people waiting for outpatient appointment are not collected centrally.

Table 4.15.14

AVERAGE WAITING TIMES AND NUMBER OF ATTENDANCES FOR FIRST OUTPATIENT APPOINTMENTS

Date	Median waiting time (weeks)	Outpatients Seen after first referral	Total first attendances seen
Q4 1994-95	6.05	2,003,009	2,569,639
Q1 1995-96	6.01	1,804,047	2,415,897
Q2 1995-96	6.31	1,847,550	2,524,893
Q3 1995-96	6.07	1,904,043	2,566,011
Q4 1995-96	6.02	2,010,250	2,715,403
Q1 1996-97	6.13	1,869,782	2,577,036
Q2 1996-97	6.18	1,893,711	2,635,007
Q3 1996-97	6.05	1,921,448	2,650,807
Q4 1996-97	6.05	1,880,221	2,642,116
Q1 1997-98	6.17	1,904,564	2,689,803
Q2 1997-98	6.37	1,896,900	2,675,010
Q3 1997-98	6.25	1,888,560	2,663,871
Q4 1997-98	6.27	1,919,032	2,732,305
Q1 1998-99	6.49	1,827,140	2,660,499
Q2 1998-99	6.8	1,881,607	2,739,913
Q3 1998-99	6.89	1,849,358	2,732,047
Q4 1998-99	6.99	1,929,607	2,803,960
Q1 1999-00	7.09	1,837,726	2,714,179
Q2 1999-00	7.31	1,907,904	2,798,366
Q3 1999-00	7.32	1,935,766	2,791,712
Q4 1999-00	7.58	2,029,867	2,955,739

  Source: QM08. NHS Trust-based figures

 (vi)   Can the Department estimate the number of people at each access point of the elective care system broken down to show:

(a)  numbers of GP consultations;

(b)  numbers of referrals to specialist outpatient clinics;

(c)  numbers of attendances at specialist outpatient clinics;

(d)  numbers of placements on waiting lists (differentiated by (i) waiting list, (ii) booked and (iii) planned); and

(e)  numbers of elective episodes of care, for each year since 1991-92?

Would the Department provide a commentary on changes over time in numbers waiting at each stage, and the conversion rates between each stage.

  12.  Table 4.15.15 shows the estimated total number of NHS GP consultations in England for each year between 1988 and 1998 (the latest date for which data are available). The estimates are prepared using:

(i)  General Household Survey (GHS) data.

(ii)  Patient data from the GMS census, as at 1 October each year.

  13.  Data are not available for 1997, as there was no General Household Survey (GHS) that year.

  14.  Table 4.15.16 shows the number of referrals for first outpatient appointments for each quarter since the quarter ending 30 June 1994.

  15.  Table 4.15.17 shows the number of attendances at first outpatient appointments for each quarter since the quarter ending 30 June 1994.

  16.  Table 4.15.18 shows the number of placements on waiting lists on a quarterly basis since the quarter ending June 1991. Data on numbers of placements on waiting lists differentiated by waiting list, booked and planned are not collected centrally.

  17.  The first column of Table 4.15.12(b) shows the number of elective episodes of care (waiting list, booked and planned) on a quarterly basis for each year between 1992-93 and 1999-2000. The quarter ending 30 June 1992 is the first quarter for which data are available.

Table 4.15.15

ESTIMATED TOTAL NUMBER OF NHS GP CONSULTATIONS IN ENGLAND PER YEAR

Year	Total Consultations (to the nearest 1,000)
1988	235,136,000
1989	255,801,000
1990	277,672,000
1991	240,627,000
1992	256,334,000
1993	284,868,000
1994	261,126,000
1995	270,032,000
1996	285,314,000
1997	—
1998	258,130,000

  Source: The consultation estimates are prepared using General Household Survey (GHS) data and patient data from the GMS census (as at 1 October each year).

Table 4.15.16

NUMBERS OF REFERRALS FOR FIRST OUTPATIENT APPOINTMENTS

Referrals for OP first appointment	GP	Other	Total
Q1 1994-95	1,819,356	340,342	2,159,698
Q2 1994-95	2,058,341	432,163	2,490,504
Q3 1994-95	1,993,288	424,785	2,418,073
Q4 1994-95	2,125,033	483,637	2,608,670
Q1 1995-96	2,099,599	533,989	2,633,588
Q2 1995-96	2,106,128	612,662	2,718,790
Q3 1995-96	2,104,220	564,372	2,668,592
Q4 1995-96	2,237,686	611,431	2,849,117
Q1 1996-97	2,210,973	671,361	2,882,334
Q2 1996-97	2,186,112	716,096	2,902,208
Q3 1996-97	2,138,072	745,217	2,883,289
Q4 1996-97	2,156,999	744,826	2,901,825
Q1 1997-98	2,328,045	824,647	3,152,692
Q2 1997-98	2,224,809	818,214	3,043,023
Q3 1997-98	2,153,204	837,943	2,991,147
Q4 1997-98	2,285,631	847,327	3,132,958
Q1 1998-99	2,301,253	847,767	3,149,020
Q2 1998-99	2,282,527	861,021	3,143,548
Q3 1998-99	2,239,178	818,292	3,057,470
Q4 1998-99	2,316,827	834,171	3,150,998
Q1 1999-00	2,317,334	863,030	3,180,364
Q2 1999-00	2,270,191	872,706	3,142,897
Q3 1999-00	2,214,415	840,426	3,054,841
Q4 1999-00	2,340,663	885,483	3,226,116

  Source: QM08. NHS Trust-based figures.

Table 4.15.17

NUMBER OF ATTENDANCES AT FIRST OUTPATIENT APPOINTMENTS

	Outpatients seen following GP referral	Total first attendances seen
Q4 1994-95	2,003,009	2,569,639
Q1 1995-96	1,804,047	2,415,897
Q2 1995-96	1,847,550	2,524,893
Q3 1995-96	1,904,043	2,566,011
Q4 1995-96	2,010,250	2,715,403
Q1 1996-97	1,869,782	2,577,036
Q2 1996-97	1,893,711	2,635,007
Q3 1996-97	1,921,448	2,650,807
Q4 1996-97	1,880,221	2,642,116
Q1 1997-98	1,904,564	2,689,803
Q2 1997-98	1,896,900	2,675,010
Q3 1997-98	1,888,560	2,663,871
Q4 1997-98	1,919,032	2,732,305
Q1 1998-99	1,827,140	2,660,499
Q2 1998-99	1,881,607	2,739,913
Q3 1998-99	1,849,358	2,732,047
Q4 1998-99	1,929,607	2,803,960
Q1 1999-00	1,837,726	2,714,179
Q2 1999-00	1,907,904	2,798,366
Q3 1999-00	1,935,766	2,791,712
Q4 1999-00	2,029,867	2,955,739

  Source: QM08. NHS Trust-based figures.

Table 4.15.18

NUMBER OF PLACEMENTS ON WAITING LISTS (DECISIONS TO ADMIT)

Quarter	Number of decisions to admit
Q1 1991-92	772,512
Q2 1991-92	793,501
Q3 1991-92	820,827
Q4 1991-92	870,775
Q1 1992-93	836,550
Q2 1992-93	858,452
Q3 1992-93	890,264
Q4 1992-93	895,002
Q1 1993-94	853,524
Q2 1993-94	869,617
Q3 1993-94	862,073
Q4 1993-94	916,501
Q1 1994-95	919,679
Q2 1994-95	924,721
Q3 1994-95	937,033
Q4 1994-95	983,974
Q1 1995-96	944,241
Q2 1995-96	967,048
Q3 1995-96	1,005,019
Q4 1995-96	1,052,517
Q1 1996-97	1,031,618
Q2 1996-97	1,034,147
Q3 1996-97	1,033,372
Q4 1996-97	1,012,374
Q1 1997-98	(1)
Q2 1997-98	(1)
Q3 1997-98	(1)
Q4 1997-98	(1)
Q1 1998-99	1,018,946
Q2 1998-99	1,063,473
Q3 1998-99	1,054,530
Q4 1998-99	1,052,374
Q1 1999-00	1,033,256
Q2 1999-00	1,042,575
Q3 1999-00	1,031,129
Q4 1999-00	1,030,425*

  * Provisional figure—requires confirmation.

   (1) In the year 1997-98, information was collected annually only.

  Source: KH06. NHS Trust-based figures.

Would the Department provide a commentary on changes over time in numbers waiting at each stage, and the conversion rates between each stage?

  18.  The total number of GP consultations for each year between 1989 and 1998 fluctuated, but remained greater than 240 million, reaching a peak of 285 million in 1996. The data in table 4.15.15 are estimates from a sample of the population and so subject to some statistical variation. The figures are best used as indicators of trends over time rather than representing accurate year-on-year changes.

  19.  During the final quarter of each year since 1994-5, the number of referrals for first outpatient appointments steadily increased from 2,608,670 during the quarter ending 31 March 1995 to 3,226,116 during the quarter ending 31 March 2000 (an increase of 23.7 per cent).

  20.  During the final quarter of each year, the number of attendances at first outpatient appointments increased from 2,569,639 during the quarter ending 31 March 1995 to 2,955,739 during the quarter ending 31 March 2000 (an increase of 15.0 per cent).

  21.  Overall, the number of placements on inpatient waiting lists increased from 772,512 during the first quarter of 1991-2 to 1,030,425 during the final quarter of 1999-2000 (an increase of 33.4 per cent).

  22.  The total number of elective episodes of care for each year increased by 33.6 per cent between 1992-3 and 1999-2000, from 4,005,769 to 5,350,601.

 (vii) What additional mechanisms have been put in place since last year's response to deal with waiting lists? How is the success of each of these measured? What assessment have you made of the effectiveness of each? What has been the cost of each of these?

  23.  Details of additional mechanisms put in place to lever change and support reductions in waiting lists and times are set out in the table below. Together, these measures have enabled the government to achieve its manifesto commitment to reduce the inpatient waiting list by 100,000 from the level inherited from the previous government. They have also supported improvements in outpatient waiting times and made services more convenient for patients.

Name of Programme	Description	Measurement of success	Assessment made of the programme's effectiveness	Cost
Direct funding to Health Authorities	Funding was provided direct to Health Authorities in 1999-2000 to support delivery of inpatient waiting list and outpatient waiting times targets	Monthly inpatient waiting lists and times figures and quarterly outpatient waiting times figures.	During 1999-2000 the inpatient waiting list was reduced by 36,000. At the end of March 2000, the Government's manifesto commitment to reduce waiting lists by 100,000 from the level inherited in the lifetime of this Parliament was achieved. The number of people waiting over 13 weeks for a first outpatient appointment following GP referral fell by 54,000 overall in 1999-2000.	£260 million
Waiting Lists and Times Performance Fund	The fund was used to support schemes designed to deliver sustainable improvements in outpatient waiting times. Bids received tackled waiting on a broad front, from providing additional capacity to initiating services in Primary Care. Every Health Authority received an allocation to reward good performance locally or tackle problems.	The money was announced in August. The number of outpatient over 13 weeks waiters fell by 16,000 in the third quarter of 1999-2000 and by 94,000 in the fourth quarter of 1999-2000.	Delivery of the scheme is being monitored by Regional Offices.	£30 million
Variations in NHS Outpatient Performance Report	This report was produced jointly by the Department of Health and the National Patients' Access Team and published in November 1999. It gives ideas for NHS Trusts to use in reducing outpatient waiting times, including a "partial booking" system that enables patients to choose a convenient appointment, based on work at two pilot sites in Basildon and Chesterfield.	Significant improvements at the two pilot sites. Recommendations have been taken up in NHS Trust outpatient improvement plans. Progress in implementing these plans will be monitored throughout the year.	Significant improvements at the two pilot sites, eg at Chesterfield hospital cancellations were reduced from 11.3% to 2.2%; Patient cancellations were reduced from 10.3% to 7.8%; DNA rates were reduced from 4.7% to 2.2%; Patient attendance increased rom 73.8% to 87.8%.	This report formed part of the National Patients' Access Team's work.
Waiting List Performance and Booked Admissions Beacons	A total of 33 Beacons were selected in 1999-2000—24 Waiting List Performance Beacons and nine Booked Admissions Beacons. The Beacons represent high quality services and contribute to the spread of good practice by hosting visits and other learning activities. The Beacons are funded for a two-year period.	Success can be measured in part by looking at the number of visits to each Beacon. In 1999-2000, a total of 742 visits were made to Waiting List Performance Beacons and Booked Admissions Beacons.	The contribution that Beacons are making to the rapid spread of good practice across the NHS will be evaluated later this year as part of the overall evaluation of the NHS Learning Network.	The total cost of the Waiting List Performance and Booked Admissions Beacons in 1999-2000 was £990,000. Each Beacon received funding of £30,000 and will receive a similar amount in 2000-01.
National Booked Admissions Programme 1999-2000	Building on the schemes established in 1998-99, a second wave of the Programme was established to further increase the number of patients able to pre-book their admission dates and/or hospital appointments. A total of 60 new pilot sites were set up. The original 24 pilots which formed the first wave of the Programme also continued into 1999-2000.	The following measures can be used to evaluate the success of the programme: coverage of booked dates; reduction in waiting lists; improvement in waiting times; improvement in DNA rates; improvement in patient cancellation rates; improvement in hospital cancellation rates.	An evaluation of the National Booked Admissions Programme is being undertaken by the Health Services Management Centre (HSMC). The HSMC published its interim report in October 1999 and the next report is due to be published in July 2000. NPAT and Regional Offices receive monthly reports from the pilot sites setting out their progress against agreed milestones.	£20 million of the £320 million Modernisation Fund was used to fund the programme in 1999-2000. Of this, £5 million was used to fund the second year of the first wave and £15 million was allocated to the first year of the second wave.
Cancer Services Collaborative	As a key component of the National Booked Admissions Programme for 1999-2000, the Cancer Services Collaborative is a programme which aims to improve access for patients with suspected or diagnosed cancer by streamlining care processes from referral through diagnosis and treatment. Work is being undertaken at nine cancer centres across the country.	Measurement is carried out at individual project level and reported monthly to NPAT.	An evaluation of the Cancer Services Collaborative is currently being undertaken by the HSMC.	£6 million over two years.
Action on Cataracts	A programme to identify best practice in the organisation of cataract services, and to disseminate this throughout the NHS in England in order to make significant improvements in access to cataract services, to improve the quality of patients' experience and to reduce variations in the provisions of services.	Number of cataract operations to reach 250,000 by 2003. By 2003, all cataract services receiving funding from the Treasury Capital Modernisation Fund (TCMF) to have a maximum waiting time of six months from referral to surgery, and to have introduced booked appointments and admissions.	117 services out of 120 applied for TCMF money. Of those who were not shortlisted, at least half have signalled their intention to carry on with modernisation of their model of service and look for other sources of capital funding. Several Regional Offices have set aside capital funding from other streams to support the Cataract Modernisation Fund.	£300,000-£100,000 for NPAT project management and £100,000 each for the two national exemplar sites. The TCMF is £20 million: £12 million in 2000-01 and £8 million in 2001-02.
Waiting List Action Team Handbook—Getting Patients Treated	Good practice guidance on managing waiting lists published in August 1999.	Improved and more consistent management of waiting lists.	Contribution to improved overall performance on inpatient and outpatient waiting lists and times.	£100,000

4.16  PERFORMANCE AGAINST KEY PATIENT'S CHARTER STANDARDS

Could the Department provide an updated version of Table 4.16 together with appropriate commentary? Could the Department explain how monitoring against Patient's Charter Standards will fit in with the new Performance Framework and High Level Performance Indicators?

  1.  The information requested is contained in table 4.16.1 below.

Table 4.16.1

SUMMARY OF PERFORMANCE IN ENGLAND AGAINST KEY PATIENT'S CHARTER STANDARDS 1999-00

	National Average
	1998-99		1999-00
National Charter Standards	QTR4	QTR1	QTR2	QTR3	QTR4
Waiting in Outpatient Clinics (percentage seen within 30 minutes)	90	(1)	(1)	(1)	88
Cancellation of Operations (number not admitted within one month of cancellation)	3,239	2,384	2,186	3,042	4,809
Emergency admission through A&E (percentage admitted within 2 hours)	79	82	82	79	76
Medical Records transferred (percentage within standards)
—Urgent	87	(1)	(1)	(1)	89
—Routine	82	(1)	(1)	(1)	71

  (1)  Monitored in Quarter 4 for all Health Authorities and in Quarter 1 to Quarter 3 by exception.

  2.  Overall, performance against the key Patient's Charter standards fell during 1999-00. When compared with the corresponding period in 1998-99, figures show that the number of breaches of the standard for urgent action following a cancelled operation increased from 3,239 in Quarter 4 of 1998-99 to 4,809 in Quarter 4 of 1999-00. This change in performance was also reflected in the standard relating to emergency admissions through A&E. However, these changes in performance should be balanced against the continuing growth in emergency care generally and consequent emergency admissions. For example, the number of general and acute non-elective (mainly emergency) hospital spells in 1999-00 increased by 0.9 per cent (Q4 estimate)—admissions through A&E Departments is estimated to have increased by over 4 per cent to 2 million—while new A&E attendances increased by 2.4 per cent to 13.1 million.

  3.  Since 1 April 1996, the waiting in outpatient clinics standard has been measured annually for those Health Authorities who achieve a satisfactory standard in Quarter 4 of the previous year. The remaining Health Authorities are required to submit returns quarterly on an exception basis. Figures show that performance against this standard fell slightly—to 88 per cent—compared to 90 per cent in the same quarter in 1998-99 and 1997-98.

  4.  Exception reporting also applies to the standards relating to Urgent and Routine transfers of medical records. In the fourth quarter of 1999-00 performance against the standard relating to Urgent transfers improved compared to the same quarter last year from 87 per cent to 89 per cent while performance against Routine transfer fell from 82 per cent to 71 per cent.

  5.  Performance against the key standards is also used to inform the new NHS Performance Assessment Framework (PAF), particularly in the area relating to Patient/Carer Experience. This is demonstrated in the High Level Performance Indicators where performance against the standards relating to Emergency Admissions through A&E ("trolley waits") and Cancelled Operations have and will continue to form a key part of the indicator set.

5.  PERSONAL SOCIAL SERVICES

5.1  Provision through PSS SSAs for year ahead

5.1  Could the Department set out the Standard Spending Assessments (SSAs) for social services in the latest year, by local authority, and SSA sub-block, in cash, per capita, per capita of relevant population and per client? Could the Department also provide a table comparing the change in the total PSS SSA between the last two years for each local authority? Could the Department describe any changes to the SSA formulae introduced in this year and provide details of any plans the Department has to review PSS SSAs further? Could the tables include sub-totals for type of authority and averages (so that individual authorities figures can be seen in context)?

STANDARD SPENDING ASSESSMENTS (SSAS) FOR SOCIAL SERVICES FOR 2000-01

  1.  Overall resources for social services increased by 5.6 per cent this financial year, more than double the rate of inflation. PSS SSAs increased by 5.1 per cent from £8,268 million in 1999-2000 to £8,693 million in 2000-2001, a cash increase of £425 million. In addition there were significant increases in the special and specific grants made available directly to local authorities social services departments by the Department of Health. The increases in grants are listed separately in response to question 5.13.

  2.  SSAs for social services for 2000-2001, by local authority and SSA sub-block, in cash, per capita and per capita of relevant population are shown in tables 5.1.1, 5.1.2 and 5.1.3. The per capita allocations for each type of authority are, in effect, averages which help to show individual authorities allocations in context.

  3.  Table 5.1.4 compares the change in the total SSA for social services between 1999-2000 and 2000-01 for each local authority.

  4.  Existing data sources do not provide information on the total number of clients receiving services, only on numbers in receipt of particular components of care. As some clients will receive more than one component of service (for example home care and meals) it is not possible to aggregate numbers for particular components to derive an estimate of overall numbers of clients. The new Referrals Assessments and Packages of Care (RAP) data collection now being introduced will help plug this gap in the data (see Question 5.10). RAP will collect data on the number of clients receiving services (provided or commissioned), by primary client type, service type and age group. The first full set of data from the RAP project will be for the financial year 2000-2001, and should be available in September 2001.

CHANGES TO THE CALCULATION OF SSAS

  5.  There were no changes to the PSS SSA resource allocation formulae for 2000-2001. Therefore, the coefficients within the formulae are unchanged. The formulae were, however, updated to take account of the latest data.

FUTURE PLANS FOR PSS-SSAS

  6.  The Department of Environment, Transport and the Regions is carrying out a three-year review of local government finance. This review is being carried out in partnership with the Local Government Association, and is considering a number of aspects of how local government is financed, including grant distribution. During the period of this review, there are no plans to make any changes to the SSA formulae (the formulae applying in 1999-2000 will be applied throughout). Where data that are more recent become available however, they will be incorporated in the SSA calculations.

  7.  The main objective of the review is to investigate whether there is a better way of determining the distribution of resources for local government, which is simpler, more stable, more robust and fairer than the present arrangements for SSAs. An initial report of the review group, setting out the alternative approaches to distributing grants, has been completed. The next step is consultation on the basis of a Green Paper to be published in the Summer. The review group is continuing to meet to discuss the alternative approaches, and once the outcome of consultation is known, it will focus on detailed development of the new system.

 Table 5.1.1 (Summary table)

THE STANDARD SPENDING ASSESSMENTS FOR 2000-2001

£ million
	(1) Elderly Residential SSA	(2) Elderly Domiciliary SSA	(3) Children's SSA	(4) Other PSS SSA	(5) Total SSA
Inner London	218.566	117.014	309.502	192.079	837.161
Outer London	295.881	165.054	263.918	203.684	928.537
London Total	514.447	282.068	573.420	395.763	1,765.698
Metropolitan Total	833.812	445.609	525.729	400.130	2,205.280
Shire Counties	1,303.374	832.870	570.033	616.339	3,322.616
Shire Unitary Authorities	497.466	300.552	328.518	273.268	1,399.805
All Shires Total	1,800.840	1,113.423	898.551	889.607	4,722.421
ENGLAND TOTAL	3,149.100	1,861.100	1,997.700	1,685.500	8,693.400

£ million
Local Authority	(1) Elderly Residential SSA	(2) Elderly Domiciliary SSA	(3) Children's SSA	(4) Other PSS SSA	(5) Total SSA
INNER LONDON
City of London	0.785	0.401	0.637	0.410	2.234
Camden	18.163	10.122	22.246	14.974	65.504
Greenwich	19.082	10.074	21.633	12.163	62.953
Hackney	19.759	9.208	29.076	17.147	75.190
Hammersmith and Fulham	12.671	6.921	17.967	12.273	49.832
Islington	17.661	8.856	26.735	14.717	67.969
Kensington and Chelsea	10.708	7.028	15.430	13.382	46.549
Lambeth	19.762	11.076	39.037	21.000	90.876
Lewisham	20.871	11.085	28.318	15.063	75.338
Southwark	20.916	11.010	35.360	18.309	85.596
Tower Hamlets	19.348	9.129	28.416	16.664	73.557
Wandsworth	20.974	11.849	23.308	17.528	73.659
Westminster	17.865	10.255	21.338	18.449	67.906
Sub-total	218.566	117.014	309.502	192.079	837.161
OUTER LONDON
Barking and Dagenham	15.687	7.371	12.559	6.773	42.391
Barnet	20.660	11.805	13.875	14.039	60.378
Bexley	13.155	7.511	8.848	7.069	36.583
Brent	15.941	7.784	21.538	15.062	60.324
Bromley	16.364	11.244	10.403	9.467	47.478
Croydon	16.425	10.395	19.217	13.852	59.888
Ealing	18.497	9.701	21.099	16.117	65.415
Enfield	18.553	10.207	14.439	10.913	54.113
Haringey	14.726	7.807	22.787	14.087	59.406
Harrow	14.151	7.468	7.902	8.143	37.664
Havering	13.853	8.193	7.240	7.050	36.336
Hillingdon	14.488	8.251	10.245	9.253	42.237
Hounslow	13.399	7.270	13.199	10.213	44.080
Kingston-upon-Thames	7.317	4.795	4.899	5.445	22.456
Merton	10.563	6.266	9.359	7.879	34.067
Newham	18.259	8.168	25.673	14.381	66.482
Redbridge	15.979	8.523	10.239	9.056	43.796
Richmond upon Thames	9.680	6.804	5.541	7.145	29.171
Sutton	10.057	6.428	7.372	6.296	30.153
Waltham Forest	18.126	9.062	17.487	11.443	56.118
Sub-total	295.881	165.054	263.918	203.684	928.537
London Sub-total	514.447	282.068	573.420	395.763	1,765.698
ENGLAND TOTAL	3,149.100	1,861.100	1,997.700	1,685.500	8,693.400
METROPOLITAN DISTRICTS
Barnsley	18.231	9.463	8.119	7.118	42.931
Birmingham	78.533	40.273	64.179	42.051	225.036
Bolton	19.189	10.070	10.872	9.196	49.326
Bradford	28.916	17.991	22.913	17.870	87.690
Bury	11.043	6.403	6.477	5.680	29.602
Calderdale	11.634	7.229	7.191	6.286	32.340
Coventry	20.409	11.120	14.907	10.936	57.372
Doncaster	20.590	10.679	11.102	9.004	51.375
Dudley	21.364	11.558	9.522	9.350	51.794
Gateshead	16.392	9.142	8.970	7.325	41.829
Kirklees	23.831	14.211	13.820	12.908	64.770
Knowsley	13.622	5.526	12.530	6.300	37.977
Leeds	47.238	28.003	28.549	25.472	129.262
Liverpool	43.646	19.839	33.142	20.529	117.156
Manchester	36.034	17.952	36.239	20.368	110.594
Newcastle upon Tyne	21.976	12.342	15.828	11.569	61.715
North Tyneside	15.592	9.147	8.316	6.571	39.626
Oldham	14.746	8.336	10.050	8.172	41.304
Rochdale	13.798	7.728	10.558	7.714	39.798
Rotherham	20.252	10.151	9.706	8.133	48.241
Salford	20.792	10.628	12.145	8.946	52.511
Sandwell	26.531	13.048	14.704	11.257	65.539
Sefton	22.137	12.966	12.164	8.819	56.085
Sheffield	45.655	24.737	21.660	19.721	111.773
Solihull	10.806	6.202	6.468	5.604	29.081
South Tyneside	13.559	7.669	8.596	5.658	35.482
St Helens	14.461	6.702	7.029	5.829	34.022
Stockport	17.659	10.529	8.882	8.416	45.486
Sunderland	23.801	12.424	13.637	10.540	60.401
Tameside	16.417	8.602	9.177	7.544	41.740
Trafford	13.562	7.765	7.622	6.782	35.731
Wakefield	23.689	11.850	10.904	10.063	56.506
Walsall	21.034	10.614	11.070	8.959	51.678
Wigan	22.900	10.961	10.411	9.804	54.076
Wirral	24.104	13.706	15.798	10.498	64.106
Wolverhampton	19.669	10.047	12.471	9.140	51.327
Metropolitan Sub-total	833.812	445.609	525.729	400.130	2,205.280
ENGLAND TOTAL	3,149.100	1,861.100	1,997.700	1,685.500	8,693.400
SHIRE COUNTIES
Bedfordshire	18.259	11.092	9.351	10.623	49.326
Buckinghamshire	21.153	13.714	10.003	12.816	57.685
Cambridgeshire	27.358	17.146	11.712	14.844	71.060
Cheshire	37.370	22.464	16.211	17.775	93.819
Cornwall	34.077	20.968	13.165	12.632	80.842
Cumbria	32.523	18.778	12.495	13.515	77.311
Derbyshire	50.627	26.869	16.369	19.626	113.491
Devon	43.280	29.910	16.781	17.180	107.151
Dorset	24.480	16.863	7.913	8.952	58.209
Durham	39.423	21.044	17.541	15.751	93.759
East Sussex	32.868	25.767	14.832	13.228	86.696
Essex	77.621	47.459	35.037	36.444	196.561
Gloucestershire	31.014	19.432	13.910	14.533	78.890
Hampshire	53.955	38.428	28.499	32.169	153.051
Hertfordshire	59.824	36.034	27.363	31.347	154.569
Kent	76.392	52.449	39.941	38.461	207.244
Lancashire	70.108	42.166	37.147	33.403	182.824
Leicestershire	29.169	17.952	10.974	14.483	72.578
Lincolnshire	36.314	24.624	14.857	15.844	91.639
Norfolk	48.411	32.906	19.772	20.694	121.783
North Yorkshire	29.331	21.704	11.241	13.729	76.004
Northamptonshire	31.273	19.264	17.844	17.021	85.402
Northumberland	19.667	11.859	8.120	8.890	48.536
Nottinghamshire	44.614	25.803	19.487	20.395	110.299
Oxfordshire	28.573	18.116	14.396	17.077	78.162
Shropshire	17.754	10.648	5.512	6.785	40.700
Somerset	29.499	19.548	11.172	11.939	72.158
Staffordshire	44.571	25.670	18.502	21.241	109.984
Suffolk	40.173	24.955	15.944	16.854	97.925
Surrey	52.862	37.912	22.833	29.872	143.479
Warwickshire	28.883	16.529	11.569	13.629	70.610
West Sussex	41.802	33.184	17.480	20.200	112.667
Wiltshire	20.742	13.662	9.106	10.263	53.772
Worcestershire	29.406	17.950	12.954	14.123	74.433
Shires Sub-total	1,303.374	832.870	570.033	616.339	3,322.616
ENGLAND TOTAL	3,149.100	1,861.100	1,997.700	1,685.500	8,693.400
SHIRE UNITARY AUTHORITIES
Isles of Scilly	0.106	0.072	0.030	0.041	0.249
Isle of Wight Council	8.805	6.466	4.310	3.486	23.068
Bath & North East Somerset	9.789	6.378	3.991	4.515	24.673
Blackburn with Darwen	8.665	5.052	7.089	5.381	26.186
Blackpool	12.350	7.029	6.687	5.201	31.267
Bournemouth	12.929	8.775	5.915	5.067	32.685
Bracknell Forest	4.537	2.943	3.179	3.468	14.127
Brighton & Hove	17.613	12.287	11.324	10.860	52.083
Bristol	26.268	14.939	18.960	14.639	74.805
Darlington	6.221	4.089	3.719	3.244	17.273
Derby	15.222	8.610	9.974	7.931	41.737
East Riding of Yorkshire	17.253	11.482	6.015	7.611	42.362
Halton	7.937	3.761	6.549	4.272	22.520
Hartlepool	6.573	3.643	4.194	3.253	17.663
Herefordshire	9.983	6.269	3.933	4.201	24.386
Kingston-Upon-Hull	21.261	12.069	14.065	10.032	57.428
Leicester	19.722	11.225	16.391	12.647	59.984
Luton	8.514	4.851	9.492	7.038	29.895
Medway	10.796	6.648	8.428	7.559	33.431
Middlesbrough	9.823	5.355	8.453	5.537	29.169
Milton Keynes	8.726	4.868	7.788	6.577	27.959
West Berkshire	5.499	3.760	2.680	3.642	15.582
North East Lincolnshire	9.808	5.989	6.276	4.787	26.860
North Lincolnshire	8.823	5.523	4.449	4.232	23.027
North Somerset	11.047	7.519	4.202	4.625	27.394
Nottingham	19.959	11.365	19.207	11.895	62.425
Peterborough	8.407	4.714	6.526	5.037	24.684
Plymouth	15.733	9.164	11.510	8.477	44.883
Poole	8.638	5.603	4.137	3.684	22.062
Portsmouth	11.304	7.387	9.467	7.502	35.659
Reading	6.536	4.483	6.596	5.494	23.109
Redcar and Cleveland	9.155	5.211	6.088	4.400	24.854
Rutland	1.375	1.001	0.574	0.752	3.702
Slough	6.523	3.504	6.372	5.274	21.674
Southend-on-Sea	12.472	7.998	7.921	5.917	34.308
South Gloucestershire	10.538	6.247	5.010	5.813	27.608
Southampton	13.147	8.204	10.978	8.627	40.956
Stockton-on-Tees	10.036	5.770	7.620	5.917	29.344
Stoke-on-Trent	19.812	10.048	10.784	8.436	49.080
Swindon	8.608	5.092	5.566	5.302	24.567
Thurrock	7.856	4.212	5.982	4.634	22.683
Torbay	10.967	6.945	4.923	3.500	26.336
Warrington	10.902	6.054	5.373	5.554	27.883
Windsor and Maidenhead	5.958	4.291	3.238	4.145	17.632
Wokingham	3.815	2.833	2.184	3.338	12.170
Telford and The Wrekin	8.431	4.399	5.871	4.637	23.338
York	9.022	6.425	4.498	5.089	25.034
Shire Unitary Sub-total	497.466	300.552	328.518	273.268	1,399.805
All Shires Sub-total	1,800.840	1,133.423	898.551	889.607	4,722.421
ENGLAND TOTAL	3,149.100	1,861.100	1,997.700	1,685.500	8,693.400

Table 5.1.2 (Summary table)

THE STANDARD SPENDING ASSESSMENTS FOR 2000-2001 PER CAPITA RESOURCES BASED ON TOTAL POPULATIONS

	(1)	(2)	(3)	(4)	(5)
	Elderly Residential SSA Per Capita All Ages £	Elderly Domiciliary SSA Per Capita All Ages £	Children's SSA Per Capita All Ages £	Other PSS SSA Per Capita All Ages £	Total SSA Per Capita All Ages £
Inner London	86.6	46.4	122.7	76.1	331.8
Outer London	63.4	35.4	56.6	43.7	199.1
London Total	71.6	39.2	79.8	55.1	245.7
Metropolitan Total	74.8	40.0	47.2	35.9	197.8
Shire Counties	57.0	36.4	24.9	26.9	145.3
Shire Unitary Authorities	60.0	36.3	39.6	33.0	168.9
All Shires Total	57.8	36.4	28.8	28.6	151.6
ENGLAND TOTAL	63.6	37.6	40.4	34.1	175.6
INNER LONDON
City of London	150.7	77.1	122.3	78.7	428.8
Camden	96.3	53.7	117.9	79.4	347.3
Greenwich	88.7	46.8	100.6	56.5	292.7
Hackney	101.5	47.3	149.4	88.1	386.2
Hammersmith and Fulham	80.5	44.0	114.1	77.9	316.5
Islington	98.7	49.5	149.4	82.2	379.8
Kensington and Chelsea	63.0	41.4	90.8	78.8	273.9
Lambeth	73.3	41.1	144.9	77.9	337.2
Lewisham	85.6	45.5	116.2	61.8	309.1
Southwark	90.2	47.5	152.4	78.9	369.0
Tower Hamlets	106.7	50.4	156.8	91.9	405.8
Wandsworth	79.0	44.6	87.8	66.0	277.3
Westminster	80.9	46.4	96.6	83.5	307.5
Sub-total	86.6	46.4	122.7	76.1	331.8
OUTER LONDON
Barking and Dagenham	100.8	47.4	80.7	43.5	272.5
Barnet	62.3	35.6	41.8	42.3	182.1
Bexley	60.4	34.5	40.6	32.5	167.9
Brent	63.0	30.7	85.1	59.5	238.3
Bromley	55.1	37.8	35.0	31.9	159.8
Croydon	48.6	30.7	56.8	41.0	177.1
Ealing	61.2	32.1	69.8	53.3	216.5
Enfield	70.0	38.5	54.5	41.2	204.3
Haringey	66.5	35.2	102.8	63.6	268.1
Harrow	67.0	35.3	37.4	38.5	178.3
Havering	60.7	35.9	31.7	30.9	159.1
Hillingdon	57.7	32.9	40.8	36.8	168.2
Hounslow	63.3	34.4	62.4	48.3	208.3
Kingston-upon-Thames	49.7	32.5	33.2	37.0	152.4
Merton	57.3	34.0	50.8	42.7	184.8
Newham	78.9	35.3	111.0	62.2	287.4
Redbridge	68.9	36.7	44.1	39.0	188.8
Richmond-upon-Thames	51.8	36.4	29.7	38.3	156.2
Sutton	56.8	36.3	41.6	35.6	170.3
Waltham Forest	81.9	40.9	79.0	51.7	253.5
Sub-total	63.4	35.4	56.6	43.7	199.1
London Sub-total	71.6	39.2	79.8	55.1	245.7
ENGLAND TOTAL	63.6	37.6	40.4	34.1	175.6
METROPOLITAN DISTRICTS
Barnsley	79.9	41.5	35.6	31.2	188.2
Birmingham	77.5	39.7	63.3	41.5	222.1
Bolton	71.7	37.6	40.6	34.4	184.4
Bradford	59.8	37.2	47.4	37.0	181.4
Bury	60.4	35.0	35.4	31.1	161.9
Calderdale	60.3	37.5	37.3	32.6	167.6
Coventry	67.1	36.5	49.0	35.9	188.5
Doncaster	70.9	36.8	38.2	31.0	176.9
Dudley	68.6	37.1	30.6	30.0	166.3
Gateshead	82.4	46.0	45.1	36.8	210.3
Kirklees	61.0	36.4	35.4	33.0	165.7
Knowsley	88.1	35.8	81.1	40.8	245.7
Leeds	64.9	38.5	39.2	35.0	177.7
Liverpool	94.6	43.0	71.8	44.5	253.9
Manchester	83.8	41.8	84.3	47.4	257.3
Newcastle upon Tyne	79.6	44.7	57.3	41.9	223.6
North Tyneside	80.4	47.1	42.9	33.9	204.2
Oldham	67.3	38.0	45.8	37.3	188.4
Rochdale	66.3	37.1	50.7	37.0	191.1
Rotherham	79.6	39.9	38.1	32.0	189.6
Salford	92.0	47.0	53.8	39.6	232.4
Sandwell	91.3	44.9	50.6	38.7	225.6
Sefton	76.9	45.1	42.3	30.6	194.9
Sheffield	86.0	46.6	40.8	37.1	210.4
Solihull	52.5	30.2	31.5	27.3	141.4
South Tyneside	87.7	49.6	55.6	36.6	229.6
St Helens	81.0	37.6	39.4	32.7	190.7
Stockport	60.3	36.0	30.3	28.7	155.5
Sunderland	81.4	42.5	46.7	36.1	206.6
Tameside	74.5	39.0	41.6	34.2	189.4
Trafford	61.6	35.2	34.6	30.8	162.2
Wakefield	74.3	37.2	34.2	31.6	177.2
Walsall	80.5	40.6	42.4	34.3	197.9
Wigan	73.8	35.3	33.5	31.6	174.2
Wirral	73.7	41.9	48.3	32.1	196.0
Wolverhampton	81.4	41.6	51.6	37.8	212.4
Metropolitan Sub-total	74.8	40.0	47.2	35.9	197.8
ENGLAND TOTAL	63.6	37.6	40.4	34.1	175.6
Shire Counties
Bedfordshire	48.9	29.7	25.0	28.5	132.1
Buckinghamshire	44.2	28.6	20.9	26.8	120.5
Cambridgeshire	48.5	30.4	20.8	26.3	126.0
Cheshire	55.6	33.4	24.1	26.4	139.5
Cornwall	69.8	42.9	27.0	25.9	165.5
Cumbria	66.0	38.1	25.4	27.4	156.9
Derbyshire	68.9	36.6	22.3	26.7	154.6
Devon	62.5	43.2	24.2	24.8	154.7
Dorset	63.2	43.5	20.4	23.1	150.3
Durham	77.9	41.6	34.6	31.1	185.2
East Sussex	66.9	52.4	30.2	26.9	176.4
Essex	60.0	36.7	27.1	28.1	151.8
Gloucestershire	55.7	34.9	25.0	26.1	141.6
Hampshire	43.6	31.0	23.0	26.0	123.6
Hertfordshire	57.9	34.9	26.5	30.3	149.5
Kent	57.4	39.4	30.0	28.9	155.6
Lancashire	61.7	37.1	32.7	29.4	160.9
Leicestershire	48.7	30.0	18.3	24.2	121.2
Lincolnshire	58.3	39.5	23.8	25.4	147.1
Norfolk	61.3	41.6	25.0	26.2	154.1
North Yorkshire	51.9	38.4	19.9	24.3	134.5
Northamptonshire	50.8	31.3	29.0	27.6	138.7
Northumberland	63.5	38.3	26.2	28.7	156.7
Nottinghamshire	59.9	34.6	26.2	27.4	148.1
Oxfordshire	46.3	29.4	23.3	27.7	126.7
Shropshire	63.3	38.0	19.7	24.2	145.2
Somerset	60.3	40.0	22.8	24.4	147.5
Staffordshire	55.0	31.7	22.8	26.2	135.8
Suffolk	59.9	37.2	23.8	25.1	145.9
Surrey	49.8	35.7	21.5	28.2	135.3
Warwickshire	57.0	32.6	22.8	26.9	139.3
West Sussex	55.6	44.1	23.2	26.9	149.9
Wiltshire	48.7	32.1	21.4	24.1	126.3
Worcestershire	54.6	33.4	24.1	26.2	138.3
Shires Sub-total	57.0	36.4	24.9	26.9	145.3
ENGLAND TOTAL	63.6	37.6	40.4	34.1	175.6
SHIRE UNITARY AUTHORITIES
Isles of Scilly	53.1	36.0	15.0	20.7	124.8
Isle of Wight Council	69.3	50.9	33.9	27.5	181.7
Bath & North East Somerset	58.5	38.1	23.9	27.0	147.5
Blackburn with Darwen	61.9	36.1	50.6	38.4	187.0
Blackpool	82.0	46.7	44.4	34.6	207.7
Bournemouth	79.6	54.0	36.4	31.2	201.2
Bracknell Forest	41.0	26.6	28.7	31.3	127.6
Brighton & Hove	68.8	48.0	44.3	42.4	203.6
Bristol	65.3	37.1	47.1	36.4	185.9
Darlington	61.3	40.3	36.7	32.0	170.3
Derby	64.5	36.5	42.3	33.6	177.0
East Riding of Yorkshire	55.2	36.7	19.2	24.3	135.4
Halton	65.2	30.9	53.8	35.1	185.0
Hartlepool	71.5	39.6	45.6	35.4	192.1
Herefordshire	59.5	37.3	23.4	25.0	145.2
Kingston-upon-Hull	81.2	46.1	53.7	38.3	219.4
Leicester	67.0	38.1	55.7	43.0	203.8
Luton	46.5	26.5	51.8	38.4	163.1
Medway	44.5	27.4	34.7	31.2	137.8
Middlesbrough	67.7	36.9	58.3	38.2	201.0
Milton Keynes	42.9	24.0	38.3	32.4	137.6
West Berkshire	38.1	26.1	18.6	25.3	108.0
North East Lincolnshire	62.8	38.3	40.2	30.6	171.9
North Lincolnshire	57.9	36.3	29.2	27.8	151.2
North Somerset	58.5	39.8	22.3	24.5	145.2
Nottingham	69.6	39.6	67.0	41.5	217.7
Peterborough	53.9	30.2	41.8	32.3	158.3
Plymouth	62.2	36.2	45.5	33.5	177.4
Poole	61.1	39.6	29.2	26.0	156.0
Portsmouth	59.5	38.9	49.8	39.5	187.7
Reading	44.2	30.3	44.6	37.2	156.3
Redcar and Cleveland	66.2	37.7	44.0	31.8	179.7
Rutland	38.5	28.1	16.1	21.1	103.7
Slough	58.4	31.4	57.1	47.2	194.1
Southend-on-Sea	70.9	45.4	45.0	33.6	194.9
South Gloucestershire	43.7	25.9	20.8	24.1	114.6
Southampton	60.9	38.0	50.8	39.9	189.6
Stockton-on-Tees	55.5	31.9	42.1	32.7	162.2
Stoke-on-Trent	78.8	39.9	42.9	33.5	195.1
Swindon	47.9	28.3	31.0	29.5	136.7
Thurrock	58.2	31.2	44.3	34.3	168.1
Torbay	89.2	56.5	40.0	28.5	214.2
Warrington	57.3	31.8	28.2	29.2	146.6
Windsor and Maidenhead	42.4	30.5	23.0	29.5	125.5
Wokingham	26.3	19.5	15.0	23.0	83.8
Telford and The Wrekin	56.3	29.4	39.2	30.9	155.8
York	50.9	36.2	25.4	28.7	141.1
Shire Unitary Sub-total	60.0	36.3	39.6	33.0	168.9
Shires Sub-total	57.8	36.4	28.8	28.6	151.6
ENGLAND TOTAL	63.6	37.6	40.4	34.1	175.6

Table 5.1.3 (Summary table)

THE STANDARD SPENDING ASSESSMENTS FOR 2000-01

PER CAPITA RESOURCES BASED ON RELEVANT POPULATIONS

	(1)	(2)	(3)	(4)	(5)
	Elderly	Elderly	Children's	Other PSS	Total SSA
	Residential	Domiciliary	SSA	SSA
	SSA	SSA
	Per Capita 65+	Per Capita 65+	Per Capita 0-17	Per Capita 18-64	Per Capita All Ages
	(£)	(£)	(£)	(£)	(£)
Inner London	737.573	394.9	550.0	115.4	331.8
Outer London	472.585	263.6	242.5	69.1	199.1
London Total	557.713	305.8	347.3	85.8	245.7
Metropolitan Total	486.922	260.2	198.3	59.0	197.8
Shire Counties	336.879	215.3	112.2	44.3	145.3
Shire Unitary Authorities	390.102	235.7	171.6	53.6	168.9
All Shires Total	350.072	220.3	128.5	46.8	151.6
ENGLAND TOTAL	404.819	239.2	176.8	55.4	175.6

	(1)	(2)	(3)	(4)	(5)
Local Authority	Elderly	Elderly	Children's	Other PSS	Total SSA
	Residential	Domiciliary	SSA	SSA
	SSA	SSA
	Per Capita 65+	Per Capita 65+	Per Capita 0-17	Per Capita 18-64	Per Capita All Ages
	(£)	(£)	(£)	(£)	(£)
INNER LONDON
City of London	798.143	408.0	855.2	117.8	428.8
Camden	763.455	425.4	603.0	117.0	347.3
Greenwich	664.198	350.6	396.4	92.3	292.7
Hackney	981.733	457.5	567.2	139.1	386.2
Hammersmith and Fulham	737.641	402.9	598.3	111.3	316.5
Islington	855.727	429.1	672.9	124.1	379.8
Kensington and Chelsea	557.110	365.7	513.7	110.9	273.9
Lambeth	698.254	391.4	613.1	118.3	337.2
Lewisham	686.899	364.8	477.3	97.8	309.1
Southwark	760.307	400.2	606.6	125.3	369.0
Tower Hamlets	937.401	442.3	545.2	153.6	405.8
Wandsworth	669.241	378.1	464.8	95.2	277.3
Westminster	649.950	373.1	595.3	117.1	307.5
Sub-total	737.573	394.9	550.0	115.4	331.8
OUTER LONDON
Barking and Dagenham	633.194	297.5	308.8	75.2	272.5
Barnet	455.518	260.3	187.4	66.2	182.1
Bexley	395.034	225.6	174.5	52.8	167.9
Brent	577.707	282.1	354.6	91.4	238.3
Bromley	324.277	222.8	166.9	51.4	159.8
Croydon	387.635	245.3	241.7	64.0	177.1
Ealing	536.940	281.6	302.4	81.4	216.5
Enfield	495.367	272.5	229.0	66.4	204.3
Haringey	638.795	338.6	443.6	95.7	268.1
Harrow	490.822	259.0	160.0	61.2	178.3
Havering	359.315	212.5	146.7	50.2	159.1
Hillingdon	418.259	238.2	179.7	58.0	168.2
Hounslow	524.492	284.6	264.6	75.0	208.3
Kingston upon Thames	360.761	236.4	157.9	56.7	152.4
Merton	446.801	265.0	230.1	65.7	184.8
Newham	789.257	353.1	359.9	105.1	287.4
Redbridge	483.980	258.2	185.7	63.0	188.8
Richmond upon Thames	366.256	257.4	148.1	58.2	156.2
Sutton	389.219	248.8	182.7	56.8	170.3
Waltham Forest	662.438	331.2	319.0	82.2	253.5
Sub-total	472.585	263.6	242.5	69.1	199.1
London Sub-total	557.713	305.8	347.3	85.8	245.7
ENGLAND TOTAL	404.8	239.2	176.8	55.4	175.6
METROPOLITAN DISTRICTS
Barnsley	503.333	261.3	155.9	50.9	188.2
Birmingham	532.237	272.9	244.1	69.7	222.1
Bolton	488.105	256.1	168.7	56.2	184.4
Bradford	417.961	260.1	181.0	62.2	181.4
Bury	421.867	244.6	152.4	49.8	161.9
Calderdale	392.983	244.2	158.7	53.3	167.6
Coventry	433.539	236.2	198.7	60.0	188.5
Doncaster	451.323	234.1	160.3	51.3	176.9
Dudley	425.718	230.3	137.4	48.7	166.3
Gateshead	492.766	274.8	208.0	59.8	210.3
Kirklees	415.355	247.7	146.9	53.9	165.7
Knowsley	647.601	262.7	301.9	68.5	245.7
Leeds	427.968	253.7	173.8	56.3	177.7
Liverpool	647.688	294.4	300.6	72.3	253.9
Manchester	634.443	316.1	313.9	79.1	257.3
Newcastle upon Tyne	513.953	288.7	260.1	67.1	223.6
North Tyneside	443.111	259.9	197.1	56.3	204.2
Oldham	477.098	269.7	181.1	61.5	188.4
Rochdale	470.306	263.4	199.8	61.2	191.1
Rotherham	524.139	262.7	162.2	52.1	189.6
Salford	572.751	292.8	228.9	65.5	232.4
Sandwell	571.120	280.9	208.6	64.9	225.6
Sefton	406.896	238.3	191.0	52.0	194.9
Sheffield	530.466	287.4	189.4	59.6	210.4
Solihull	329.892	189.3	139.0	44.4	141.4
South Tyneside	492.454	278.5	237.8	62.3	229.6
St Helens	535.117	248.0	174.9	52.4	190.7
Stockport	368.840	219.9	136.0	46.8	155.3
Sunderland	537.028	280.3	197.0	59.0	206.6
Tameside	508.106	266.2	174.2	55.7	189.4
Trafford	388.104	222.2	150.9	50.3	162.2
Wakefield	510.210	255.2	147.5	50.7	177.2
Walsall	509.528	257.1	176.3	57.0	197.9
Wigan	527.176	252.3	147.1	49.9	174.2
Wirral	420.044	238.8	209.7	54.0	196.0
Wolverhampton	493.117	251.9	210.9	64.1	212.4
Metropolitan Sub-total	486.922	260.2	198.3	59.0	197.8
ENGLAND TOTAL	404.8	239.2	176.8	55.4	175.6
SHIRE COUNTIES
Bedfordshire	358.112	217.5	108.2	45.0	132.1
Buckinghamshire	320.173	207.6	89.8	42.5	120.5
Cambridgeshire	338.383	212.1	94.7	41.3	126.0
Cheshire	343.043	206.2	108.1	43.0	139.5
Cornwall	346.993	213.5	126.9	44.1	165.5
Cumbria	368.983	213.0	118.0	45.2	156.9
Derbyshire	419.995	222.9	103.1	43.1	154.6
Devon	300.492	207.7	115.7	42.6	154.7
Dorset	280.356	193.1	100.3	40.5	150.3
Durham	486.232	259.5	154.9	50.5	185.2
East Sussex	291.401	228.4	141.3	48.3	176.4
Essex	363.593	222.3	122.4	45.8	151.8
Gloucestershire	322.139	201.8	111.3	43.3	141.6
Hampshire	279.864	199.3	100.9	42.2	123.6
Hertfordshire	390.170	235.0	114.3	48.9	149.5
Kent	333.452	228.9	132.7	48.0	155.6
Lancashire	373.732	224.8	141.6	48.7	160.9
Leicestershire	316.526	194.8	82.6	38.8	121.2
Lincolnshire	306.082	207.5	111.6	42.7	147.1
Norfolk	313.339	213.0	120.0	43.9	154.1
North Yorkshire	285.628	211.4	91.8	40.4	134.5
Northamptonshire	357.810	220.4	121.1	44.7	138.7
Northumberland	375.352	226.3	120.9	46.8	156.7
Nottinghamshire	368.980	213.4	119.2	44.3	148.1
Oxfordshire	335.111	212.5	100.8	43.9	126.7
Shropshire	351.416	210.8	90.7	40.1	145.2
Somerset	311.637	206.5	102.2	41.9	147.5
Staffordshire	363.621	209.4	102.5	41.9	135.8
Suffolk	341.021	211.8	104.3	42.1	145.9
Surrey	310.251	222.5	97.3	45.6	135.3
Warwickshire	360.937	206.6	103.8	43.2	139.3
West Sussex	275.509	218.7	109.1	45.9	149.9
Wiltshire	303.274	199.8	92.9	39.6	126.3
Worcestershire	336.347	205.3	108.4	42.6	138.3
Shires Sub-total	336,879	215.3	112.2	44.3	145.3
ENGLAND TOTAL	404.8	239.2	176.8	55.4	175.6
SHIRE UNITARY AUTHORITIES
Isles of Scilly	255.495	173.0	59.5	38.5	124.8
Isle of Wight Council	303.444	222.8	167.8	48.2	181.7
Bath & North East Somerset	315.309	205.4	116.9	44.2	147.5
Blackburn with Darwen	461.902	269.3	183.0	65.2	187.0
Blackpool	429.540	244.5	218.4	57.1	207.7
Bournemouth	358.886	243.6	195.6	52.7	201.2
Bracknell Forest	386.249	250.6	115.3	48.6	127.6
Brighton & Hove	404.569	282.2	232.3	66.4	203.6
Bristol	427.792	243.3	212.9	58.1	185.9
Darlington	371.014	243.9	158.9	53.0	170.3
Derby	412.888	233.5	181.0	55.1	177.0
East Riding of Yorkshire	312.328	207.9	90.0	39.9	135.4
Halton	513.662	243.4	209.5	57.0	185.0
Hartlepool	459.843	254.8	187.5	58.8	192.1
Herefordshire	312.466	196.2	105.8	42.5	145.2
Kingston upon Hull	537.668	305.2	218.4	63.6	219.4
Leicester	482.550	274.7	216.8	71.1	203.8
Luton	409.176	233.1	190.8	62.4	163.1
Medway	356.699	219.7	141.9	49.4	137.8
Middlesbrough	474.220	258.5	227.6	63.4	201.0
Milton Keynes	434.863	242.6	148.3	50.4	137.6
West Berkshire	297.499	203.4	77.4	40.0	108.0
North East Lincolnshire	382.159	233.3	163.8	51.9	171.9
North Lincolnshire	348.835	218.3	128.6	45.8	151.2
North Somerset	309.234	210.5	106.1	40.8	145.2
Nottingham	473.822	269.8	275.8	68.0	217.7
Peterborough	398.816	223.6	166.8	52.6	158.3
Plymouth	391.359	227.9	203.8	54.2	177.4
Poole	316.211	205.1	135.4	44.1	156.0
Portsmouth	386.410	252.5	230.6	62.7	187.7
Reading	341.320	234.1	199.0	57.5	156.3
Redcar and Cleveland	413.107	235.1	183.7	53.0	179.7
Rutland	248.714	181.0	67.7	34.7	103.7
Slough	511.686	274.9	225.7	74.6	194.1
Southend-on-Sea	387.018	248.2	210.1	55.8	194.9
South Gloucestershire	316.489	187.6	91.0	38.1	114.6
Southampton	396.715	247.6	231.9	63.6	189.6
Stockton-on-Tees	397.493	228.5	171.3	53.2	162.2
Stoke-on-Trent	499.502	253.3	187.0	54.7	195.1
Swindon	351.156	207.7	131.4	47.0	136.7
Thurrock	460.041	246.6	181.9	54.5	168.1
Torbay	381.455	241.6	197.2	50.5	214.2
Warrington	407.233	226.1	122.1	46.5	146.6
Windsor and Maidenhead	282.936	203.8	104.3	46.9	125.5
Wokingham	226.740	168.4	62.5	35.7	83.8
Telford and The Wrekin	464.800	242.5	156.3	49.3	155.8
York	298.317	212.5	120.7	46.3	141.1
Shire Unitary Sub-total	390.102	235.7	171.6	53.6	168.9
Shires Sub-total	350.072	220.3	128.5	46.8	151.6
ENGLAND TOTAL	404.8	239.2	176.8	55.4	175.6

Table 5.1.4 (Summary table)

COMPARISON OF PSS-SSA FOR THE LATEST TWO YEARS

	1999-00	2000-01	% difference
	(£m)	(£m)
Inner London	792.927	837.161	5.6
Outer London	886.903	928.537	4.7
London Total	1,679.830	1,765.698	5.1
Metropolitan Total	2,107.413	2,205.280	4.6
Shire Counties	3,149.733	3,322.616	5.5
Shire Unitary Authorities	1,331.024	1,399.805	5.2
All Shires Total	4,480.757	4,722.421	5.4
ENGLAND TOTAL	8,268.000	8,693.400	5.1
Local Authority	1999-00	2000-01	% difference
	(£m)	(£m)
INNER LONDON
City of London	2.141	2.234	4.4
Camden	62.276	65.504	5.2
Greenwich	59.829	62.953	5.2
Hackney	70.924	75.190	6.0
Hammersmith and Fulham	47.450	49.832	5.0
Islington	63.842	67.969	6.5
Kensington and Chelsea	42.924	46.549	8.4
Lambeth	85.677	90.876	6.1
Lewisham	72.399	75.338	4.1
Southwark	81.220	85.596	5.4
Tower Hamlets	70.136	73.557	4.9
Wandsworth	70.929	73.659	3.8
Westminster	63.180	67.906	7.5
Sub-total	792.927	837.161	5.6
OUTER LONDON
Barking and Dagenham	40.115	42.391	5.7
Barnet	57.160	60.378	5.6
Bexley	34.958	36.583	4.6
Brent	57.980	60.324	4.0
Bromley	45.988	47.478	3.2
Croydon	57.303	59.888	4.5
Ealing	62.472	65.415	4.7
Enfield	51.591	54.113	4.9
Haringey	56.376	59.406	5.4
Harrow	35.983	37.664	4.7
Havering	34.526	36.336	5.2
Hillingdon	40.156	42.237	5.2
Hounslow	42.113	44.080	4.7
Kingston-upon-Thames	21.483	22.456	4.5
Merton	33.010	34.067	3.2
Newham	62.896	66.482	5.7
Redbridge	41.741	43.796	4.9
Richmond-upon-Thames	27.734	29.171	5.2
Sutton	29.319	30.153	2.8
Waltham Forest	54.001	56.118	3.9
Sub-total	886.903	928.537	4.7
London Sub-total	1,679.830	1,765.698	5.1
ENGLAND TOTAL	8,268.000	8,693.400	5.1

Local Authority	1999-00	2000-01	% difference
	(£m)	(£m)
METROPOLITAN DISTRICTS
Barnsley	40.442	42.931	6.2
Birmingham	213.861	225.036	5.2
Bolton	47.300	49.326	4.3
Bradford	83.862	87.690	4.6
Bury	28.292	29.602	4.6
Calderdale	30.755	32.340	5.2
Coventry	55.049	57.372	4.2
Doncaster	49.286	51.375	4.2
Dudley	49.726	51.794	4.2
Gateshead	40.197	41.829	4.1
Kirklees	62.197	64.770	4.1
Knowsley	36.111	37.977	5.2
Leeds	123.268	129.262	4.9
Liverpool	111.716	117.156	4.9
Manchester	105.994	110.594	4.3
Newcastle upon Tyne	58.970	61.715	4.7
North Tyneside	37.531	39.626	5.6
Oldham	39.562	41.304	4.4
Rochdale	38.017	39.798	4.7
Rotherham	46.143	48.241	4.5
Salford	50.561	52.511	3.9
Sandwell	63.319	65.539	3.5
Sefton	53.516	56.085	4.8
Sheffield	107.439	111.773	4.0
Solihull	27.565	29.081	5.5
South Tyneside	33.714	35.482	5.2
St Helens	32.627	34.022	4.3
Stockport	43.401	45.486	4.8
Sunderland	57.451	60.401	5.1
Tameside	40.174	41.740	3.9
Trafford	34.193	35.731	4.5
Wakefield	53.407	56.506	5.8
Walsall	49.639	51.678	4.1
Wigan	51.926	54.076	4.1
Wirral	60.927	64.106	5.2
Wolverhampton	49.275	51.327	4.2
Metropolitan Sub-total	2,107.413	2,205.280	4.6
ENGLAND TOTAL	8,268.000	8,693.400	5.1
SHIRE COUNTIES
Bedfordshire	46.436	49.326	6.2
Buckinghamshire	54.624	57.685	5.6
Cambridgeshire	67.300	71.060	5.6
Cheshire	89.064	93.819	5.3
Cornwall	76.676	80.842	5.4
Cumbria	73.435	77.311	5.3
Derbyshire	105.922	113.491	7.1
Devon	101.824	107.151	5.2
Dorset	54.798	58.209	6.2
Durham	88.713	93.759	5.7
East Sussex	82.308	86.696	5.3
Essex	185.579	196.561	5.9
Gloucestershire	75.545	78.890	4.4
Hampshire	145.063	153.051	5.5
Hertfordshire	145.941	154.569	5.9
Kent	197.541	207.244	4.9
Lancashire	174.928	182.824	4.5
Leicestershire	69.144	72.578	5.0
Lincolnshire	87.061	91.639	5.3
Norfolk	114.085	121.783	6.7
North Yorkshire	71.927	76.004	5.7
Northamptonshire	81.346	85.402	5.0
Northumberland	45.987	48.536	5.5
Nottinghamshire	104.069	110.299	6.0
Oxfordshire	73.885	78.162	5.8
Shropshire	38.329	40.700	6.2
Somerset	68.124	72.158	5.9
Staffordshire	104.400	109.984	5.3
Suffolk	93.150	97.925	5.1
Surrey	137.183	143.479	4.6
Warwickshire	66.946	70.610	5.5
West Sussex	106.904	112.667	5.4
Wiltshire	50.826	53.772	5.8
Worcestershire	70.669	74.433	5.3
Shires Sub-total	3,149.733	3,322.616	5.5
ENGLAND TOTAL	8,268.000	8,693.400	5.1
SHIRE UNITARY AUTHORITIES
Isles of Scilly	0.223	0.249	11.6
Isle of Wight Council	21.589	23.068	6.9
Bath & North East Somerset	23.523	24.673	4.9
Blackburn with Darwen	24.939	26.186	5.0
Blackpool	29.974	31.267	4.3
Bournemouth	31.237	32.685	4.6
Bracknell Forest	13.537	14.127	4.4
Brighton & Hove	49.704	52.083	4.8
Bristol	70.812	74.805	5.6
Darlington	16.377	17.273	5.5
Derby	39.368	41.737	6.0
East Riding of Yorkshire	40.098	42.362	5.6
Halton	21.488	22.520	4.8
Hartlepool	16.615	17.663	6.3
Herefordshire	23.057	24.386	5.8
Kingston upon Hull	54.787	57.428	4.8
Leicester	57.227	59.984	4.8
Luton	28.533	29.895	4.8
Medway	32.019	33.431	4.4
Middlesbrough	27.491	29.169	6.1
Milton Keynes	26.411	27.959	5.9
West Berkshire	14.979	15.582	4.0
North East Lincolnshire	25.552	26.860	5.1
North Lincolnshire	21.965	23.027	4.8
North Somerset	25.994	27.394	5.4
Notthingham	59.781	62.425	4.4
Peterborough	23.645	24.684	4.4
Plymouth	42.516	44.883	5.6
Poole	21.069	22.062	4.7
Portsmouth	34.299	35.659	4.0
Reading	21.889	23.109	5.6
Redcar and Cleveland	23.823	24.854	4.3
Rutland	3.577	3.702	3.5
Slough	20.805	21.674	4.2
Southend-on-Sea	32.468	34.308	5.7
South Gloucestershire	26.235	27.608	5.2
Southampton	38.851	40.956	5.4
Stockton-on-Tees	27.586	29.344	6.4
Stoke-on-Trent	46.787	49.080	4.9
Swindon	23.281	24.567	5.5
Thurrock	21.235	22.683	6.8
Torbay	24.944	26.336	5.6
Warrington	26.497	27.883	5.2
Windsor and Maidenhead	16.819	17.632	4.8
Wokingham	11.784	12.170	3.3
Telford and The Wrekin	21.937	23.338	6.4
York	23.696	25.034	5.6
Shire Unitary Sub-total	1,331.024	1,399.805	5.2
Shires Sub-total	4,480.757	4,722.421	5.4
ENGLAND TOTAL	8,268.000	8,693.400	5.1

5.2  COMPARISON OF BUDGETS WITH SSAS

Could the Department provide a table comparing PSS SSAs with the corresponding budget for each local authority for the latest two years for which comparable information is available? Could the Department illustrate how the total of PSS SSAs and budgeted expenditure in PSS have compared at the national level over the latest five years? Could the Department provide a commentary on any trends shown by these figures?

  1.  Comparisons of 1998-99 PSS SSAs with provisional outturn expenditure, and 1999-2000 PSS SSAs with budgeted expenditure for each local council, appear at Table 5.2.1. Provisional outturn and budget figures have been provided by local councils but have been adjusted by the Department of the Environment, Transport and the Regions to make them comparable with standard spending assessments. This has meant excluding expenditure supported by special and specific grants, and making some other technical changes. The provisional outturn figures for 1998-99 and budget figures for 1999-2000 are therefore not on the same basis as figures quoted in response to other questions (where such adjustments have not been made).

  2.  The money provided to local councils by Government is not hypothecated. That is, it is a block amount within which the amounts to be spent on each service, such as PSS, are not prescribed. Local councils decide how precisely to deploy these resources in the light of local circumstances and priorities. Councils are free to spend more or less than the amount of the SSA for any particular service.

  3.  Table 5.2.1 shows that taken together, councils spent about nine per cent more on social services than the total of PSS SSAs in 1998-99 and 11 per cent more the following year. The table shows a wide variation between councils in 1999-2000, ranging from a few spending over 30 per cent more than PSS SSA to those spending below SSA. The figures show marked differences in the levels of expenditure between similar and neighbouring councils. Generally, however, unitary councils tend to exceed their SSAs for social services by a higher average amount than the other classes of council. Metropolitan districts tend to exceed their PSS SSAs by the lowest amounts.

  4.  Table 5.2.2 lists those councils that have budgeted to spend less on social services in 1999-2000 than the level indicated by their PSS SSA. The table shows that only 12 local councils planned to spend less on social services than indicated by the level of their SSA. This compares to 18 such councils in 1998-99. SSA resources are unhypothecated and local councils are free to set their own budgets. As stated in paragraph 1, the figures for budgets quoted in this table have been adjusted by Department of Environment, Transport and the Regions to make them comparable to SSA. This involves a degree of estimation and allowances should be made for marginal errors when viewing the table.

  5.  Figure 5.2.3 compares PSS SSAs and budgeted expenditure at the national level in recent years. The growth in the amount spent on social services by local councils has increased by slightly more than the increase in PSS SSAs.

Table 5.2.1 (Summary table)

PSS PROVISIONAL OUTTURN 1998-99 AND BUDGET 1999-2000 COMPARED TO SSA (1)

£ million and percentages	PSS SSA 1998—99£m	Provisional Outturn 1998—99£m	% Difference	PSS SSA 1999—2000£m	Budget 1999—2000£m	% Difference
Total Inner London	769.767	855.177	11.1	792.927	896.990	13.1
Total Outer London	856.594	938.263	9.5	886.903	994.813	12.2
Total London Boroughs	1,626.361	1,793.440	10.3	1,679.830	1,891.803	12.6
Total Metropolitan Districts	1,942.883	2,141.777	10.2	2,107.413	2,304.550	9.4
Total Shire Counties	2,991.506	3,206.461	7.2	3,149.733	3,456.690	9.7
Total Shire Unitaries	1,253.952	1,411.447	12.6	1,331.024	1,516.921	14.0
Total Shire Areas	4,245.457	4,617.908	8.8	4,480.757	4,973.611	11.0
TOTAL ENGLAND	7,814.651	8,553.125	9.4	8,268.000	9,169.964	10.9

£ million and percentages
	PSS SSA 1998—99£m	Provisional Outturn 1998—99£m	% Difference	PSS SSA 1999—2000£m	Budget 1999—2000£m	% Difference
INNER LONDON
City of London	1.563	5.366	243.3	2.141	4.943	130.9
Camden	61.751	70.592	14.3	62.276	73.751	18.4
Greenwich	54.460	61.307	12.6	59.829	65.873	10.1
Hackney	74.325	84.046	13.1	70.924	84.831	19.6
Hammersmith & Fulham	47.201	54.672	15.8	47.450	58.851	24.0
Islington	62.989	68.919	9.4	63.842	69.087	8.2
Kensington & Chelsea	41.484	50.515	21.8	42.924	54.716	27.5
Lambeth	88.775	84.429	--4.9	85.677	92.832	8.4
Lewisham	71.877	71.592	--0.4	72.399	75.404	4.2
Southwark	74.806	85.447	14.2	81.220	89.609	10.3
Tower Hamlets	63.511	66.460	4.6	70.136	72.423	3.3
Wandsworth	68.153	74.742	9.7	70.929	74.311	4.8
Westminster	58.871	77.090	30.9	63.180	80.359	27.2
Total Inner London	769.767	855.177	11.1	792.927	896.990	13.1
OUTER LONDON
Barking & Dagenham	33.451	36.272	8.4	40.115	42.054	4.8
Barnet	56.293	64.163	14.0	57.160	67.591	18.2
Bexley	30.511	37.211	22.0	34.958	40.834	16.8
Brent	62.388	54.453	--12.7	57.980	55.850	--3.7
Bromley	42.433	51.512	21.4	45.988	54.424	18.3
Croydon	55.453	62.120	12.0	57.303	68.308	19.2
Ealing	62.257	60.343	--3.1	62.472	63.983	2.4
Enfield	47.445	51.297	8.1	51.591	49.899	--3.3
Haringey	60.534	59.111	--2.4	56.376	62.098	10.1
Harrow	34.686	41.252	18.9	35.983	44.520	23.7
Havering	31.752	39.930	25.8	34.526	40.702	17.9
Hillingdon	37.911	46.376	22.3	40.156	49.835	24.1
Hounslow	40.673	44.415	9.2	42.113	47.545	12.9
Kingston-upon-Thames	20.269	26.360	30.1	21.483	28.146	31.0
Merton	30.422	28.003	--8.0	33.010	31.976	--3.1
Newham	65.129	75.246	15.5	62.896	77.427	23.1
Redbridge	39.465	41.542	5.3	41.741	45.078	8.0
Richmond-upon-Thames	26.442	29.521	11.6	27.734	32.348	16.6
Sutton	27.193	32.472	19.4	29.319	33.586	14.6
Waltham Forest	51.887	56.664	9.2	54.001	58.609	8.5
Total Outer London	856.594	938.263	9.5	886.903	994.813	12.2
Total London Boroughs	1,626.361	1,793.440	10.3	1,679.830	1,891.803	12.6

£ million and percentages	PSS SSA 1998—99£m	Provisional Outturn 1998—99£m	% Difference	PSS SSA 1999—2000£m	Budget 1999—2000£m	% Difference
METROPOLITAN DISTRICTS
Barnsley	36.555	35.374	--3.2	40.442	37.919	--6.2
Birmingham	209.271	212.083	1.3	213.861	224.712	5.1
Bolton	43.439	47.180	8.6	47.300	49.091	3.8
Bradford	81.198	90.559	11.5	83.862	95.760	14.2
Bury	26.168	29.226	11.7	28.292	30.896	9.2
Calderdale	28.746	36.484	26.9	30.755	38.079	23.8
Coventry	50.562	58.648	16.0	55.049	64.202	16.6
Doncaster	44.686	48.201	7.9	49.286	51.625	4.7
Dudley	44.307	46.728	5.5	49.726	50.277	1.1
Gateshead	35.261	42.152	19.5	40.197	44.570	10.9
Kirklees	60.045	63.861	6.4	62.197	68.563	10.2
Knowsley	30.512	33.535	9.9	36.111	35.984	--0.4
Leeds	115.244	135.240	17.4	123.268	142.452	15.6
Liverpool	100.400	126.533	26.0	111.716	129.508	15.9
Manchester	103.344	105.187	1.8	105.994	119.613	12.8
Newcastle upon Tyne	52.731	64.987	23.2	58.970	67.566	14.6
North Tyneside	33.064	40.727	23.2	37.531	43.083	14.8
Oldham	36.980	39.822	7.7	39.562	42.450	7.3
Rochdale	34.772	38.988	12.1	38.017	41.627	9.5
Rotherham	40.689	43.199	6.2	46.143	49.026	6.2
Salford	45.626	53.396	17.0	50.561	54.723	8.2
Sandwell	57.424	62.486	8.8	63.319	65.301	3.1
Sefton	49.663	53.463	7.7	53.516	58.031	8.4
Sheffield	98.697	100.638	2.0	107.439	111.855	4.1
Solihull	24.349	30.023	23.3	27.565	33.392	21.1
South Tyneside	28.784	33.405	16.1	33.714	36.410	8.0
St Helens	28.632	34.148	19.3	32.627	40.106	22.9
Stockport	39.151	51.972	32.7	43.401	55.795	28.6
Sunderland	51.406	54.831	6.7	57.451	59.969	4.4
Tameside	36.042	39.763	10.3	40.174	42.651	6.2
Trafford	32.767	35.646	8.8	34.193	39.249	14.8
Wakefield	47.541	48.680	2.4	53.407	53.642	0.4
Walsall	47.519	47.480	--0.1	49.639	49:694	0.1
Wigan	46.380	46.361	0.0	51.926	51.604	--0.6
Wirral	55.426	57.380	3.5	60.927	64.913	6.5
Wolverhampton	45.449	53.391	17.5	49.275	60.212	22.2
Total Metropolitan Districts	1,942.833	2,141.777	10.2	2,107.413	2,304.550	9.4

£ million and percentages	PSS SSA 1998—99 £m	Provisional Outturn 1998—99 £m	% Difference	PSS SSA 1999—2000 £m	Budget 1999—2000 £m	% Difference
SHIRE COUNTIES (2)
Bedfordshire	44.404	51.311	15.6	46.436	55.511	19.5
Buckinghamshire	53.123	60.923	14.7	54.624	65.681	20.2
Cambridgeshire	63.712	69.005	8.3	67.300	77.511	15.2
Cheshire	82.658	91.087	10.2	89.064	100.732	13.1
Cornwall	71.338	70.489	--1.2	76.676	76.163	--0.7
Cumbria	68.264	68.779	0.8	73.435	72.111	--1.8
Derbyshire	98.561	112.415	14.1	105.922	122.965	16.1
Devon	97.583	97.951	0.4	101.824	105.873	4.0
Dorset	52.186	51.835	--0.7	54.798	58.687	7.1
Durham	79.392	83.757	5.5	88.713	92.697	4.5
East Sussex	81.311	82.066	0.9	82.308	85.193	3.5
Essex	172.301	194.359	12.8	185.579	202.726	9.2
Gloucestershire	70.932	73.064	3.0	75.545	78.736	4.2
Hampshire	140.137	140.835	0.5	145.063	155.009	6.9
Hertfordshire	140.562	152.485	8.5	145.941	164.500	12.7
Kent	189.754	197.320	4.0	197.541	207.546	5.1
Lancashire	167.807	183.343	9.3	174.928	200.383	14.6
Leicestershire	64.202	62.293	--3.0	69.144	70.181	1.5
Lincolnshire	82.327	86.758	5.4	87.061	93.297	7.2
Norfolk	107.473	116.647	8.5	114.085	127.780	12.0
North Yorkshire	71.579	73.524	2.7	71.927	77.114	7.2
Northhamptonshire	75.443	90.969	20.6	81.346	93.337	14.7
Northumberland	42.560	52.415	23.2	45.987	56.596	23.1
Nottinghamshire	96.908	110.234	13.8	104.069	118.108	13.5
Oxfordshire	72.914	82.331	12.9	73.885	91.135	23.3
Shropshire	35.789	37.609	5.1	38.329	42.090	9.8
Somerset	65.256	66.931	2.6	68.124	71.192	4.5
Staffordshire	96.536	101.898	5.6	104.400	106.239	1.8
Suffolk	88.352	88.228	--0.1	93.150	98.492	5.7
Surrey	134.019	152.928	14.1	137.183	162.344	18.3
Warwickshire	61.872	65.081	5.2	66.946	70.530	5.4
West Sussex	106.461	110.516	3.8	106.904	117.662	10.1
Wiltshire	48.928	57.167	16.8	50.826	60.208	18.5
Worcestershire	66.861	69.908	4.6	70.669	78.361	10.9
Total Shire Counties	2,991.506	3,206.461	7.2	3,149.733	3,456.690	9.7

£ million and percentages	PSS SSA 1998—99 £m	Provisional Outturn 1998—99 £m	% Difference	PSS SSA 1999—2000 £m	Budget 1999—2000 £m	% Difference
SHIRE UNITARIES
Isles of Scilly	0.258	0.257	--0.5	0.223	0.255	14.1
Isle of Wight	20.734	20.818	0.4	21.589	21.821	1.1
Bath & North East Somerset	22.746	24.310	6.9	23.523	26.849	14.1
Blackburn with Darwen	24.250	28.496	17.5	24.939	29.542	18.5
Blackpool	28.853	29.182	1.1	29.974	31.459	5.0
Bournemouth	31.554	32.966	4.5	31.237	35.501	13.6
Bracknell Forest	12.744	16.139	26.6	13.537	18.064	33.4
Brighton & Hove	49.272	53.020	7.6	49.704	59.244	19.2
Bristol	66.931	83.545	24.8	70.812	86.768	22.5
Darlington	15.506	14.535	--6.3	16.377	15.774	--3.7
Derby City	37.809	44.292	17.1	39.368	46.978	19.3
East Riding of Yorkshire	37.946	37.733	--0.6	40.098	43.819	9.3
Halton	18.907	18.332	--3.0	21.488	20.279	--5.6
Hartlepool	14.840	16.469	10.9	16.615	17.190	3.5
Herefordshire	21.804	24.315	11.5	23.057	25.030	8.6
Kingston-upon-Hull	50.717	56.349	11.1	54.787	61.880	12.9
Leicester City	57.304	58.569	2.2	57.227	60.989	6.6
Luton	26.761	30.151	12.7	28.533	34.154	19.7
Medway Towns	29.499	35.670	20.9	32.019	37.735	17.9
Middlesborough	25.305	26.584	5.1	27.491	28.672	4.3
Milton Keynes	24.296	29.878	23.0	26.411	32.500	23.1
West Berkshire	14.898	21.862	46.7	14.979	23.391	56.2
North East Lincolnshire	23.849	23.743	--0.4	25.552	25.985	1.7
North Lincolnshire	20.393	25.225	23.7	21.965	26.637	21.3
North Somerset	25.057	25.196	0.6	25.995	25.887	--0.4
Nottingham	55.112	64.374	16.8	59.781	70.302	17.6
Peterborough	22.284	28.780	29.2	23.645	30.204	27.7
Plymouth	40.836	43.159	5.7	42.516	46.016	8.2
Poole	19.463	21.634	11.2	21.069	22.322	5.9
Portsmouth	32.969	37.021	12.3	34.299	39.996	16.6
Reading	21.395	25.289	18.2	21.889	25.789	17.8
Redcar & Cleveland	21.521	25.711	19.5	23.823	27.137	13.9
Rutland	3.386	3.746	10.6	3.577	3.826	7.0
Slough	19.790	23.424	18.4	20.805	25.683	23.4
Southend-on-Sea	29.518	31.746	7.5	32.468	34.862	7.4
South Gloucestershire	23.538	26.395	12.1	26.235	30.187	15.1
Southampton	37.146	43.219	16.4	38.851	46.456	19.6
Stockton-on-Tees	24.729	28.485	15.2	27.586	29.661	7.5
Stoke-on-Trent	41.200	43.330	5.2	46.787	44.700	--4.5
Swindon	21.363	24.545	14.9	23.281	26.525	13.9
Thurrock	18.539	21.467	15.8	21.235	23.533	10.8
Torbay	24.066	22.370	--7.0	24.944	26.621	6.7
Warrington	24.530	24.551	0.1	26.497	27.097	2.3
Windsor &Maidenhead	16.547	26.053	57.5	16.819	26.980	60.4
Wokingham	11.571	18.245	57.7	11.784	20.275	72.1
Telford & The Wrekin	19.704	23.105	17.3	21.937	25.623	16.8
York	22.505	27.162	20.7	23.696	26.723	12.8
Total Shire Unitaries	1,253.952	1,411.447	12.6	1,331.024	1,516.921	14.0

Footnotes:

1.  Authorities which budget to spend less than their PSS SSAs appear with a negative sign.

2.  Expenditure by shire districts has been added to the parent county, eg 1999-2000 budget figures for Bedfordshire £55.511 million consisting of parent county expenditure figure of £55.386 million plus £0.125 million for districts.

Table 5.2.2

COUNCILS THAT ARE SPENDING LESS THAN PSS SSA

Local Council	PSS SSA 1999-2000£m	Adjusted Budget 1999-2000£m	% Difference
Brent	57.980	55.850	--3.7
Enfield	51.591	49.899	--3.3
Merton	33.010	31.976	--3.1
Barnsley	40.442	37.919	--6.2
Knowsley	36.111	35.984	--0.4
Wigan	51.926	51.604	--0.6
Cornwall	76.676	76.163	--0.7
Cumbria	73.435	72.111	--1.8
Darlington	16.377	15.774	--3.7
Halton	21.488	20.279	--5.6
North Somerset	25.994	25.887	--0.4
Stoke-on-Trent	46.787	44.700	--4.5

  5.3  Variations between authorities in unit costs

5.3  Could the Department set out in a table how the unit costs of the main social services for children and adults have changed over time? Could the Department quantify the degree of variation in these unit costs between authorities? Could the Department provide a commentary on these figures?

  1.  The unit cost figures in table 5.3.1 show in cash and real terms (deflated by GDP at 1998-99 prices) the increases in selected unit costs for personal social services from 1994-95 to 1998-99. The unit costs cover residential and nursing care for older people who are financially supported by the local authorities, hourly costs for home support services, and costs for placements of children looked after with foster parents or in local authority maintained children's homes.

  2.  The real terms weekly unit cost for supporting older people in nursing care rose each year between 1994-95 and 1997-98 but decreased slightly in 1998-99. The real terms unit cost of supporting elderly residents in local authority staffed residential care homes increased each year between 1994-95 and 1998-99, apart from a minor decrease in 1996-97. The real terms unit cost of supporting elderly residents in independent residential care homes decreased between 1994-95 and 1998-99 but with a small increase in 1996-97 and a further increase in 1998-99 (the latter may reflect the inclusion of placements in other local authorities). Costs in the independent sector (private and voluntary homes) represent the costs to local authorities in purchasing care, whereas the costs for local authority homes represent own provision, from a declining stock as homes have been transferred out of local authority control.

  3.  The rise in unit costs of residential care for older people may have been associated with better or more intensive services (more space, higher staff/resident ratios) and changes in cost or efficiency. There has over the same period been an increase in dependency (measured by age) with the over 85s accounting for 50 per cent of long stay supported residents in homes for older people in 1994-95 and 55 per cent of long stay supported residents aged 65 or over in 1998-99.

  4.  In 1998-99 the majority (72 per cent) of elderly supported residents were accommodated in independent sector (private and voluntary) residential care homes for older people, the proportion increasing from 49 per cent in 1994-95.

  5.  The real terms hourly unit cost for home help/care has been relatively stable at around £9 for the past five years. There has been an increase in home help/care provision over the same period, with an increase from 2.2 million contact hours reported in 1994-95 to 2.6 million contact hours in 1997-98 and 1998-99.

  6.  Real terms unit costs for placing a looked after child in local authority maintained homes increased gradually over the three years up to 1997-98. The real terms cost per week for placing children with foster parents has risen from £172 to £200 over the four years to 1998-99. The placements of children looked after have changed over this period, with the total number of children being looked after gradually increasing, there has been a slight increase in the proportion of children being fostered and a reduction in the proportion placed in children's homes.

VARIATION BETWEEN AUTHORITIES

  7.  There is substantial variation between local authorities in these unit costs, as figures 5.3.1 to 5.3.6 below demonstrate. Such wide variability of individual authority figures points to issues of data quality and there is a risk that misreporting of data by local authorities has had an effect. In examining unit costs it is likely that extreme high or low values are the result of misreporting of expenditure data by local authorities. It is however notable that even if the more extreme figures are discounted significant variation remains. The Department is of the view that the information provided by local authorities should be used in monitoring social services, which should act as an incentive for authorities to improve their management information generally.

  8.  Figures 5.3.1 to 5.3.5 show the unit cost values calculated using expenditure data for 1998-99. Figure 5.3.6 gives unit costs based on 1997-98 expenditure and activity data, as the expenditure data for children looked after in LA maintained children's homes is no longer available. Where a local authority has reported activity but no expenditure (an implied zero unit cost) they have been excluded from the charts. Also excluded from figures 5.3.1-5.3.5 are local authorities formed on 1 April 1998 since there is no activity data available for 31 March 1998 for these authorities (activity at 31 March 1998 and at 31 March 1999 is averaged - see footnote 2 to table 5.3.1). Similarly local authorities formed on 1 April 1997 are excluded from figure 5.3.6.

  9.  Figure 5.3.1 shows the weekly unit cost of supporting older people in nursing care in 1998-99. The average weekly unit cost for England was £291 in 1998-99 ranging from under £100 a week in one authority to more than £500 a week in others. The middle 50 per cent of the authorities had a unit cost between £249 and £364.

  10.  The average weekly cost for supporting a resident aged 65 or over in local authority residential care in 1998-99 was £330, with the middle 50 per cent of authorities having a unit cost between £285 and £420.

  11.  The weekly cost for a supported resident aged 65 or over in independent (private or voluntary) residential care during 1998-99 for individual authorities is shown in figure 5.3.3. For individual authorities this unit cost varied from less than £100 to over £500 (the average for England was £240), with the middle 50 per cent of authorities having a unit cost between £192 and £283.

  12.  Figure 5.3.4 shows the hourly cost of home help/care for individual authorities in 1998-99. The hourly cost varied from less than £5 to more than £25, with over one third of authorities having a unit cost of between £8 and £10 per hour. The average hourly unit cost for England was £9.40. The middle 50 per cent of authorities had a unit cost between £8.40 and £11.50.

  13.  Figure 5.5.5 shows the variation in weekly unit costs between authorities for placing a looked after child with foster parents. The unit cost for the middle 50 per cent of authorities was between £153 and £251, with an average unit cost for England in 1998-99 of £200.

  14.  The average weekly cost of supporting a looked after child in a local authority maintained children's home in 1997-98 in England was £1,325. This unit cost ranged from less than £400 per week to over £5,000. The middle 50 per cent of authorities had unit costs between £979 and £1,822 per week.

  15.  Variations between authorities in unit costs are to be expected as the demand for services varies, prices will be affected by regional wage rates (for example higher prices in the South East), and supply factors such as the number of residential care homes will have a bearing. Variations between authorities in dependency of clients may also be relevant.

  16.  The Performance Assessment Framework for Personal Social Services introduced in 1999 consists of 50 indicators, 11 of which relate to cost and efficiency. These are:

Indicator	Service area
B 7 Children looked after in family placements	Children
B 8 Cost of services for children looked after	Children
B 9 Unit cost of children's residential care	Children
B10 Unit cost of foster care	Children
B11 Intensive home care as a proportion of intensive home   and residential care	Adults
B12 Cost of intensive social care for adults	Adults
B13 Unit cost of residential and nursing care for older   people	Adults
B14 Unit cost of residential and nursing care for people   with learning disabilities	Adults
B15 Unit cost of residential and nursing care for people   with mental illness	Adults
B16 Unit cost of residential and nursing care for people   with physical disabilities	Adults
B17 Unit cost of home care for adults	Adults

  17.  Indicators B8 and B12 have been made Best Value Performance Indicators. Councils are required to set annual targets for improvement for these indicators consistent with achieving the current top quartile for their family group (Inner London Boroughs, Outer London Boroughs, metropolitan Boroughs, Unitaries, County Councils (Shires)) over five years.

Table 5.3.1

UNIT COSTS (£s) OF SELECTED PERSONAL SOCIAL SERVICES ENGLAND, 1994-95 TO 1998-99

£ Unit Cost		1994-95	1995-96	1996-97	1997-98	1998-99
Gross expenditure per week on supporting residents aged 65 and over in nursing care (1)	Cash Terms Real Terms (8)	225 253	233 255	255 271	286 295	291 291
Gross expenditure per week on supporting residents aged 65 and over in local authority residential care (1), (2)	Cash Terms Real Terms (8)	280 316	297 325	301 319	317 327	330 330
Gross expenditure per week on supporting residents aged 65 and over in independent residential care (1), (2)	Cash Terms Real Terms (8)	235 265	223 244	234 248	217 224	240 240
Gross expenditure per hour of home care/help for all clients aged 18 or over (3)	Cash Terms Real Terms (8)	7.9 8.9	8.2 9.0	8.6 9.2	8.8 9.1	9.4 9.4
Gross expenditure per week per child looked after by foster parents (4), (5)	Cash Terms Real Terms (8)	153 172	161 176	175 186	190 196	200 200
Gross expenditure per week per child looked after in local authority maintained children's homes (6), (7)	Cash Terms Real Terms (8)	1,105 1,246	1,146 1,256	1,258 1,336	1,325 1,369	.. ..

  Key .. = not available.

  (1)  These unit costs have been calculated by taking gross current expenditure throughout the year on residential and nursing care as appropriate and dividing it by the average number of supported residents in such homes reported at 31 March in Consecutive years. A supported resident is one who is supported wholly or in part by the local authority. Residents in local authority homes who are assessed to pay the full costs and residents in other homes whose fees are paid in part or through income support are not included.

  (2)  From 1998-99 the definition of local authority care as reported on form RO3 has changed to exclude expenditure on people placed in the home of another local authority. This expenditure is now included in the independent sector expenditure.

  (3)  This unit cost is calculated by taking gross current expenditure throughout the year on home care services and dividing it by activity data collected during a sample week in the Autumn.

  (4)  This unit cost has been calculated by taking gross current expenditure throughout the year on foster placements and dividing it by the average number of children looked after placed in foster placements at 31 March in consecutive years.

  (5)  From 1998-99 expenditure on foster placements also includes expenditure on lodgings, living independently, residential employment, children placed with parents or placed for adoption.

  (6)  This unit cost has been calculated by taking gross current expenditure throughout the year on LA maintained children's homes and dividing it by the average number of children looked after placed in LA maintained children's homes at 31 March in consecutive years.

  (7)  From 1998-99 expenditure on LA maintained children's homes is no longer separately identified.

  (8)  Deflated using the GDP deflator at 1998-99 prices.

5.4  INDEPENDENT SECTOR PROVISION

Could the Department provide a table showing for each local authority the latest information on the proportion of social services for adults which are purchased from the independent sector rather than being provided directly? Could the Department supply a commentary on these figures?

  1.  Table 5.4.1 shows for each authority the percentage contribution of the independent sector in respect of three main elements of community-based social services for adults (contact hours of home help/care; meals provided at home and at luncheon clubs; day centre places) and the percentage of local authority supported residents in independent sector residential care homes.

  2.  Use of the independent sector varies considerably between authorities and between services within authorities. A significant number of authorities still make little or no use of the independent sector in the provision of community based services and particularly day centre services, where 30 local authorities contract out less than 10 per cent of provision to the independent sector. However, at the other extreme, six local authorities use the independent sector to provide all meals services, and a further five contract out over 90 per cent to the independent sector. In the case of the meals service, this largely relates to the existence in the area of voluntary bodies who may take a significant role in the preparation or delivery of meals.

  3.  Local authorities place and financially support significant numbers of clients in independent sector residential care homes—71 per cent of all local authority supported residents in residential care. There is some variation in the proportions between authorities, but not to the same extent as with community based services. Over the last few years a substantial number of authorities have transferred some of their homes to independent ownership; some of the variation in proportionate use of the independent sector may reflect the fact that authorities are at different stages in this process. At 31 March 1999 only one authority placed all its clients in independent sector homes.

  4.  Information on the total amount spent in the independent sector is not collected centrally.

Table 5.4.1

PROPORTION OF SOCIAL SERVICES FOR ADULTS WHICH ARE PURCHASED BY THE LOCAL AUTHORITY FROM THE INDEPENDENT SECTOR: ENGLAND: YEAR ENDING 31 MARCH 1999 (1)

percentage
Government Office Region and Local Authority	Contact hours of home help/care	Meals served at home, luncheon clubs and at day centres	Day centre places (2)	Supported residents in residential care (3)
ENGLAND	46	40	26	71
NORTH EAST
Shire Counties
Durham	52	39	15	59
Northumberland	..	..	37	73
Unitary Authorities
Darlington	50	53	20	63
Hartlepool	37	46	20	62
Middlesbrough	11	3	22	58
Redcar & Cleveland	8	43	16	62
Stockton-on-Tees	32	14	16	64
Metropolitan Districts
Gateshead	18	17	15	62
Newcastle-upon-Tyne	..	44	69	88
North Tyneside	6	0	41	76
South Tyneside	41	14	4	63
Sunderland	25	65	17	69
NORTH WEST
Shire Counties
Cheshire	32	39	..	77
Cumbria	34	..	35	45
Lancashire	64	58	20	74
Unitary Authorites
Blackburn and Darwen	58	14	10	71
Blackpool	51	56	32	77
Halton	54	29	10	72
Warrington	48	31	16	79
Metropolitan Districts
Bolton	17	22	19	75
Bury	48	14	4	57
Manchester	28	14	29	93
Oldham	23	69	18	78
Rochdale	30	97	0	69
Salford	..	16	8	61
Stockport	..	..	..	98
Tameside	33	0	33	89
Trafford	9	80	8	65
Wigan	2	54	6	88
MERSEYSIDE
Metropolitan Districts
Knowsley	..	0	..	100
Liverpool	..	9	2	68
St Helens	13	..	0	53
Sefton	71	22	14	76
Wirral	23	55	0	68
YORKSHIRE & THE HUMBER
Shire Counties
North Yorkshire	31	39	34	60
Unitary Authorities
East Riding	68	100	14	91
Kingston-upon-Hull	26	13	0	88
North East Lincolnshire	18	0	..	93
North Lincolnshire	46	..	6	77
York	41	13	10	56
Metropolitan Districts
Barnsley	48	8	12	76
Bradford	24	29	24	65
Calderdale	29	11	28	54
Doncaster	47	67	12	59
Kirklees	13	23	40	64
Leeds	9	..	15	54
Rotherham	20	5	18	63
Sheffield	..	72	..	70
Wakefield	2	0	0	76
EAST MIDLANDS
Shire Counties
Derbyshire	22	62	20	62
Leicestershire	70	23	18	70
Lincolnshire	44	35	..	81
Northamptonshire	61	32	48	62
Nottinghamshire	21	12	..	68
Unitary Authorities
Derby	21	71	25	57
Leicester	56	34	30	75
Nottingham	18	1	..	70
Rutland	44	68	23	48
WEST MIDLANDS
Shire Counties
Shropshire	70	49	24	89
Staffordshire	..	35	..	61
Warwickshire	46	..	..	75
Worcestershire	31	65	10	74
Unitary Authorities
Herefordshire	19	79	35	67
Stoke-on-Trent	51	..	0	42
The Wrekin	60	67	11	75
Metropolitan Districts
Birmingham	..	..	21	61
Coventry	62	14	32	61
Dudley	36	37	33	64
Sandwell	49	28	22	61
Solihull	47	100	20	67
Walsall	70	38	35	53
Wolverhampton	59	..	21	55
SOUTH WEST
Shire Counties
Cornwall	70	91	41	98
Devon	54	24	25	82
Dorset	28	58	2	71
Gloucestershire	62	11	29	92
Isles of Scilly	..	10	0	50
Somerset	96	71	35	87
Wiltshire	49	..	41	44
Unitary Authorities
Bath & North East Somerset	20	23	17	60
Bournemouth	46	33	12	89
Bristol	10	..	23	49
North Somerset	25	23	..	77
Plymouth	..	..	30	78
Poole	50	29	10	89
South Gloucestershire	7	25	12	47
Swindon	16	38	30	62
Torbay	46	11	52	84
EASTERN
Shire Counties
Bedfordshire	..	47	19	92
Cambridgeshire	55	91	17	62
Essex	61	32	21	61
Hertfordshire	74	27	16	82
Norfolk	42	80	54	73
Suffolk	48	75	29	44
Unitary Authorities
Luton	54	57	0	45
Peterborough	39	54	17	50
Southend	53	46	6	83
Thurrock	59	0	9	55
LONDON
InnerLondon
Camden	55	29	46	79
Greenwich	67	7	12	65
Hackney	72	29	39	91
Hammersmith & Fulham	53	9	8	63
Islington	65	38	50	79
Kensington & Chelsea	52	78	39	73
Lambeth	34	100	11	82
Lewisham	34	..	3	85
Southwark	78	..	32	69
Tower Hamlets	56	36	32	88
Wandsworth	58	100	34	88
Westminster	58	91	54	79
City of London	53	3	66	80
Outer London
Barking & Dagenham	26	0	1	..
Barnet	75	63	..	68
Bexley	12	3	35	79
Brent	50	0	10	83
Bromley	21	..	55	94
Croydon	32	82	28	55
Ealing	76	0	6	68
Enfield	57	26	22	86
Haringey	..	..	37	80
Harrow	57	2	3	94
Havering	..	44	8	47
Hillingdon	44	32	7	46
Hounslow	61	0	26	65
Kingston-upon-Thames	72	100	44	70
Merton	50	12	35	63
Newham	35	100	0	76
Redbridge	46	2	10	92
Sutton	53	18	33	72
Waltham Forest	24	23	27	72
SOUTH EAST
Shire Counties
Buckinghamshire	28	65	28	81
East Sussex	70	0	61	86
Hampshire	69	70	38	67
Kent	80	80	56	80
Oxfordshire	51	77	53	54
Surrey	64	17	..	69
West Sussex	21	75	17	73
Unitary Authorities
Bracknell Forest	39	61	30	64
Brighton & Hove	71	..	26	85
Isle of Wight	32	15	77	92
Medway Towns	79	59	8	83
Milton Keynes	17	78	47	93
Portsmouth	78	52	14	54
Reading	49	..	1	59
Slough	52	3	32	55
Southampton	72	16	36	73
West Berkshire	46	64	20	71
Windsor & Maidenhead	53	85	3	70
Wokingham	53	80	37	77

Footnotes:

  1.  Data collected on DH annual returns HH1 (home help), MS1 (meals), DC3 (day centres) for a survey week during the autumn 1998, and SR1 (supported residents) as at 31 March 1999. These figures do not include clients supported by local authorities in nursing care homes, which are all in the independent sector, or clients supported in any unstaffed homes.

  2.  Whole day equivalent places.

  3.   Includes residents supported in other authorities.

  ..   not available.

5.5  Care for children

Could the Department provide a table, by local authority, comparing the number of children fostered, with the number of children placed in community homes? Could the Department provide data on the number of children involved in schemes which are specifically designed to support families?

Children looked after by local authorities

  1.  Table 5.5.1 headed "Children looked after by placement at 31 March 1999 by placement" compares the number of children fostered with the numbers placed in community homes. Community Homes refers to childrens' homes managed directly by Local Authorities and certain homes managed by Local Authorities in conjunction with Voluntary Organisations. These do not include homes run entirely by Voluntary Organisations or private "for profit" organisations. Children placed in these settings will be included "as Other placements". This third category also includes children placed in residential schools and children on Care Orders but living at home with their families.

  2.  There was a long-term decline in the numbers of children looked after until 1994. This was accompanied by fewer and fewer children being cared for in residential care, so that the proportion of children in foster care increased correspondingly. Since 1994 the numbers of children looked after has increased by 9 per cent. The numbers of children in foster care has increased over this recent period but the numbers of children in community homes has remained roughly constant.

Children involved in schemes to support families

  3.  As the Committee may be aware, data on children who are not formally looked after or on child protection registers are not yet part of the Department's regular (annual) statistical collections. However, we have been working with authorities to fill this gap, with the result that the first collection of data on all children in need nationally took place in February 2000. We hope to have results from this by the autumn. The data collection includes, amongst other things, children seen at family centres and by members of family support teams. Otherwise, our best estimate of the number of children in need served by local authorities at any given time remains in the order of 350,000.

Table 5.5.1

NUMBER AND PERCENTAGE OF CHILDREN LOOKED AFTER BY PLACEMENT AT 31 MARCH 1999 (1)

	Numbers				Percentages
	All	Foster	Community	Other	Foster	Community	Other
	Children	placements	Homes	Placements	placements	Homes	Placements
ENGLAND	55,300	36,200	4,800	14,300	65	9	26
North East
Shire Counties
Durham	486	295	54	137	61	11	28
Northumberland	297	177	39	81	60	13	27
Unitary Authorities
Darlington	135	87	16	32	64	12	24
Hartlepool	112	55	1	56	49	1	50
Middlesbrough	175	113	17	45	65	10	26
Redcar & Cleveland	165	122	13	30	74	8	18
Stockton-on-Tees	178	125	21	32	70	12	18
Metropolitan Districts
Gateshead	279	180	45	54	65	16	19
Newcastle upon Tyne	442	286	52	104	65	12	24
North Tyneside	280	187	18	75	67	6	27
South Tyneside	296	187	47	62	63	16	21
Sunderland	421	254	69	98	60	16	23
North West
Shire Counties
Cheshire	478	357	39	82	75	8	17
Cumbria	520	329	33	158	63	6	30
Lancashire	1,491	841	294	356	56	20	24
Unitary Authorities
Blackburn & Darwen	285	154	41	90	54	14	32
Blackpool	228	139	30	59	61	13	26
Halton	138	111	5	22	80	4	16
Warrington	144	101	10	33	70	7	23
Metropolitan Districts
Bolton	309	201	20	88	65	6	28
Bury	208	116	24	68	56	12	33
Manchester	1,248	834	72	342	67	6	27
Oldham	268	165	38	65	62	14	24
Rochdale	231	125	38	68	54	16	29
Salford	480	301	51	128	63	11	27
Stockport	334	200	43	91	60	13	27
Tameside	243	158	14	71	65	6	29
Trafford	160	76	47	37	48	29	23
Wigan	411	268	35	108	65	9	26
Merseyside
Metropolitan Districts
Knowsley	245	165	15	65	67	6	27
Liverpool	1,172	688	102	382	59	9	33
Sefton	269	155	48	66	58	18	25
St Helens	259	135	32	92	52	12	36
Wirral	341	220	27	94	65	8	28
Yorkshire & Humberside
Shire Counties
North Yorkshire	327	203	26	98	62	8	30
Unitary Authorities
East Riding of Yorkshire	221	138	31	52	62	14	24
Kingston-upon-Hull	701	425	49	227	61	7	32
North East Lincolnshire	260	181	17	62	70	7	24
North Lincolnshire	202	120	35	47	59	17	23
York	125	78	14	33	62	11	26
Metropolitan Districts
Barnsley	335	188	44	103	56	13	31
Bradford	674	444	54	176	66	8	26
Calderdale	246	158	38	50	64	15	20
Doncaster	364	200	42	122	55	12	34
Kirklees	337	158	53	126	47	16	37
Leeds	1,228	796	165	267	65	13	22
Rotherham	335	212	32	91	63	10	27
Sheffield	603	357	47	199	59	8	33
Wakefield	460	338	34	88	73	7	19
East Midlands
Shire Counties
Derbyshire	609	467	37	105	77	6	17
Leicestershire	262	197	23	42	75	9	16
Lincolnshire	514	285	59	170	55	11	33
Northamptonshire	590	352	74	164	60	13	28
Nottinghamshire	491	313	33	145	64	7	30
Unitary Authorities
Derby	459	317	21	121	69	5	26
Leicester	455	311	37	107	68	8	24
Nottingham	612	393	67	152	64	11	25
Rutland	7	3	-	4	43	-	57
West Midlands
Shire Counties
Shropshire	183	110	20	53	60	11	29
Staffordshire	568	365	44	159	64	8	28
Warwickshire	363	279	3	81	77	1	22
Worcestershire	548	415	31	102	76	6	19
Unitary Authorities
Herefordshire	208	152	2	54	73	1	26
Stoke-on-Trent	348	242	32	74	70	9	21
Telford & Wrekin	143	93	21	29	65	15	20
Metropolitan Districts
Birmingham	1,678	985	272	421	59	16	25
Coventry	434	271	35	128	62	8	29
Dudley	334	207	33	94	62	10	28
Sandwell	459	337	27	95	73	6	21
Solihull	173	115	1	57	66	1	33
Walsall	339	241	29	69	71	9	20
Wolverhampton	376	260	15	101	69	4	27
South West
Shire Counties
Cornwall	548	389	28	131	71	5	24
Devon	655	467	38	150	71	6	23
Dorset	253	208	10	35	82	4	14
Gloucestershire	483	336	35	112	70	7	23
Isles of Scilly	-	-	-	-	-	-	-
Somerset	376	264	46	66	70	12	18
Wiltshire	256	206	14	36	80	5	14
Unitary Authorities
Bath & North East Somerset	137	116	2	19	85	1	14
Bournemouth	182	141	9	32	77	5	18
Bristol	559	378	56	125	68	10	22
North Somerset	140	114	3	23	81	2	16
Plymouth	362	261	25	76	72	7	21
Poole	111	87	-	24	78	-	22
South Gloucestershire	163	108	-	55	66	-	34
Swindon	193	167	2	24	87	1	12
Torbay	221	162	7	52	73	3	24
London
Inner London
Camden	299	198	2	99	66	1	33
City of London	3	2	-	1	67	-	33
Greenwich	398	242	21	135	61	5	34
Hackney	479	356	30	93	74	6	19
Hammersmith & Fulham	340	231	22	87	68	6	26
Islington	464	272	47	145	59	10	31
Kensington & Chelsea	220	130	18	72	59	8	33
Lambeth	654	441	4	209	67	1	32
Lewisham	467	302	25	140	65	5	30
Southwark	610	476	46	88	78	8	14
Tower Hamlets	249	177	30	42	71	12	17
Wandsworth	326	231	19	76	71	6	23
Westminster	275	159	21	95	58	8	35
Outer London
Barking & Dagenham	210	155	24	31	74	11	15
Barnet	214	161	14	39	75	7	18
Bexley	178	125	21	32	70	12	18
Brent	323	214	3	106	66	1	33
Bromley	252	154	12	86	61	5	34
Croydon	366	234	43	89	64	12	24
Ealing	370	201	36	133	54	10	36
Enfield	255	169	25	61	66	10	24
Haringey	356	270	34	52	76	10	15
Harrow	151	98	16	37	65	11	25
Havering	137	96	10	31	70	7	23
Hillingdon	297	192	36	69	65	12	23
Hounslow	241	139	23	79	58	10	33
Kingston-upon-Thames	100	62	10	28	62	10	28
Merton	194	145	7	42	75	4	22
Newham	478	354	10	114	74	2	24
Redbridge	145	90	9	46	62	6	32
Richmond-upon-Thames	97	63	4	30	65	4	31
Sutton	131	94	1	36	72	1	27
Waltham Forest	263	187	12	64	71	5	24
Eastern
Shire Counties
Bedfordshire	313	191	31	91	61	10	29
Cambridgeshire	453	328	20	105	72	4	23
Essex	1,061	611	78	372	58	7	35
Hertfordshire	735	514	61	160	70	8	22
Norfolk	658	474	57	127	72	9	19
Suffolk	528	365	37	126	69	7	24
Unitary Authorities
Luton	266	183	16	67	69	6	25
Peterborough	359	270	17	72	75	5	20
Southend	255	172	5	78	67	2	31
Thurrock	173	103	7	63	60	4	36
South East
Shire Counties
Buckinghamshire	236	145	27	64	61	11	27
East Sussex	438	299	28	111	68	6	25
Hampshire	816	502	83	231	62	10	28
Kent	1,427	1,030	95	302	72	7	21
Oxfordshire	478	298	34	146	62	7	31
Surrey	640	360	62	218	56	10	34
West Sussex	671	424	43	204	63	6	30
Unitary Authorities
Bracknell Forest	70	33	7	30	47	10	43
Brighton & Hove	345	278	10	57	81	3	17
Isle of Wight	146	121	7	18	83	5	12
Medway Towns	314	219	10	85	70	3	27
Milton Keynes	309	203	20	86	66	6	28
Portsmouth	226	136	27	63	60	12	28
Reading	144	75	16	53	52	11	37
Slough	126	68	14	44	54	11	35
Southampton	360	238	16	106	66	4	29
West Berkshire	130	71	9	50	55	7	38
Windsor & Maidenhead	75	43	11	21	57	15	28
Wokingham	93	41	10	42	44	11	45

  1.  Figures for children looked after in this table exclude agreed series of short-term placements.

5.6  Variations in service delivery

Could the Department provide figures showing how the delivery of non-residential social services has changed over the last five years and comment on these trends?

  1.  Table 5.6.1 presents information on home help/care, meals services and day centre provision for the period from 1994 to 1998. Information is derived from the statistical collections for a sample week in September/October each year. Fuller information is published in the statistical publication Community Care Statistics Day and Domiciliary Personal Social Services for Adults, England 1998 (ref. HMD/98 ISBN 1 84182 109 8). Information for 1998 presented last year was of a provisional nature and has been finalised here.

Home help/care contact hours

  2.  Between 1994 and 1998 the total number of contact hours provided during the survey week increased by around 18 per cent, from 2.2 million to 2.6 million hours. By contrast, the number of households receiving home help/care dropped from around 540,000 in 1994 to around 450,000 in 1998 suggesting a more intensive service is being provided to fewer households. All of the increase in provision was in the independent sector, while the number of contact hours provided directly by local authorities dropped by 21 per cent over the period, emphasising that local authorities are continuing to make more use of the independent sector.

  3.  The increase in the intensity of service is highlighted in the length and frequency of visits to households during the survey week (not shown in the table). In 1998, 31 per cent of households received a more intensive service (of more than 5 hours and 6 or more visits), compared to 15 per cent in 1994. The proportion of households receiving a "low" intensity service (just one visit lasting less than 2 hours) was around 38 per cent in 1994, dropping to 25 per cent in 1998.

Meals service

  4.  The total number of meals provided (either in luncheon clubs, day centres or to clients' own homes) increased by 3 per cent over the period 1994 to 1995 (1,108,000 to 1,142,000) but then dropped in 1996, 1997 and again in 1998. Similarly, the number of people receiving meals dropped over the period from just over 300,000 in 1994 to 247,000 in 1997. (The number of meals served at luncheon clubs is now no longer collected, therefore comparable figures for 1998 are unavailable). The number of meals served to clients' homes in 1998 was 180,000. The local authority sector still accounts for the majority of all meals provided, 60 per cent in 1998 from 64 per cent in 1994. The proportion of meals supplied by the independent sector however has increased from 36 per cent in 1994 to 40 per cent in 1998.

Day centre places

  5.  The number of available day centre places (days per week) increased by 9 per cent from 569,000 in 1994 to 621,000 in 1997. The 683,000 day centres places for 1998 now include day care facilities within residential accommodation which also cater for non-residents and is not directly comparable with the earlier years. The number of attendances at day centres increased from around 449,000 in 1994 to 469,000 in 1997, the last year for which information on attendances was collected. This information has now been replaced by data on the number of clients attending day centres during the survey week, which for 1998 was 253,000. The local authority share of places provision has dropped steadily over the period from 86 per cent to 74 per cent of the total.

Table 5.6.1

NON-RESIDENTIAL SOCIAL SERVICES FOR ADULTS, AUTUMN SURVEY WEEK, 1994 TO 1998, ENGLAND (1)

units
	Year	All sectors	Local Authority	Independent	NHS
Home help/care:
contact hours provided	1994	2,215,100	1,787,000	428,200	—
	1995	2,395,700	1,688,900	706,800	—
	1996	2,486,700	1,581,200	900,900	—
	1997	2,637,300	1,506,500	1,130,800	—
	1998	2,607,400	1,410,500	1,197,000	—
households receiving	1994	538,900	479,300	59,600	—
	1995	512,400	419,600	93,900	—
	1996	491,100	370,200	121,000	—
	1997	479,100	335,100	144,000	—
	1998	447,200	294,500	152,700	—
Meals services: (2)
meals provided	1994	1,108,300	707,100	396,800	4,500
	1995	1,141,600	709,700	427,000	4,900
	1996	1,092,700	677,000	414,300	2,000
	1997	1,069,500	646,500	417,900	2,500
	1998	1,000,300	598,200	399,500	2,600
people receiving meals	1994	300,400	152,000	146,200	2,200
	1995	266,600	126,000	138,900	1,500
	1996	251,800	119,500	131,700	600
	1997	247,900	115,000	132,500	400
	1998 (4)	180,100	101,000	78,300	800
Day centres: (3)
places	1994	569,300	487,100	82,100	—
	1995	602,000	496,500	105,600	—
	1996	609,300	482,200	127,000	—
	1997	620,800	481,300	139,500	—
	1998	682,900	503,800	179,100	—
attendances/attendees	1994	449,000	386,500	62,500	—
	1995	464,000	386,200	77,900	—
	1996	482,100	386,400	95,700	—
	1997	469,100	366,900	102,200	—
	1998 (5)	252,800	174,100	78,700	—
Footnotes: 1.  Data are collected on DH annual returns HH1 (home help/care), MS1 (meals service) and DC3 (day centres) for a survey WEEK during the Autumn. The figures are rounded to the nearest hundred. Components may not therefore add to the totals. Meals to peoples' homes as meals-on-wheels, at luncheon clubs, or at day centres. Figures are whole-day equivalent places. 1998 data now includes day care facilities within residential accommodation which also cater for non-residents. For 1998. Refers to the number of people receiving meals at home only. In 1998, a change of collection occurred for day centres—attendees are now collected as opposed to attendances. -  Not applicable/not available. .. not available. NB  The data in this table may have been updated since last year, as LAs can provide more complete data.

5.7  PSS demographic pressures

Could the Department provide details of the specific inflation index calculated for social services, and an assessment of the financial effect of demographic pressures on social services?

The inflation index

  1.  The specific price index figures for 1996-97 and earlier years was calculated by the former Cleveland County Council on the basis of a questionnaire seeking details from local authorities on pay, running costs and the actual costs of contracted out services. However, following the recent changes to local government boundaries, Cleveland County Council no longer exists. The Department of Health has produced the index for 1997-98 and 1998-99, annual increases in which are set out below at table 5.7.1, using broadly the same method. Data is not yet available to calculate the index for 1999-2000.

Table 5.7.1

PSS PAY AND PRICES INDEX

	% increase over previous year
1997-98	2.5
1998-99	2.6

The financial effect of demographic changes

  2.  The Department's estimates of the notional financial consequences of demographic changes on social services are set out in table 5.7.2 below.

  3.  The calculation is based on estimated population changes for children (aged 0-17), adults (18-64) and people aged 65 and over. The elderly age group is further broken down into five year age bands: 65-69 years, 70-74 years, 75-79 years, 80-84 years and 85 years and over.

  4.  Local authority expenditure returns are used to divide total expenditure into children, elderly and younger adults' age groups. Expenditure on the elderly is additionally separated into four different categories of service: residential PSS, home care, meals and day centres.

  5.  Activity data is used to estimate the breakdown of elderly expenditure in each of these four service categories into five year age bands. For example, expenditure on residential PSS on those aged 65-69, home care expenditure on those aged 70-74 and so on. Activity data is derived from DH statistics, supplemented with information on service utilisation from the General Household Survey.

  6.  Estimated expenditure for each age band is then multiplied by projected future changes in populations in each age band to arrive at estimated demographic pressure in each band. Summing across all age bands gives total financial demographic pressure, which is then divided by current expenditure to give an expression of the effects of demographic changes in percentage terms. This is set out in table 5.7.2 below.

Table 5.7.2

NOTIONAL FINANCIAL EFFECT ON PSS OF DEMOGRAPHIC PRESSURES

	% increase over previous year
1998-1999	0.3
1999-2000	0.7
2000-2001	0.9
2001-2002	0.6
2002-2003	0.2
2003-2004	0.0

  7.  The interpretation of this table is that, for example, on the basis of these estimations, resources for social services need to increase by 0.6 per cent between 2000-01 and 2001-02 in order to keep pace with changes in the age composition of the population, assuming that all other relevant factors remain constant.

5.8  PSS Programme Budgets

Could the Department provide a breakdown by client group of gross expenditure for the latest available two years on the main items of social services activity. Could the Department also update table 5.8?

  1.  Tables 5.8.1 and 5.8.2 show the breakdown by client group of gross expenditure for 1998-99 and 1997-98. Table 5.8.3 updates last year's response.

  2.  The data shown in tables 5.8.1 and 5.8.2 is illustrated in charts 5.8.1 and 5.8.2.

Table 5.8.1

PSS GROSS EXPENDITURE, 1998-99

England £million	Total	Mental Health (1)	Learning Disabilities (1)	Children (1)	Adults (1)	Elderly (1)
HQ Costs	149	.	.	.	.	.
Area Officers/Senior Managers	348	28	26	161	29	103
Care Management/Social Work	1,136	126	76	505	101	329
Residential Care	5,184	224	838	724	218	3,180
Non Residential Care	3,822	186	555	1,074	402	1,605
Other	208	—	—	—	208	—
Total	10,847	564	1,495	2,465	958	5,216

. Not available

Source: RO3 return.

Reference:

1.  In accordance with CIPFA guidance, a number of Support Management costs are reallocated to individual client groups.

Table 5.8.2

PSS GROSS EXPENDITURE, 1997-98

England						£million
	Total	Mental Health (1)	Learning Disabilities (1)	Children (1)	Adults (1)	Elderly (1)
HQ Costs	128	\	\	\	\	\
Area Officers/Senior Managers	336	24	26	155	27	104
Care Management/Social Work	1,066	113	75	459	95	325
Residential Care	4,776	208	737	690	200	2,942
Non Residential Care	3,531	169	487	952	382	1,541
Other	147	—	—	—	147	—
Total	9,984	515	1,324	2,256	850	4,912

\ Not available

Source: RO3 return.

Reference:

1.  In accordance with CIPFA guidance, a number of Support Management costs are reallocated to individual client groups.

Table 5.8.3

PSS GROSS EXPENDITURE, 1998-99 PRICES

England								£million
	1988-89	1993-94	1994-95	1994-95	1995-96	1996-97	1997-98	1998-99
				(with unallocated	(with allocated	(with allocated	(with allocated	(with allocated
				central admin.)	central admin.)	central admin.)	central admin.)	central admin.)
HQ Costs
Director and senior staff	—	—	50.1	78.0	75.6	71.5	71.0	83.1
Registration, Inspection and Complaints	—	43.9	51.7	51.7	56.5	58.6	61.4	65.4
Mental Health
Residential	45.9	51.7	116.9	131.0	161.4	196.5	214.6	223.7
Non Residential (exc. Field Social Work)	28.9	135.2	122.9	132.3	154.7	162.4	174.6	186.1
Field Social Work (1)	—	72.2	26.3	26.3	28.6	20.6	18.9	—
Care Assessment/Care Management (1)	—	—	68.1	68.1	75.6	90.9	98.1	126.0
Learning Disabilities
Residential	213.1	376.6	494.7	551.8	614.4	705.5	761.1	838.1
Non Residential (exc. Field Social Work)	252.2	365.0	383.8	441.7	471.3	478.4	502.4	555.1
Field Social Work (1)	—	61.2	22.4	22.4	21.5	15.1	17.4	—
Care
Assessment/Care Management (1)	—	—	39.6	39.6	51.4	61.2	59.6	75.7
Children
Residential	589.5	564.0	610.0	693.7	691.6	697.5	712.4	724.3
Non Residential (exc. Field Social Work)	540.5	757.9	772.0	893.9	921.5	962.8	982.9	1,074.5
Field Social Work (1)	—	372.7	147.7	147.7	131.6	120.0	108.5	—
Care Assessment/Care Management (1)	—	—	283.6	283.6	316.8	341.2	365.4	505.0
Adults
Residential	69.8	84.1	134.5	148.6	167.6	192.0	206.2	218.0
Non Residential (exc. Field Social Work)	142.7	274.3	269.6	312.8	365.6	378.9	394.6	401.8
Field Social Work (1)	—	71.1	23.3	23.3	20.6	17.3	17.6	—
Care Assessment/Care Management (1)	—	—	56.5	56.5	67.5	78.7	80.3	101.1
Elderly
Residential	1,230.4	1,402.6	1,957.6	2,141.7	2,501.1	2,850.9	3,037.7	3,179.7
Non Residential (exc. Field Social Work)	926.7	1,081.5	1,308.8	1,479.3	1,540.5	1,556.6	1,591.6	1,604.6
Field Social Work (1)	—	210.5	63.8	63.8	67.2	47.0	47.0	—
Care Assessment/Care Management (1)	—	—	232.2	232.2	242.7	310.3	288.1	328.5
Other Adults (2) (3)	131.6	104.0	92.3	99.1	95.9	102.2	151.5	208.4
Field Social Work for other adults	—	35.4	—	—	—	—	—	—
Field Social Work (6)	622.6	—	—	—	—	—	—	—
Care Management/Care Assessment (4) (6)	—	122.3	—	—	—	—	—	—
Area Officers/Senior Managers	—	—	134.6	340.8	356.7	326.8	346.9	348.3
Training (5)	57.5	89.6	95.2	95.2	88.4	82.6	86.5	76.2
Occupational Therapy (5)	—	42.7	45.7	45.7	41.8	48.4	48.9	66.6
Unallocated central admin.	768.6	861.0	1,007.0	—	—	—	—	—
Total	5,620.1	7,179.3	8,460.2	8,460.1	9,197.7	9,833.8	10,310.0	10,847.3

Source: RO3 return.

  1.  Field social work included with care management for 1998-99.

  2.  Includes both residential and non residential costs not specified elsewhere.

  3.  Includes health related Social Work from 1994-95.

  4.  Includes all client groups.

  5.  Reallocated within total SSMSS from 1994-95.

  6.  Where not separately identifiable.

5.9  Capital spending on social services

(i)   Could the Department provide figures on the acquisition, upgrade and sale of personal social services assets, for the years 1995-96 to 1999-2000?

(ii)   Could the Department comment on the outcome for personal social services of the Capital Challenge Pilot Fund scheme?

(iii)   What are the Department's criteria for supporting PFI projects in personal social services?

(iv)   Could the Department comment on the use of PFI to date?

(v)   Could the Department compare actual spend with credit approvals?

Capital Expenditure and Income

  1.  Table 5.9.1 shows Councils' expenditure on and income from, their capital assets.

Table 5.9.1

LOCAL AUTHORITY PERSONAL SOCIAL SERVICES CAPITAL EXPENDITURE AND INCOME 1995-96 TO 1999-2000

£ million
	1995-96	1996-97	1997-98	1998-99 provisional	1999-2000 provisional
Maintenance	17.7	16.1	13.7	12.2	17.1
New acquisitions	182.3	163.9	136.0	129.8	186.9
TOTAL SPEND	200.0	180.0	149.7	142.0	204.0
Sale of buildings	32.0	35.2	34.4	37.6	56.8
Sale of equipment	8.0	8.8	8.6	9.4	14.2
TOTAL SALES	40.0	44.0	43.0	47.0	71.0
NET SPEND	160.0	136.0	106.7	95.0	133.0

  Source: COR3 return.

Capital Challenge

  2.  The Department has nothing further to add to its reply in 1998.

Private Finance Initiative (PFI)

  3.  The Department is seeking to support innovative approaches to the problems associated with social exclusion. This can apply to any social services client group.

  4.  There are now 11 social services PFI projects which have been approved by both the Department and the Treasury. Four of these have signed contracts with their partner organisations. The first signed contract involved the demolition of an old residential home and the building of a new high quality dual registered residential/nursing home. This is now completed and operating. The second involved the transfer of 17 homes to a housing association which has been upgrading the homes and providing a high standard of care for elderly people. The third was for a combined residential and day care facility which included a unit targeted for Asian elderly and is also operating successfully. The last signed contract was for a combined social services—health office building, where new joint services could be provided for a variety of clients including those with mental health needs.

  5.  Seven other projects have been approved and are in various stages of negotiation. One of these is a project for the building of four small children's homes, which has included a long process of community consultation. Two others are projects for people with learning disabilities, combining community focused day services with respite care. Four are projects for elderly people, involving innovative models of care, joint working with health, neighbourhood based solutions and intermediate care.

  6.  The interest in social services PFI is increasing rapidly, with more and more councils registering an interest with the Department. The PFI is proving to be an effective tool for the development of new and innovative approaches to new services and new assets.

Capital Expenditure and Available Credit Approvals

  7.  Table 5.9.2 shows Councils' total expenditure and total credit approvals available.

Table 5.9.2

LOCAL AUTHORITY PERSONAL SOCIAL SERVICES CAPITAL EXPENDITURE AND DEPARTMENTAL CREDIT APPROVALS 1995-96 TO 1999-2000

£ million

	1995-96	1996-97	1997-98	1998-99	1999-2000
TOTAL SPEND	200.0	180.0	149.7	142.0	204.0
CREDIT APPROVALS	144.0	102.9	68.2	53.7	55.7

5.10  Changes to PSS Statistical Information

Could the Department provide details of any forthcoming changes to statistical information the Department collects on personal social services?

Changes to Current Collections

Children Looked After

  1.  Simplification of detailed child level return (SSDA903): The classifications and related codes used for each child looked after by a local authority and recorded on the detailed child level return (SSDA903) have been simplified. The simplified coding has been introduced from April 2000.

  2.  Ethnic origin information on looked after children: DH is collecting ethnic data on children looked after from 1 April 2000 by means of a new field on the detailed child level return (SSDA903).

  Social services workforce—gender and ethnic data

  3.  In agreement with the ADSS, DH has been collecting gender data on local authority social services staff from September 1999, and will collect ethnic data on staff from September 2000.

New Collections

Children in need census

  4.  This project grew out of the fact that whilst there is well established data on the children who are looked after by local authorities there is little information on children in need who are not formally looked after. Expenditure on social services provision for children is currently around £2.2 billion per year; of this an estimated £900 million each year is spent on children in need not formally looked after. There is no reliable information on the number of children in need who are living with their families or independently and who are receiving assistance from social services departments. Nor is there sufficient information on their needs, the services they receive or the costs of those services.

  5.  The new Children in Need Data Collection will plug this gap. It is designed as a database which links needs, services and costs of provision made by Local authority social services departments to all children known to them as being in need. The database therefore fulfils the dual function of providing management information to local authorities and summary data on activity resources and costs to DH. Social Services Departments are currently collating activity and expenditure data on all children in need, for a week in February 2000. It is intended to publish the results in Autumn 2000, once the data have been evaluated with local authorities.

Referrals and assessments of children in need

  6.  Starting in 2001-02, a new collection will take place of data on referrals and assessments of children in need, including data on child protection. The details of the collection had not been finalised at the time of going to press.

Outcome indicators for looked after children and care leavers

  7.  A new statistical collection on outcome indicators for looked after children has been introduced to cover the year from 1 October 1999. Local authorities will provide aggregate data on educational attainment in the SATs tests and at GCSE, school attendance, school exclusions, offending rates, and the health care received by these children. The collection will help to support a range of indicators under the Quality Protects Programme including some of the Performance Assessment Framework series. The first data will be available in spring 2001.

  8.  In parallel with this outcome indicator collection, a new child based collection has also been introduced to collect data on the educational qualifications of young people leaving care aged 16 or over. This will provide data to enable the DH to assess progress towards one of its important targets for children's social services. It will also enable educational outcome data to be linked to data on the care histories of these children to permit further analysis. This collection has been introduced to cover the year from 1 April 1999, with the first figures becoming available in autumn 2000.

  9.  In addition, local authorities will also be asked to provide data about the occupation and accommodation of their care leavers after they have left care. Starting in April 1999 this scheme will require authorities to keep in touch with young people leaving care aged 16 and provide data when they reach 19 years old. Data collection will begin in 2001-02.

PSS user satisfaction survey

  10.  Local authorities will be required to undertake user satisfaction surveys for the first time in 2000-01 in the context of Best Value, including a social services user satisfaction survey. Information from these will be collected by DH, producing two of the indicators in the Performance Assessment Framework (users who said they got help quickly following assessment and users who said that matters relating to race, culture or religion were noted during assessment). Local authorities will include additional questions in their surveys for their own use. To minimise the burden on councils, only new users assessed during November will be surveyed.

RAP (referrals assessments and packages of care) project

  11.  This major statistical development project in the adults and elderly area will provide a framework for defining and collecting aggregated person-based information on the main aspects of the community care provision and assessment process. After passing through successive "dress rehearsal" stages, the full implementation of this annual collection is taking place from 1 April 2000 to 31 March 2001. The intention will be to publish results in the autumn of 2001. Additional returns on waiting times have been included but these returns will have "dress rehearsal" status for the 2000-01 period and, in the main, refer to new clients only. Information relating to the ethnic group of clients with completed assessments and receiving services is also being collected.

Workload and performance of registration and inspection units

  12.  A new collection on registration and inspection unit staffing and workload was introduced for 1998-99. Both local authority and health authority inspection units are covered by the survey. In the light of experience with the 1998-99 collection a revised return was introduced in April 2000 in respect of the financial year 1999-2000. Data from 1998-99 onwards will be used as baseline data against which DH can monitor trends on an annual basis until at least 2002 when the National Commission for Care Standards is planned to come into effect.

Ethnic origin data

  13.  There is very strong support within the DH and also from data providers, for collection of ethnic data on workforce and clients. It is anticipated that, in principle, such data should be collected on a basis consistent with the 2001 census categories; with a transition period for datasets where ethnic data are already being collected in whatever form (generally based on 1991 census categories, or variants of them).

Internet Data Collection Project for PSS Returns

  14.  This project is not strictly a data collection but is a key development as part of DH's contribution to the e-government initiative.

  15.  There has been some move in the last few years to enable local authorities to submit information in electronic media but this has not been taken up on a large scale. This year DH is developing a pilot initiative to make a number of social services returns available in electronic format over the Internet. These returns will have the advantage of including validations that will enable data providers to check on the accuracy of the data provided, at source. The pilot covers the following returns:

Looked after children aggregate return (CLA100)

Children on Child Protection Registers (CPR1/2)

Educational Qualifications of Care Leavers (OC1)

Number of homes and places in residential care homes (RA Form A, Parts 1,2 3)

Independent sector nursing care homes registered under Section 23 of the Registered Homes Act 1984 (RH(N)Parts A/1to A/3)

Local authority supported residents (SR1)

Key statistics (KS1)

  The intention is that all feasible returns should be available for completion via the Internet by 31 March 2001

Note: examples of the returns and the publications referred to above can be viewed on the DH Internet site: www.doh.gov.uk/public/stats1.htm

5.11  Research on outcomes and effectiveness of social care

Could the Department provide details of any research work currently being sponsored by the Department on the outcomes and effectiveness of social care?

  1.  In the children's field we have commissioned a programme of studies designed to look at Costs and Effectiveness in Child Social Care. The programme currently consists of 10 studies as follows:

—  The costs and consequences of different types of child care provision for looked after children;

—  Leadership, resources and efficiency in children's homes;

—  Costs and outcomes of non-infant adoptions;

—  Costs and effectiveness of adolescent support teams;

—  Costs and outcomes of different interventions for sexually abused children;

—  Remuneration and performance in foster care;

—  Variations and unit costs of child care;

—  Meeting the mental health needs of children in the child protection system;

—  A structured approach to assessing family capacities and children's needs-an exploratory study of the impact and costs of the new Framework of the Assessment of Children in Need and their Families;

—  Costs and consequences of services for troubled adolescents.

  2.  A recently completed programme of studies considered the effectiveness of intervention on children looked after in residential care. An Overview of the findings of the completed studies was published in the DH research "Messages" series as "Caring For Children away From Home: Messages from Research" (Wiley). Current studies of effectiveness include the following:

—  Longitudinal study of children looked after in foster care;

—  Factors associated with positive outcomes for troubled adolescents and children;

—  Evaluation of "Enabling Parents", a community programme supporting parenting skills.

  3.  In the adult field, we have commissioned a series of 13 linked studies on outcomes of social care for adults (OSCA). The purpose of this initiative is to deliver research evidence to inform the planning, commissioning and delivery of cost-effective services. The initiative is now drawing to a close and plans are in hand to prepare an overview of the findings across the studies. This is scheduled to be completed in spring 2001. The client groups served are older people, learning disability, mental health, alcohol and carers. The study titles are:

—  The management and effectiveness of home care assistants;

—  Older people with dementia and their carers: professional intervention in primary care;

—  Routine use of a standardised assessment for measuring the outcomes of social care;

—  Integrating social and health care: a comparative study of outcomes for older peoples and their carers;

—  Subjective and objective quality of life assessment: their interrelationship and determinants;

—  Client and carer focussed measure of social care outcomes for adults with sever mental health problems;

—  Ten years on: outcomes and costs of community care for people with learning disabilities and mental health problems;

—  A cost-benefit study of an open access detoxification centre;

—  Caring relationships over time: predicting outcomes for carers;

—  Carers needs and the Carers Act: evaluating the process and outcomes of assessment;

—  Developing evidence based social care policy and practice.

  4.  The Department currently has a major programme of research on the outcomes and effectiveness of adult social care. Most of the projects began in 1997-98 and most are due for completion in 2000. The Department funds the work of the Personal Social Services Research Unit. PSSRU is mostly concerned with cost effectiveness and efficiency and some of its recent work has been on community care for elderly people, performance indicators and costing innovative respite services for people with learning disabilities.

  5.  The recently completed programme of studies considered the effectiveness of intervention on children looked after in residential care are summarised in an overview "Caring for Children Away from Home: Messages from Research". This includes: "Working in Children's Homes, Challenges and Complexities"; "Children's Homes, A Study in Diversity"; "Going Missing, Young People Absent from Care"; "Leadership in Residential Child Care, Evaluating Qualification Training" and "Sexually Abused and Abusing Children in Substitute Care". Current studies on adoption will be drawn together with other studies on the subject in an overview in the "Messages from Research" series.

  6.  It is important to note that the measurement of the effectiveness of interventions in social care is hampered by complexity of outcomes and the absence of robust measures of effectiveness. A number of studies listed above include the development of improved measures in this area.

5.12  Fees and Charges

Could the Department update Tables 5.12 providing separate figures on residential care for each client group? Could the Department quantify the degree of variation in domiciliary charges between authorities? Could the Department provide a commentary?

Could the Department provide an analysis, to include chart, tables and commentary, of (i) the recent national trend in the percentage of gross expenditure on residential accommodation for older people recouped through fees and charges and (ii) the recent national trend in the percentage of gross expenditure on home care/home help for all client groups recouped through fees and charges?

Could the Department provide an analysis, to include chart, tables and commentary, of (i) the local authority variations in the latest year in the percentage of gross expenditure on residential accommodation for older people recouped through fees and charges and (ii) the local authority variations in the latest year in the percentage of gross expenditure on home care/home help for all client groups recouped through fees and charges?

  1.  Table 5.12.1 updates last year's information and provides separate figures on residential care for each client group. Figures 5.12.1 and 5.12.2 illustrate the recent national trends in the percentage of gross expenditure on residential accommodation for older people recouped through sales, fees and charges and the percentage of gross expenditure on home care/home help for all client groups recouped through sales, fees and charges. It is not possible to include figures for the period prior to 1994-95 as the data for these earlier years were collected on a different basis.

  2.  The table shows that the percentage of gross expenditure recouped in sales, fees and charges for residential care for the elderly rose from 33 per cent in 1996-97 to 37 per cent in 1998-99; in absolute terms the amount recouped rose from £823 million in 1996-97 to £1,097 million in 1998-99. The amount recouped for home care and home help service also rose from £104 million in 1996-97 (representing 9 per cent of gross expenditure) to £160 million (12 per cent of gross expenditure) in 1998-99.

Variations in charges for domiciliary services

  3.  Figures 5.12.3 and 5.12.4 illustrate the percentage of gross expenditure recovered in charges by each local authority for home help/home care and meals on wheels services, the two main items of service provided in a domiciliary setting. Table 5.12.2 sets out in tabular form the percentage of gross expenditure on home care/home help recouped through sales, fees and charges.

  4.  At the Local Authority level, there is a wide variation in the amounts raised in sales, fees and charges made from domiciliary provision. Local Authorities are free to decide upon the level of charges to raise on domiciliary services in the light of what it is reasonable to expect the client to pay. A wide range of charging policies are in operation ranging from flat rate charges to income-related charges. The White Paper "Modernising Social Services" published on 20 November 1998 explains the issue of charging for non-residential services. The Government believes that the scale of variation in the discretionary charging system, including the difference in how income is assessed, is unacceptable. We intend therefore to consider how we might improve the system in the light of both the Royal Commission's report on the funding of long term care, and the Audit Commission's survey of local authority charging practices (published as "Charging with Care" in May 2000). Our aim is to establish greater consistency and fairness in charging.

  5.  There are a number of instances where Local Authorities have reported that they raised no sales, fees and charges income for home care/home help services provided; at the other extreme, some authorities reported recouping 39 per cent or more. Such wide variability of individual authority figures points to issues of data quality and there is a risk that misreporting of data by local authorities has had an effect. The current Performance Management Framework for Best Value in Personal Social Services will help to reinforce the message to Local Authorities that it is important they report their PSS financial data accurately on the central returns.

  6.  For England as a whole, 12 per cent of the direct cost of the home care/home help service was recouped in sales, fees and charges to clients. Within authorities, the actual figures reported varied from zero in the case of 10 authorities to 30 per cent or more in five authorities. The middle 50 per cent of authorities had recoupment rates between 8 per cent and 16 per cent compared to rates between 6 per cent and 15 per cent for the previous year.

  7.  For meals on wheels services the overall England recoupment rate was 46 per cent: LA figures range from zero in 13 authorities to over 100 per cent in five authorities. The middle 50 per cent of authorities had recoupment rates between 35 per cent and 64 per cent compared to rates between 32 per cent and 62 per cent for the previous year.

Variations in charges for residential services

  8.  Figure 5.12.5 illustrates the percentage of gross expenditure on residential accommodation for older people recouped through sales, fees and charges. Table 5.12.3 tabulates these figures.

  9.  The charges levied to individual residents in care homes are determined nationally. The overall recoupment rate for residential provision for the elderly in England was 37 per cent. LA figures varied between zero in one authority and 53 per cent in another authority. This may again just reflect misreporting by local authorities. The middle 50 per cent of authorities had recoupment rates between 31 per cent and 43 per cent compared to rates between 18 per cent and 42 per cent for the previous year.

Table 5.12.1

SALES, FEES AND CHARGES AS A PERCENTAGE OF GROSS EXPENDITURE BY TYPE OF SERVICE

England £ million	1996-97			1997-98			1998-99
	Gross current expenditure1	Sales, Fees and Charges	Sales, Fees and Charges as a percentage of Gross current expenditure	Gross current expenditure1	Sales, Fees and Charges	Sales, Fees and Charges as a percentage of Gross current expenditure	Gross current expenditure1	Sales, Fees and Charges	Sales, Fees and Charges as a percentage of Gross current expenditure
Residential care:
Residential care for Children	586	21	4%	614	21	3%	656	28	4%
Residential care for Elderly	2,494	823	33%	2,732	958	35%	2,097	1,907	37%
Residential care for people with a Physical Disability	169	39	23%	186	48	26%	204	54	26%
Residential care for People with Learning Disabilities	604	137	23%	673	164	24%	773	213	28%
Residential care for People with Mental Health needs	170	49	29%	193	55	29%	209	61	29%
Other residential provision	20	4	19%	20	4	19%	—	—	—
Non residential care: of which Home care/home helps	1,130	104	9%	1,231	129	10%	1,298	160	12%
Day centres and lunch clubs2	622	38	6%	651	44	7%	686	49	7%
Meals on wheels	83	37	44%	86	39	45%	85	39	46%

Footnotes:

  1.  Excluding administrative and training overheads.

  2.  Lunch clubs not recorded separately on RO3 for 1998-99; intended to be included under day centres.

  —  Not available.

Table 5.12.2

PROPORTION OF NON RESIDENTIAL COSTS RECOUPED IN SALES, FEES & CHARGES: HOME CARE/HOME HELPS, 1998-99

England
			Percentages
	£ thousands		Sales, Fees and
	Sales, Fees and Charges	Gross current expenditure	Charges as a percentage of Gross current expenditure
BARKING & DAGENHAM	299	6,712	4
BARNET	1,017	12,575	8
BARNSLEY	848	6,855	12
BATH & NORTH EAST SOMERSET UA	368	3,043	12
BEDFORDSHIRE	995	8,780	11
BEXLEY	1,632	5,173	32
BIRMINGHAM	1,214	23,572	5
BLACKBURN UA	351	3,571	10
BLACKPOOL UA	417	4,216	10
BOLTON	1,255	7,803	16
BOURNEMOUTH UA	1,037	4,235	24
BRACKNELL FOREST UA	236	2,182	11
BRADFORD	1,653	9,648	17
BRENT	716	7,937	9
BRIGHTON & HOVE UA	724	8,167	9
BRISTOL UA	723	10,035	7
BROMLEY	1,350	9,212	15
BUCKINGHAMSHIRE	2,943	12,223	24
BURY	691	3,796	18
CALDERDALE	840	5,785	15
CAMBRIDGESHIRE	976	9,884	10
CAMDEN	345	11,809	3
CHESHIRE	740	14,114	5
CITY OF LONDON	103	705	15
CORNWALL	3,189	19,825	16
COVENTRY	512	9,941	5
CROYDON	494	5,665	9
CUMBRIA	0	10,995	0
DARLINGTON UA	3	1,169	0
DERBY UA	67	6,851	1
DERBYSHIRE	764	20,633	4
DEVON	4,052	14,617	28
DONCASTER	1,157	8,665	13
DORSET	2,053	7,688	27
DUDLEY	1,260	8,216	15
DURHAM	1,181	13,420	9
EALING	0	7,249	0
EAST RIDING OF YORKSHIRE UA	1,299	7,032	18
EAST SUSSEX	1,316	11,499	11
ENFIELD	658	10,044	7
ESSEX	3,353	33,561	10
GATESHEAD	543	6,455	8
GLOUCESTERSHIRE	1,333	11,880	11
GREENWICH	473	9,839	5
HACKNEY	573	14,164	4
HALTON UA	441	2,860	15
HAMMERSMITH & FULHAM	0	7,881	0
HAMPSHIRE	3,279	22,862	14
HARINGEY	864	7,800	11
HARROW	624	7,705	8
HARTLEPOOL UA	199	1,603	12
HAVERING	1,247	8,729	14
HEREFORDSHIRE UA	910	3,070	30
HERTFORDSHIRE	87	24,057	0
HILLINGDON	733	5,759	13
HOUNSLOW	685	4,935	14
ISLE OF WIGHT UA	630	3,182	20
ISLES OF SCILLY	2	3	67
ISLINGTON	553	9,185	6
KENSINGTON & CHELSEA	471	6,498	7
KENT	5,668	30,417	19
KINGSTON UPON HULL UA	494	5,794	9
KINGSTON UPON THAMES	528	3,183	17
KIRKLEES	1,784	11,281	16
KNOWSLEY	52	5,204	1
LAMBETH	224	9,070	2
LANCASHIRE	2,665	29,767	9
LEEDS	1,322	19,153	7
LEICESTER UA	682	7,176	10
LEICESTERSHIRE	1,506	12,104	12
LEWISHAM	771	8,762	9
LINCOLNSHIRE	1,884	12,694	15
LIVERPOOL	2,105	15,345	14
LUTON UA	470	3,766	12
MANCHESTER	2,356	16,406	14
MEDWAY TOWNS UA	792	4,940	16
MERTON	569	4,811	12
MIDDLESBROUGH UA	266	3,165	8
MILTON KEYNES UA	848	4,210	20
NEWBURY UA	461	3,443	13
NEWCASTLE UPON TYNE	1,091	13,113	8
NEWHAM	294	8,815	3
NORFOLK	3,331	19,707	17
NORTH EAST LINCOLNSHIRE UA	886	4,060	22
NORTH LINCOLNSHIRE UA	369	3,291	11
NORTH SOMERSET UA	502	3,364	15
NORTH TYNESIDE	1,532	6,308	24
NORTH YORKSHIRE	2,398	11,298	21
NORTHAMPTONSHIRE	350	12,634	3
NORTHUMBERLAND	1,891	11,381	17
NOTTINGHAM UA	702	5,136	14
NOTTINGHAMSHIRE	2,264	13,004	17
OLDHAM	2,503	6,382	39
OXFORDSHIRE	2,864	17,906	16
PETERBOROUGH UA	343	2,658	13
PLYMOUTH UA	810	3,413	24
POOLE UA	830	3,692	22
PORTSMOUTH UA	495	6,190	8
READING UA	252	3,973	6
REDBRIDGE	493	7,323	7
REDCAR & CLEVELAND UA	446	3,083	14
RICHMOND UPON THAMES	448	5,841	8
ROCHDALE	477	7,784	6
ROTHERHAM	1,341	7,111	19
RUTLAND UA	128	787	16
SALFORD	2,180	9,020	24
SANDWELL	873	9,700	9
SEFTON	663	9,876	7
SHEFFIELD	(24)	17,702	0
SHROPSHIRE	944	6,551	14
SLOUGH UA	272	2,437	11
SOLIHULL	584	5,433	11
SOMERSET	4,342	11,008	39
SOUTH GLOUCESTERSHIRE UA	816	3,868	21
SOUTH TYNESIDE	500	4,450	11
SOUTHAMPTON UA	989	6,420	15
SOUTHEND UA	448	4,448	10
SOUTHWARK	4,744	16,174	29
ST HELENS	864	5,228	17
STAFFORDSHIRE	3,394	16,855	20
STOCKPORT	992	10,750	9
STOCKTON ON TEES UA	0	3,723	0
STOKE-ON-TRENT UA	1,552	6,147	25
SUFFOLK	3,303	17,092	19
SUNDERLAND	1,528	8,459	18
SURREY	2,898	15,628	19
SUTTON	720	4,790	15
SWINDON UA	465	3,731	12
TAMESIDE	903	6,514	14
THE WREKIN UA	379	2,570	15
THURROCK UA	454	3,234	14
TORBAY UA	462	2,819	16
TOWER HAMLETS	0	6,332	0
TRAFFORD	915	6,436	14
WAKEFIELD	856	7,224	12
WALSALL	666	6,597	10
WALTHAM FOREST	0	6,902	0
WANDSWORTH	1,003	9,029	11
WARRINGTON UA	360	4,976	7
WARWICKSHIRE	1,804	11,852	15
WEST SUSSEX	1,954	15,292	13
WESTMINSTER	483	10,317	5
WIGAN	1,612	6,881	23
WILTSHIRE	1,027	8,435	12
WINDSOR & MAIDENHEAD UA	400	2,868	14
WIRRAL	1,084	7,749	14
WOKINGHAM UA	414	2,454	17
WOLVERHAMPTON	6	10,610	0
WORCESTERSHIRE	2,408	8,829	27
YORK UA	809	3,885	21
ENGLAND TOTAL	160,011	1,297,809	12
1997-98 LAs
BERKSHIRE	2,035	17,357	12
CAMBRIDGESHIRE	1,319	12,542	11
CHESHIRE	1,541	21,950	7
DEVON	5,324	20,849	26
ESSEX	4,255	41,243	10
HEREFORD & WORCESTER	3,318	11,899	28
KENT	6,460	35,357	18
LANCASHIRE	3,433	37,554	9
NOTTINGHAMSHIRE	2,966	18,140	16
SHROPSHIRE	1,323	9,121	15

Source: RO3 return.

Table 5.12.3

PROPORTION OF RESIDENTIAL COSTS RECOUPED IN FEES & CHARGES FOR THE ELDERLY, 1998-99

England
				Percentages
	£ thousands			Sales, Fees and Charges
	Sales, Fees and Charges	Gross current expenditure		as a percentage of Gross current expenditure
BARKING & DAGENHAM	1,452		10,241	14
BARNET	6,463		18,491	35
BARNSLEY	1,159		10,042	12
BATH & NORTH EAST SOMERSET UA	4,814		11,743	41
BEDFORDSHIRE	6,297		18,092	35
BEXLEY	4,160		12,644	33
BIRMINGHAM	27,962		71,759	39
BLACKBURN UA	4,639		10,852	43
BLACKPOOL UA	5,994		14,698	41
BOLTON	6,310		16,312	39
BOURNEMOUTH UA	5,688		11,717	49
BRACKNELL FOREST UA	1,495		4,183	36
BRADFORD	17,739		38,859	46
BRENT	3,764		9,906	38
BRIGHTON & HOVE UA	8,009		19,448	41
BRISTOL UA	13,674		34,594	40
BROMLEY	6,636		17,631	38
BUCKINGHAMSHIRE	11,289		24,384	46
BURY	6,405		12,905	50
CALDERDALE	6,823		16,258	42
CAMBRIDGESHIRE	8,758		21,661	40
CAMDEN	5,232		16,237	32
CHESHIRE	19,249		46,447	41
CITY OF LONDON	170		583	29
CORNWALL	12,450		30,004	41
COVENTRY	3,242		16,983	19
CROYDON	8,679		21,767	40
CUMBRIA	13,549		32,555	42
DARLINGTON UA	9		4,123	0
DERBY UA	8,200		16,826	49
DERBYSHIRE	5,632		32,634	17
DEVON	26,360		51,324	51
DONCASTER	8,952		24,587	36
DORSET	8,644		19,076	45
DUDLEY	6,984		17,741	39
DURHAM	3,202		27,244	12
EALING	3,456		14,166	24
EAST RIDING OF YORKSHIRE UA	8,902		19,702	45
EAST SUSSEX	16,733		35,893	47
ENFIELD	8,149		16,734	49
ESSEX	21,739		60,741	36
GATESHEAD	6,566		16,867	9
GLOUCESTERSHIRE	13,233		28,369	47
GREENWICH	3,595		12,355	29
HACKNEY	3,727		9,638	39
HALTON UA	2,722		7,396	37
HAMMERSMITH & FULHAM	1,199		8,943	13
HAMPSHIRE	23,774		53,998	44
HARINGEY	4,105		12,249	34
HARROW	3,000		8,540	35
HARTLEPOOL UA	1,082		6,013	18
HAVERING	4,233		11,873	36
HEREFORDSHIRE UA	68		6,151	1
HERTFORDSHIRE	17,002		45,234	38
HILLINGDON	1,973		10,673	18
HOUNSLOW	3,835		11,617	33
ISLE OF WIGHT UA	5,185		10,091	51
ISLES OF SCILLY	89		243	37
ISLINGTON	3,603		14,601	25
KENSINGTON & CHELSEA	2,483		7,799	32
KENT	34,431		77,490	44
KINGSTON UPON HULL UA	8,703		21,487	41
KINGSTON UPON THAMES	3,240		9,751	33
KIRKLEES	8,985		25,458	35
KNOWSLEY	72		4,866	1
LAMBETH	5,718		15,528	37
LANCASHIRE	36,638		86,027	43
LEEDS	4,017		33,156	12
LEICESTER UA	7,746		18,544	42
LEICESTERSHIRE	11,041		25,273	44
LEWISHAM	5,837		17,927	33
LINCOLNSHIRE	18,712		42,615	44
LIVERPOOL	4,841		34,626	14
LUTON UA	2,768		8,654	32
MANCHESTER	14,043		32,316	43
MEDWAY TOWNS UA	4,623		10,380	45
MERTON	2,636		7,840	34
MIDDLESBROUGH UA	1,227		8,233	15
MILTON KEYNES UA	3,585		8,143	44
NEWBURYUA	2,259		5,909	38
NEWCASTLE UPON TYNE	539		12,481	4
NEWHAM	1,758		13,440	13
NORFOLK	31,001		64,925	48
NORTH EAST LINCOLNSHIRE UA	5,333		11,204	48
NORTH LINCOLNSHIRE UA	4,305		9,966	43
NORTH SOMERSET UA	5,903		13,615	43
NORTH TYNESIDE	1,519		10,836	14
NORTH YORKSHIRE	17,175		40,806	42
NORTHAMPTONSHIRE	14,824		35,434	42
NORTHUMBERLAND	10,952		25,045	44
NOTTINGHAM UA	9,362		22,094	42
NOTTINGHAMSHIRE	21,345		53,495	40
OLDHAM	7,485		14,945	50
OXFORDSHIRE	5,922		24,463	24
PETERBOROUGH UA	1,063		5,253	20
PLYMOUTH UA	9,530		19,706	48
POOLE UA	2,803		6,623	42
PORTSMOUTH UA	5,861		12,784	46
READING UA	834		4,927	17
REDBRIDGE	3,046		11,985	25
REDCAR & CLEVELAND UA	1,459		8,413	17
RICHMOND UPON THAMES	3,696		10,092	37
ROCHDALE	589		9,766	6
ROTHERHAM	6,966		17,948	39
RUTLAND UA	681		1,852	37
SALFORD	8,086		22,287	36
SANDWELL	8,623		23,605	37
SEFTON	10,517		26,016	40
SHEFFIELD	4,357		34,678	13
SHROPSHIRE	8,944		19,226	47
SLOUGH UA	2,303		6,267	37
SOLIHULL	1,233		5,663	22
SOMERSET	907		16,677	5
SOUTH GLOUCESTERSHIRE UA	1,269		7,458	17
SOUTH TYNESIDE	1,793		11,833	15
SOUTHAMPTON UA	5,311		12,427	43
SOUTHEND UA	4,275		11,438	37
SOUTHWARK	8,707		21,833	40
ST HELENS	4,564		12,977	35
STAFFORDSHIRE	15,899		40,202	40
STOCKPORT	11,273		22,848	49
STOCKTON ON TEES UA	5,127		13,074	39
STOKE-ON-TRENT UA	7,797		19,642	40
SUFFOLK	17,754		40,398	44
SUNDERLAND	8,384		22,021	38
SURREY	18,942		52,560	36
SUTTON	3,787		9,750	39
SWINDON UA	251		5,916	4
TAMESIDE	5,499		13,553	41
THE WREKIN UA	3,584		9,360	38
THURROCK UA	2,026		5,706	36
TORBAY UA	7,034		13,343	53
TOWER HAMLETS	366		12,465	3
TRAFFORD	5,959		14,328	42
WAKEFIELD	1,013		13,429	8
WALSALL	1,300		14,698	9
WALTHAM FOREST	3,833		11,031	35
WANDSWORTH	8,044		19,097	42
WARRINGTON UA	5,466		12,311	44
WARWICKSHIRE	10,600		24,576	43
WEST SUSSEX	22,426		51,883	43
WESTMINSTER	3,856		12,811	30
WIGAN	8,580		18,828	46
WILTSHIRE	3,808		15,983	24
WINDSOR & MAIDENHEAD UA	2,551		6,865	37
WIRRAL	10,053		23,857	42
WOKINGHAM UA	1,293		3,409	38
WOLVERHAMPTON	7,432		18,324	41
WORCESTERSHIRE	12,200		30,330	40
YORK UA	4,599		10,986	42
ENGLAND TOTAL	1,097,235		2,966,727	37

  Source: RO3 return.

1997-98 LAs
BERKSHIRE	10,735	31,560	34
CAMBRIDGESHIRE	9,821	26,914	36
CHESHIRE	27,437	66,154	41
DEVON	42,924	84,373	51
ESSEX	28,040	77,885	36
HEREFORD & WORCESTER	12,268	36,481	34
KENT	39,054	87,870	44
LANCASHIRE	47,271	111,577	42
NOTTINGHAMSHIRE	30,707	75,589	41
SHROPSHIRE	12,528	28,586	44

5.13  Volume, Purpose and Monitoring of Grants

Could the Department provide details of the volume of specific or special grants made available, by the Department, to social services departments for the years 1996-97 to 2000-01? Could the Department provide a full explanation of any changes introduced this year, to the volume, the purpose or the monitoring arrangements for any of the grants?

  1.  Table 5.13.1 shows the volume and purposes of local council PSS grants for the years requested.

Table 5.13.1

GRANTS AVAILABLE FOR PERSONAL SOCIAL SERVICES 1996-97 TO 2000-01

£ million
	1996-97	1997-98	1998-99	1999-00	2000-01
Specific Grants
AIDS Support Grant	13.7	13.7	13.7	15.5	16.0
Drugs & Alcohol Specific Grant	2.5	2.5	2.5	4.5	6.8
Guardians Ad Litem & Reporting Officer services	6.3	6.3
Mental Health Grant	58.3	67.3	73.3	116.5	129.5
Training Support Programme	35.5	35.5	35.5	39.0	42.5
Secure Accommodation (Capital)	27.2	13.2	8.2	6.2	6.2
Special Grants
Community Care Special Transitional Grant	418.0	325.0	350.0
Capital Limits for Residential Accommodation Charges Grant	64.5
Drugs & Alcohol Special Grant				0.2
Asylum-Seekers' Grants	28.0	89.6	208.2	52.4	N/A
Promoting Independence: Partnership Grant				253.0	216.0
Promoting Independence: Prevention Grant				20.0	30.0
Promoting Independence: Carers Grant				20.0	50.0
Children's Services (Quality Protects) Grant			5.0	75.0	118.5
Invest to Save					4.3
TOTAL	654.0	553.1	696.4	602.3	619.8

  Note—figures may not sum due to rounding

  N/A—not yet announced

AIDS Support Grant

  2.  Volume: The only change in 2000-01 is that £16 million is being made available to councils, a 3 per cent increase on the 1999-2000 amount of £15.5 million.

Drugs and Alcohol Grant

  3.   Volume: On 1 April 1999, £0.7 million of the existing grant was transferred to the Rough Sleepers Unit in DETR. Overall however, the value of the 1999-2000 grant increased to £4.8 million. A further increase, 42 per cent, has been agreed for 2000-01 making the grant a total of £6.8 million.

  4.   Purpose: The 1999-2000 grant had three component parts, two of which were new. Specific grant of £1.8 million was paid in accordance with existing aims and conditions. The additional £3 million was available to help councils develop more co-ordinated and flexible service provision and improve access to services for substance misusers. £2.8 million of the £3 million was paid as a specific grant to develop new drug services in approximately a quarter of local council areas. The balance of £0.2 million was paid as a special grant to those councils that had agreed to develop better approaches to service commissioning. The money transferred to the London Rough Sleepers Unit will be used to develop drug and alcohol services for rough sleepers in London.

  5.   Monitoring: Additional targets were set for 1999-2000 for the new funding of £2.8 million and £0.2 million. These were a 10 per cent increase in the number of problem substance misusers participating in effective treatment, a reduction in the time spent by problem misusers in waiting for an assessment of their needs, and a 10 per cent increase in the proportion of decisions to approve funding, made within two weeks of a misuser having been formally assessed as needing it. Performance against the targets are monitored through Drug Action Teams' annual reports. The Teams in the Social Care Regions have agreed plans with each council and monitor compliance with the agreed outcomes. The London Rough Sleepers Unit monitors the money distributed for the development of drug and alcohol services using the outcome funding methodology employed on the existing Drug and Alcohol Grant.

  6.   Effectiveness: The achievement of the targets set out in paragraph 5 above are the measure of grant effectiveness.

7. Decisions for the 2000-01 grant will be announced shortly.

Mental Health Grant

  8.   Volume: A total of £129.5 million is being made available nationally in 2000-01 for social care services for people with mental illness, including dementia, an increase of £13 million over the 1999-2000 grant level. Of this, £0.5 million is being transferred to DETR for the Rough Sleepers Unit to allocate for mental health social care services in central London. The Mental Health Social Care Partnership Fund is being increased by £0.1 million to £7.2 million. Other Funds within the grant have remained at the 1999-2000 level, leaving £97 million available as the core grant which supports existing and new services in line with the implementation of the Mental Health National Service Framework.

  9.   Purpose: This is broadly the same, to support implementation of the Mental Health National Service Framework standards in line with local milestones set out in local implementation plans which have been developed since last year.

  10.   Monitoring:   Councils have been advised that the Department will ask for evidence of their progress during 2000-01 through their Joint Investment Plans in which each component of the grant must be clearly identified. The Department is designing a detailed performance management and reporting framework for the "National Priorities Guidance" for CAMHS.

Training Support Programme

  11.   Volume:   The grant for 2000-01 was increased from £39 million to £42.5 million.

  12.   Purpose:   This remains the same but with some additions. The extra funding will be used to increase the numbers of staff being trained in the new Post Qualifying Child Care Award.

  13.   Effectiveness:   Further amounts of TSP have been ring-fenced for the training of domiciliary care workers, training registered managers of adults' homes and for safety of social care workers training.

  14.  There are no changes to monitoring arrangements.

Asylum-Seekers' Grants

  15.  Responsibility for the Adult Asylum-Seekers' Accommodation Grant and the Persons From Abroad Children's Grant was transferred to the Home Office from 1 April 1999.

Unaccompanied Asylum-Seeking Children

  16.   Legislation:   Special Grant Report No.60 was laid under the powers contained in Section 88B(5) of the Local Government Finance Act 1988, as substituted by paragraph 18 of Schedule 10 to the Local Government Finance Act 1992.

  17.   Volume:   In 1999-2000 the grant was £52.4 million.

  18.   Effectiveness:   The terms and conditions were the same as for 1998-99, except that in addition, the 12 local councils that provided for the greatest number of unaccompanied asylum-seeking children were invited to claim up to an additional £100 per person per week. Although councils were invited to submit claims by 29 February 2000 at the latest, all claims for relevant expenditure received by 10 March 2000 were paid in full. Payments were made to 102 authorities.

  19.  There are no changes to the purpose or monitoring arrangements.

Promoting Independence: Partnership Grant

  20.   Legislation: Special Grant Report No. 56 was laid under the powers contained in section 88B(5) of the Local Government Finance Act 1988, as substituted by paragraph 18 of Schedule 10 to the Local Government Finance Act 1992.

  21.   Volume:   The 2000-01 grant is £216 million, a reduction of £37 million on 1999-2000.

  22.   Monitoring:   Monitoring arrangements remain the same. In May 1999 each council provided the Secretary of State with a written plan setting out the measures it will take to meet the 1999-2000 grant conditions. By 31 May 2000, each council will provide an updated and more detailed version of the 2000-01 section of that plan. A year-end report will have to be submitted by May 2001.

  23.   Effectiveness:   The Department will be assessing the grant's effectiveness by continuing to measure the performance of councils against the joint health and social services objectives in the "National Priorities Guidance 1999-2000 to 2001-02". These are, to "reduce nationally the average per capita rate of growth in emergency admissions of people aged over 75 to an annual average of 3 per cent over the five years up to 2002-03" and "reduce the national percentage of delayed discharges of over 75 year olds occupying an acute hospital bed to 11 per cent in 2000-01, 10 per cent in 2001-02 and 9 per cent in 2002-03". The guidance also lists a number of baseline indicators in the national PSS Performance Assessment Framework against which the success of Partnership Grant outcomes will be assessed.

  24.  There is no change to the purpose of the grant.

Promoting Independence: Prevention Grant

  25.   Legislation:   Special Grant Report No. 57 was laid under the powers contained in section 88B(5) of the Local Government Finance Act 1988, as substituted by paragraph 18 of Schedule 10 to the Local Government Finance Act 1992.

  26.   Volume:   The grant has been increased from £20 million in 1999-2000 to £30 million in 2000-01. The amount required to be spent on additional services, as defined in the Special Grant Report, has been increased from 75 per cent in 1999-2000 to 85 per cent in 2000-01.

  27.   Monitoring:   Monitoring arrangements remain the same. By 29 October 1999, each council provided the Secretary of State with a written plan, agreed jointly with each health authority in their area, setting out how the grant objectives will be met over the three years 1999-2000 to 2001-02. By 31 May 2000 each council also has to provide a report setting out the progress made on its preventative strategy and the amount spent on additional services in 1999-2000.

  28.   Effectiveness:   The measures of effectiveness remain the same but in addition, councils have set indicators against which progress in implementing their strategies will be measured.

  29.  There is no change to the purpose of the grant.

Promoting Independence: Carers Grant

  30.   Legislation:   Special Grant Report No. 58 was laid under the powers contained in section 88B(5) of the Local Government Finance Act 1988, as substituted by paragraph 18 of Schedule 10 to the Local Government Finance Act 1992.

  31.   Volume:   The grant has been increased from £20 million in 1999-2000 to £50 million in 2000-01.

  32.   Purpose:   The "Caring about Carers" strategy sets out the Government's intention to stimulate greater diversity and flexibility of provision to enable carers to take a break from caring. In 1999-2000 the grant was intended to help councils to enhance their community care services in carrying out these objectives. In 2000-01 the grant will additionally be used for breaks for parents of disabled children and for young carers. 20 per cent of the national total is allocated on that basis.

  33.   Monitoring:   A condition of the 1999-2000 grant was that by 29 October 1999 each council had to provide the Secretary of State with a programme of change and development in a written plan agreed with partner heath authorities. The plan set out how the council intended to diversify and improve the range of relevant community care services it provided. Changes to the grant conditions for 2000-01, especially to include children's services, has meant the need for a revised plan which councils must provide by 31 May 2000.

  34.   Effectiveness:   Effectiveness will be measured through the achievement of the objectives and targets set each year in local council plans.

Children's Services (Quality Protects) Grant

  35.   Legislation:   A Special Grant Report will be laid under the powers contained in Section 88B(5) of the Local Government Finance Act 1988, as substituted by paragraph 18 of Schedule 10 to the Local Government Finance Act 1992.

  36.   Volume:   In 2000-01 grant is being increased by £43.5 million to £118.5 million.

  37.   Purpose:   In addition to the existing six priority areas, two new areas have been introduced: improving the life chances of looked after children through expenditure on their education and health needs; and enhancing capacity to manage change.

  38.  There are no changes to monitoring arrangements and the measures of effectiveness remain the same.

Invest to Save Grants

  39.   Legislation:   A Special Grant Report will be laid under the powers contained in Section 88B(5) of the Local Government Finance Act 1988, as substituted by paragraph 18 of Schedule 10 to the Local Government Finance Act 1992.

  40.   Volume:   Total funding of £4.3 million will be made available to 13 councils in 2000-01. Of this £1.4 million is for capital and £2.8 million is for revenue expenditure.

  41.   Purpose:   The Invest to Save Budget is managed by Treasury, in consultation with Cabinet Office. Bids for funding are invited from a wide range of public sector bodies. In April 1999 local councils were invited to bid for funding for 2000-01 and 2001-02 and 13 councils successfully bid for social services led projects. The purpose of the grants is to fund projects which bring together two or more public service bodies to deliver services in an innovative and more efficient fashion.

  42.   Monitoring:   Each of the 13 councils was required, by 31 May 2000, to provide the Secretary of State with a project implementation plan. The plan had to set out key milestones which are measurable in terms of specific outputs, the impacts the project is expected to achieve, how it will be monitored and evaluated, what lessons the council thinks the project will provide for other public service organisations and how these can best be disseminated. In addition, councils are required to submit a claim for their grant to the Secretary of State, by 31 October 2000 for the period 1 April 2000 to 30 September 2000 and by 15 February 2000 for the period 1 October 2000 to 31 March 2001. By 31 December 2001 councils must also submit an audit certificate, signed by an external auditor appointed by the Audit Commission, showing the relevant expenditure which has been met from the grant received during 2000-01.

  43.   Effectiveness:   By 31 March 2001 each council must provide a report to the Secretary of State explaining the progress made on the project as detailed in their plan. The achievement of the specific outputs and other targets set out in paragraph 42 above will be the measure of grant effectiveness.

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Prepared 27 October 2000