4. BREAKDOWN OF SPENDING PROGRAMME
(continued)
4.6.2 Could the Department detail trends
in the unit costs of the main social services for adults each
year since 1999-2000? How do costs vary between authorities? Could
the Department comment on these figures? (Q57)
ANSWER
1. The unit cost figures in Table 57
show in cash and real terms (deflated by GDP at 2004-05 prices)
the increases in selected unit costs for personal social services
from 1999-2000 to 2004-05. The unit costs cover residential and
nursing care for older people who are financially supported by
the local authorities and hourly costs for home care services.
Between 2003-04 and 2004-05 the unit cost for local authority
residential care increased by 9% in real terms whilst the unit
costs of independent residential care and home care and nursing
care increased by 4% in real terms.
2. The real terms weekly unit cost for supporting
older people in nursing care placements rose between 1999-2000
and 2000-01 but fell between 2000-01 and 2001-02 before rising
again in 2002-03. It is not possible to compare nursing care costs
between 2002-03 and 2003-04 because of a change in the treatment
of the nursing care element. Between 2003-04 and 2004-05 the unit
costs have increased by 4% in real terms. The real terms unit
costs of supporting older people in local authority staffed residential
care homes and in independent residential care homes increased
each year between 1999-2000 and 2004-05. Costs in the independent
sector (private and voluntary residential homes and nursing homes)
represent the costs to local authorities in purchasing care, whereas
the costs for local authority homes represent the full cost of
running such homes, which are declining in number as homes are
transferred out of local authority control. 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.
3. The real terms hourly unit cost for home
help/care rose from £12.70 in 1999-2000 to £12.90 in
2001-02 before falling back to £12.80 in 2002-03 and rising
again to £13.60 in 2004-05. There has been an increase in
home care provision over the same period, with an increase from
2.7 million contact hours reported in 1999-2000 to 3.4 million
contact hours in 2004-05.
Table 57
UNIT COSTS OF SELECTED PERSONAL SOCIAL SERVICES
ENGLAND 1999-2000 to 2004-05
|
| |
| | | | £s
|
| Unit Cost | 1999-2000
(est)
| 2000-01 | 2001-02
| 2002-03 | 2003-04
| 2004-05 |
|
| Gross expenditure per week on | Cash terms
| 341 | 368
| 368 | 394
| 381 | 407 |
| supporting residents aged 65 | Real terms(7)
| 386 | 411
| 402 | 417
| 391 | 407 |
| and over in nursing care(1)(2)(3)(4) |
| | | |
| | |
| Gross expenditure per week on | Cash terms
| 382 | 426
| 446 | 494
| 539 | 609 |
| supporting residents aged 65 and | Real terms(7)
| 433 | 475
| 487 | 523
| 554 | 609 |
| over in local authority | |
| | |
| | |
| residential care(1)(2)(3)(5) |
| | | |
| | |
| Gross expenditure per week on | Cash terms
| 271 | 279
| 286 | 313
| 338 | 361 |
| supporting residents aged 65 and | Real terms(7)
| 307 | 311
| 312 | 331
| 347 | 361 |
| over in independent | |
| | | |
| |
| residential care(1)(2)(3)(5) |
| | | |
| | |
| Gross expenditure per hour | Cash terms
| 11.2 | 11.4
| 11.9 | 12.1
| 12.9 | 13.6
|
| of home care for all clients | Real terms(7)
| 12.7 | 12.7
| 12.9 | 12.8
| 13.3 | 13.6
|
| aged 18 or over(1)(6) | |
| | |
| | |
|
Source: PSS EX1 return.
Footnotes:
1. From 2000-01 total costs (ie total gross current expenditure
+ capital costs) as reported on form PSS EX1 are used to calculate
unit costs. Expenditure includes a full share of Social Services
Management and Support Services (SSMSS) costs. For 1999-2000 gross
current expenditure as reported on form RO3 has been used to calculate
unit costs; an estimated share of SSMSS costs has been included.
2. From 2000-01 these unit costs have been calculated by taking
total costs throughout the year for residential and nursing care
placements as appropriate and dividing by the number of weeks
older people were supported in such care during the year. 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 in full or through income support have been
included where the relevant expenditure is included in the numerator.
3. For 1999-2000 these unit costs have been calculated by
taking gross current expenditure throughout the year on residential
and nursing homes as appropriate and dividing it by the average
number of supported residents in such homes reported at 31 March
in consecutive years. Nursing homes includes nursing places in
dual registered homes; residential homes includes residential
places in dual registered homes. 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.
4. From 2003-04 the costs of nursing care placements exclude
the nursing costs which have been paid by the NHS from 1 April
2003.
5. The definition of local authority care excludes expenditure
on people placed in the home of another local authority. This
expenditure is included in the independent sector expenditure.
6. 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 September.
7. Deflated using the GDP deflator at 2004-05 prices.
Variation Between Authorities
4. There is substantial variation between local authorities
in these unit costs, as Figures 57a to 57d demonstrate.
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. However, such wide variability
of individual authority figures also 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.
5. Figures 57a to 57d show the unit cost values calculated
using expenditure data for 2004-05. Where a local authority has
reported activity but no expenditure (an implied zero unit cost)
they have been excluded from the charts.
6. Figure 57(a) shows the weekly unit cost for older
people in nursing homes in 2004-05. The average weekly unit cost
for England was £407 in 2004-05 ranging from under £250
a week in three authorities (Barnsley, Redcar and Cleveland and
Wigan) to more than £1,000 a week in one authority (Lewisham).
The middle 50% of the authorities had a unit cost between £353
and £472.
7. The weekly unit cost for residents aged 65 or over
in local authority residential homes in 2004-05 is shown in Figure
57b. The average for England was £609, with the middle 50%
of authorities having a unit cost between £529 and £847.
One authority recorded a unit cost of under £100 (Somerset).
Six authorities had a unit cost greater than £1,500 per week
(Bradford, Hackney, Harrow, North East Lincolnshire, Oldham and
Wiltshire).
8. The weekly cost for residents aged 65 or over in independent
(private or voluntary) residential homes during 2004-05 for individual
authorities is shown in Figure 56c. For individual authorities
this unit cost varied from under £250 for four authorities
(Harrow, Oldham, Redcar and Cleveland and Slough) to over £500
in seven authorities (Brent, Hillingdon, Islington, Kensington
and Chelsea, Lewisham, Southwark and Waltham Forest). The average
for England was £361, with the middle 50% of authorities
having a unit cost between £325 and £396.
9. Figure 56(d) shows the hourly cost of home help/care
for individual authorities in 2004-05. The hourly cost varied
from £9 to £26. The average hourly unit cost for England
was £13.60. The middle 50% of authorities had a unit cost
between £12.40 and £15.70.
4.6.3 What grants were available for Personal Social
Services in each year since 2003-04? Could the Department comment
on these data? (Q58)
ANSWER
1. Table 58 lists grants made available for Personal
Social Services for adults since 2003-04. Provisional allocations
are provided for 2007-08. This table has been further subdivided
into revenue and capital allocations.
2. The table shows that in comparison to 2003-04, total
Local Authority Specific Grant Resource allocations will, by 2007-08,
have increased by £196.188 million.
3. However, specific revenue grant allocations for 2006-07
can be seen to have decreased when compared to 2005-06 for several
reasons, namely:
— the transfer of £214 million of Residential
Allowance funding into Formula Grant which was notified to and
agreed with local authorities by way of a consultation exercise;
— the transfer of a proportion of Preserved Rights
funding into Formula Grant reflects the ongoing reduction in the
number of people with the preserved rights covered by this funding.
The treatment of the Preserved Rights Grant meets the Government's
commitment to roll this funding into Formula Grant in stages,
and was also agreed with local authorities as part of the 2004
consultation referred to above; and
— the fact that the £100 million increase to
the Access and Systems Capacity Grant made in the previous two
financial years was not made recurrent.
Table 58 PERSONAL SOCIAL SERVICES
GRANT ALLOCATIONS 2003-04 TO 2007-08
|
| | |
| | £ millions
|
| 2003-04
| 2004-05 | 2005-06
| 2006-07 | 2007-08
(provisional)
|
|
| Revenue Grants | |
| | |
|
| Access and Systems Capacity, including LRR(1)
| 170.000 | 486.000
| 642.000 | 546.000
| 546.000 |
| AIDS Support | 16.500
| 16.500 | 16.500
| 16.500 | 16.500
|
| Carers | 100.000
| 125.000 | 185.000
| 185.000 | 185.000
|
| Care Direct(2) | 4.500
| 2.817 | |
| |
| CAMHS(3) | 50.000
| 66.000 | 90.539
| 90.539 | 90.539
|
| Children's Trusts(4) | 1.000
| 1.000 | |
| |
| CSCI reimbursement grant | |
| 0.750 | 0.750
| 0.750 |
| Deferred Payments | 40.000
| | | |
|
| Delayed Discharges | 50.000
| 100.000 | 100.000
| 100.000 | 100.000
|
| Human Resources Development Strategy(5) |
9.525 | 23.900
| 62.750 | 49.750
| 49.750 |
| Individual Budget Pilots | |
| | 6.000
| 6.000 |
| Mental Health | 133.500
| 133.000 | 132.950
| 132.900 | 132.900
|
| National Training Strategy | 24.884
| 30.979 | 94.859
| 107.859 | 107.859
|
| Performance Fund | 100.000
| | | |
|
| POPP | | |
| 20.000 | 40.000
|
| Preserved Rights(6) | 508.523
| 458.279 | 348.230
| 297.565 | 275.248
|
| Preventative Technology | |
| | 30.000
| 50.000 |
| Residential Allowance(7) | 182.496
| 409.480 | 214.455
| | |
| Training Support Programme(8) | 56.500
| 53.300 | |
| |
| Young people's substance misuse Planning(9) |
4.500 | 4.500
| | | |
| DH funded—allocated by OGD(10) |
| 5.500 | 8.500
| 7.500 | 7.500
|
| Total Revenue Grants(11): | 1,451.928
| 1,916.255 | 1,896.533
| 1,590.363 | 1,608.046
|
| Capital Grants | |
| | |
|
| SCE(R)Separate Programme element for AIDS/HIV
| 3.100 | 3.100
| 3.100 | 3.100
| 3.100 |
| Extra care housing grant | |
| | 20.000
| 40.000 |
| Improving Information Management Grant | 25.000
| 25.000 | 25.000
| 25.000 | 25.000
|
| Total Capital Grants | 28.100
| 28.100 | 28.100
| 48.100 | 68.100
|
Total Local Authority
Specific Grant Resources
| 1,480.028 | 1,944.355
| 1,924.633 | 1,638.463
| 1,676.146 |
|
Source: Local Authority Service Letters 2005(5), 2004(26)
and 2003(8).
Footnotes:
1. An additional £100 million was added on a one off
basis to this grant for 2005-06. An additional £4 million
has been added to this grant for 2006-07 and 2007-08 to allow
local authorities to meet any liabilities arising from the repeal
of the Liable Relative Rules.
2. Funding ended for these pilot sites 2004-05.
3. The whole of this grant is allocated by DH in relation
to children's PSS. The SR2004 settlement provided total funding
of £93.539 million in each year. Of this, £90.539 million
will be allocated by DH, and the remaining £3 million distributed
by DfES through the Treatment Foster Care grant.
4. Transferred to Dfes 2005-06.
5. Funding reduced by £13 million because of transfer
into NTS see Q.
6. The decline in Grant is rolled into baseline.
7. Rolled into baseline 2006-07.
8. Rolled into baseline 2006-07.
9. Transferred to Home Office 2004-05.
10. Current examples include CAMHS—£3 million transfer
to DfES for each of the years 2005-06, 2006-07 and 2007-08. Young
People's Substance Misuse—£4.5 million transfer to
Home Office recurring in 2005-06, 2006-07 and 2007-08.
11. Carers, CAMHS, Human Resources Development Strategy, Improving
Information Management and National Training Strategy all include
an element of funding for Children's services.
4.6.4 Could the Department detail trends in the Personal
Social Services Pay and Price Index since 1997-98 and outline
the assumptions behind the index? What are the expected financial
effects of demographic pressures on PSS over the next five years?
(Q59)
ANSWER
The PSS inflation index
1. The Personal Social Services (PSS) Pay and Prices
Index is set out in Table 59a.
2. The interpretation of this table is that, for example,
PSS pay and prices rose by approximately 4.3% between April 2004
and April 2005. The average increase between April 1996 and April
2005 of 4.21%.
The financial effect of demographic changes
3. The Department's estimates of the notional financial
consequences of demographic changes on adult social services are
set out in Table 59b. Only demographic pressures for adult
social services are included, as children's social services are
the responsibility of the Department for Education and Skills.
4. The interpretation of this table is that, for example
and on the basis of these estimations, resources for adult social
services will need to increase by 1.0% between 2006-07 and 2007-08
in order to keep pace with changes in the age composition of the
population, assuming that all other relevant factors remain constant.
Table 59a
PSS PAY AND PRICES INDEX
|
| Year% increase over previous year
|
|
| April 1996 | 3.2
|
| April 1997 | 4.4
|
| April 1998 | 4.1
|
| April 1999 | 4.8
|
| April 2000 | 3.3
|
| April 2001 | 4.4
|
| April 2002 | 4.4
|
| April 2003 | 5.0
|
| April 2004 | 4.2
|
| April 2005 | 4.3
|
|
Source: New Earnings Survey/Annual Survey of Hours
and Earnings.
Table 59b
NOTIONAL FINANCIAL EFFECT ON PERSONAL SOCIAL SERVICES
OF DEMOGRAPHIC PRESSURES
|
| Year% increase over previous year (1)
|
|
| 2007-08 | 1.0
|
| 2008-09 | 0.9
|
| 2009-10 | 0.9
|
| 2010-11 | 1.1
|
| 2011-12 | 1.0
|
|
Source: PSS EX1.
Footnotes:
1. Estimates rounded to nearest decimal place.
4.6.5 Could the Department detail trends in sales
and charges as a percentage of gross Personal Social Services
expenditure on adults by type of service (a) nationally and (b)
by local authority? (Q60)
ANSWER
1. The information requested is given in Table 60a
and Table 60b and in Figure 60a to Figure
60e.
2. The trend for charges for non-residential care has
been to see a steady rise in the recoupment rate for all client
groups from just under 7% in 1995-96 to around 12% from 1999-2000
until 2002-03 when it dropped to around 10% to 2004-05.
3. The drop to 10% in 2002-03 is likely to relate to
the implementation of the Department's guidance on charging for
non-residential care "Fairer Charging Policies for Home Care
and Other Non-residential Social Services Practices" issued
in August 2002, which was followed by statutory guidance in September
2003. As a result, councils will have reviewed their charging
policies following consultation with local populations.
| 
