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Accident and Emergency Social Care

Volume 573: debated on Tuesday 14 January 2014

11. What assessment he has made of the effect of social care budget changes on the number of accident and emergency attendances. (901954)

13. What assessment he has made of the effect of social care budget changes on the number of accident and emergency attendances. (901957)

16. What recent assessment he has made of the effect of social care budget changes on accident and emergency attendances. (901960)

Although councils have reduced social care budgets, the evidence suggests that this is not having an impact on the NHS. In fact, the data published by NHS England show that councils are getting better at getting people out of hospital at the appropriate time.

The National Audit Office reports that cuts to social care led to nearly 500,000 delayed bed days in accident and emergency in 2012-13, so will the Government see sense and commit to investing in lowering the eligibility threshold to moderate, ensuring that older and disabled people’s needs in Easington and throughout the country can be met in their community so they do not need to present to A and E causing further pressures on it?

Taking the hon. Gentleman’s question in the spirit he intends, I think there is a misunderstanding of the statistics. We need to reduce the pressure on A and E, and evidence from NHS England already shows that improvements in how social care works with the NHS over this Parliament are delivering improvements to care. In 2011-12 there were about 523,000 bed days lost because of delays attributable to social care, but in 2012-13 the number had fallen to 476,000, a drop of nearly 50,000. That shows that social care is working well to reduce pressure on A and E.

I am absolutely amazed at the answer the Minister has just given. Stoke-on-Trent, which, despite the local authority having to cut a third of its budget, has managed to make cuts—or efficiency savings as the Government would call them, of course—and move money into social care. Despite that, however, it still has less to spend this year than it had just three years ago, and that is resulting in people not getting social care because of cuts to the budget and to eligibility. When is the Minister going to wake up and do something about it?

There is always a lot of political smoke around this, but spending has roughly been flat in cash terms according to the Association of Directors of Adult Social Services survey and councils are budgeting to spend more this year than they were last year on social care. In addition, we are setting up the integrated care fund of £3.8 billion to better join up health and social care, and that will help to improve the care available to patients as well as reduce pressure on budgets.

But Government budget cuts have forced Salford local authority to change its eligibility criteria. For 1,400 people it is going to be zero-day social care, not seven-day social care, and even our excellent Salford Royal hospital is going to struggle when those 1,400 people find that the hospital is the only option for them. Age UK says these cuts make “no financial sense” and are “morally wrong”. When are Health Ministers going to see that point?

I make two points. First, the eligibility criteria began to change under the previous Government, so it is wrong of the hon. Lady to try to make political points which do not stand up to scrutiny. Secondly, I am disappointed that she is unable to recognise that there is very good integration of health and social care in Salford, in her own constituency. That is a model that we could look at to see how good care can be delivered elsewhere.

I am delighted that Cornwall has been chosen as a pioneer area for joining up health and social care. It is the only pioneer area to be led by the voluntary sector. Will the Minister meet me and the Cornwall team to enable us to deliver that care in Cornwall?

I can confirm that the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), will be delighted to meet my hon. Friend to take that further, and that he and I will be visiting Cornwall in the next few months to see at first hand the excellent work that is being done there.

Would the Minister like to congratulate the Northamptonshire Healthcare NHS Foundation Trust, Kettering general hospital and the Northampton General Hospital NHS Trust for coming together to form the frail and elderly crisis hub in Northamptonshire, to prevent unnecessary admissions of elderly people to local accident and emergency departments?

I would very much like to do that. It is important, given that we sometimes have adversarial discussions on these matters, to highlight the examples of good practice. The example in my hon. Friend’s local area of Kettering is exactly the sort of initiative that we need to see elsewhere in the country. That is why we have given £3.8 billion to better support the integration of health and care.

Changing working practices in hospitals is an important way of reducing pressures on social care and on A and E. Will my hon. Friend join me in praising the staff of the George Eliot hospital, who, through changes to working practices implemented under the supervision of the Keogh process, achieved the second-best A and E four-hour target performance in the country over the busy Christmas and new year period?

My hon. Friend is absolutely right to highlight the fact that integrated care working, better intermediate care and ensuring that GPs work closely with accident and emergency departments are exactly the kind of factors, along with joining up health and social care, that take pressure off A and E departments. I am delighted that things are going so well in his local area.

Happy new year, Mr Speaker.

People want a care system that gets the best results for patients and one that makes the best use of taxpayers’ resources, but under this Government they are getting neither. Half a million fewer people are now getting social care services to help them to continue to live at home, and half a million more older people are being admitted as more expensive hospital emergency cases that could have been avoided. Will the Minister tell us how that record represents good care and good value for taxpayers’ money?

The point I made earlier is that the number of cases of bed blocking due to social care delays has decreased under this Government. Also, it was the previous Government who began to change the eligibility criteria. Labour Members talk about a crisis in social care, but per-head funding for social care fell in the last term of the previous Government. That is the legacy that we are dealing with, and we are sorting it out—

Order. I do not wish to be unkind to the Minister, but I am quite interested in making progress with Back-Bench Members, who have had to wait too long.