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Many of the remarkable developments in provision, choice and human rights for people with intellectual disability and complex needs that have evolved over the last decade are being systematically dismantled as a result of punitive Government cuts to local authority budgets across the UK. How local authorities apportion these cuts varies but the decisions on where to make ‘savings’ are made by councillors and handed over to local authority officers to implement. East Sussex have published their intention to cut £40m of funding to Adult Social Care by 2019 here.

ESCC are loading the cuts onto the most vulnerable people through removing funding to essential community based provisions that in many cases provide uniquely tailored support. Many organisations in ESCC will close under the proposed timetable of savings to Adult Social Care. ESCC are planning to spread the £40 million savings over three years. In their recent 2015 Budget Consultation document they state:

‘ In 2016/17 we plan to make £10 million savings. In 2017/18 we plan to make £10 million savings. In 2018/19 we plan to make £20 million savings.’

There is confusion. On the one hand the Government recognises the need to support people who have complex needs and on the other East Sussex County Councillors are proposing to cut services that support them.

In the Guardian’s article – A Quick Guide to the Care Act, 28th April 2015 – Janet Snell points out:

‘The Care Act 2014 is the most significant change in social care law for 60 years. It applies to England and replaces a host of out-of-date and often confusing care laws. The legislation sets out how people’s care and support needs should be met and introduces the right to an assessment for anyone, including carers and self-funders, in need of support.’

What is the most important change? The act’s “wellbeing principle” spells out a local authority’s duty to ensure people’s wellbeing is at the centre of all it does. There will be more emphasis on outcomes and helping people to connect with their local community.’

The Winterbourne View scandal, exposed in 2011, led to the Government pledge to move all people with learning disabilities and/or autism inappropriately placed in such institutions into community care by June 2014. Stephen Bubb in his government commissioned 2014 report WINTERBOURNE VIEW – TIME FOR CHANGE Transforming the commissioning of services for people with learning disabilities and/or autism stated that:

‘Only by a big expansion of community provision can we achieve a move from institution to community. So we need a mandatory national commissioning framework that delivers that expansion, pooled budgets, and a focus on the individual’s needs not the system boundaries. The role of the many voluntary and community organisations that both advocate for and provide services for people with learning disabilities and/or autism is crucial to that aim, as are the individuals themselves, their families, clinicians, managers and professionals across the health service and in local councils, who need to work together to achieve a dramatic turn-around.’

Further confusion can be found in the laudable aims of East Sussex Better Together (ESBT) a ‘bold and transformative approach to developing a fully integrated health and social care economy in East Sussex.’

The ESBTshared vision is that by 2018 there will be a fully integrated health and social care economy in East Sussex that makes sure people receive proactive, joined up care, supporting them to live as independently as possible’.

My questions are:

  1. How will ESCC ensure this happens while essential support services are being cut?
  2. Do ESC councillors know about central government and/or NHS policy on improving and increasing community based cohesion and services to support people who have complex needs to live in their communities or the 2014 Care Act’s wellbeing principle?
  3. How is ESCC going to work with the Government and the NHS to achieve a big expansion of specialised community provision for people who have complex needs?

The ESBT vision is good. It recognises the need for strong communities of support around people to ensure wellbeing and to enable them to live at home rather than to stay in or be moved to institutions. Why then are these points of community connection and cohesion – seen in organisations funded via ES Commissioning Grants – being dismantled? It feels like one policy and/or vision working against another and it doesn’t make sense. If this is a strategy for building joint funding systems to support vulnerable people and to meet the legislation of the Care Act, then ESCC should ensure that the innovative and responsive models of support for people in their communities do not close but are enabled to develop and work within the ESBT framework.

ESCC need to think again. I believe that their proposals are not joined up, they are not strategic and they are loaded onto the most vulnerable citizens of East Sussex.

Kate Adams MBE

November 2015

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