The government announced draft plans to standardise eligibility criteria for adult social care last week, but the level it is being set at could risk the independence of some people with learning disabilities.
Amid the hoopla surrounding the Comprehensive Spending Review last week, the Department of Health’s (DH) announcement of its draft plans to introduce standardised national eligibility criteria for adult social care got lost in the mainstream news agenda.
This is a potentially very concerning as it not only points to the future of adult social care but also puts the independence of some people with mild to moderate learning disabilities at risk.
On the face of it, national eligibility criteria are a great idea. The current system, where councils set their own eligibility criteria, has led to a patently unfair postcode lottery for social care, where someone could qualify for services in one local authority area but move to the next door authority and receive nothing. Standardising criteria would end this.
But the worry has always been that the standardised eligibility criteria would be set too high and those with moderate needs, who need help with getting up or preparing meals and such like, would miss out. As things stand, that worry has been made real because the government plans to set the eligibility standard at the current ‘substantial’ level.
I can see the logic to this move: it’s going with what the majority of councils already do. In 2013, 130 councils set their eligibility threshold at substantial, while only three provided social care to people falling in to all the four bands – critical, substantial, moderate or low – according to DH figures. Meanwhile, 16 provide care to those with moderate needs and above and three councils only provided care for those with critical needs.
But that doesn’t mean it is the right move: disability charity Scope estimates that 100,000 disabled people could lose out under these plans. Of these, it is possible that a significant proportion would be people with mild to moderate learning disabilities.
For some people with learning disabilities, having just a few hours of support a week can be the difference between living independently and not. Without that support, they would be at much greater risk of becoming isolated and, worse, hitting a crisis that could see them go into residential living.
The DH has spoken widely in recent times of placing a greater emphasis on preventative services – again, logical because they can avoid the need for more complex and expensive services down the line and it takes pressure off other areas of the healthcare system, such as hospitals – but setting eligibility criteria this high seems to go against that aim.
Also, as Richard Hawkes, chief executive of Scope, noted, with councils facing a further 10% budget cut from 2015, “the hope that other services will pick up the preventative work is unrealistic.”
However, while this is worrying, these are only draft regulations, published for discussion before a more formal consultation takes place next year.
This gives people with learning disabilities, their families and supporters time to lobby local and national government about this and make the case to ensure that people with learning disabilities do not miss out on the care they need – and it must be done.