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Two years on from the Care Act, progress is ‘too slow’ says British Red Cross

22 September 2017

Local authorities are struggling to meet their obligations to prevent, reduce, or delay the need for care as set out in the Care Act 2014*, according to a new report published by the Red Cross today.

Government ambitions to fully integrate health and social care are also lagging behind.

There are some positive examples of change on a local level, the report finds, and even some pockets of excellence that suggest there is a real willingness to change the way the system works.

However, this is not happening at the pace and scale needed for transformation to be realised by the Government’s own deadline of 2020.

The report Prevention in Action 2017 finds:

  • At a time when local government should be investing in prevention and integrating health and social care services, budgets are being cut despite acknowledging that prevention will reduce costs in the future.
  • Inconsistency between local authorities when it comes to defining the meaning of ‘prevention’ as set out in the Care Act 2014.
  • Varying interpretations of how to fulfil government ambitions for full health and social care integration.
  • A lack of clarity on how to implement practical measures to prevent, reduce or delay the need for care and support.
  • Despite some improvements in the last 12 months, necessary changes are not happening at the scale or pace needed to truly ease the current pressures on our health and social care system.

The British Red Cross is calling on the Government to reassess the resources required to implement the duties outlined by the Care Act 2014 and explore what is needed to make integration and prevention work in practice.

'Distant ambition'

Since April 2015, the Care Act has placed a duty on councils in England to make sure preventative services are available locally. It also places a duty on local authorities to integrate with health services.

Mike Adamson, chief executive of the British Red Cross, said: “It is concerning that spending on preventative care has gone down at a point when local authorities should be scaling up.

“The Red Cross is concerned that intentions to fully integrate health and social care might remain a mere aspiration too.

“We don’t want to be in a position where, in a further two years, meaningful integration of health and social care services remains a distant ambition despite the Government’s 2020 target for implementation.

“It appears that across England there is a willingness to implement change and there are some great examples of the transformation in action, but it is crucial that local decision makers are given the backing and resources they need if we are to see consistent and effective implementation in all parts of the country.

“The proposed Green Paper on social care provides a good opportunity to reconsider what is needed to make the Care Act’s vision for prevention and the integration of health and social care services a reality.”

In Bristol and South Gloucestershire, the British Red Cross has expanded its prevention services to form First Call – a hospital and community-based support service aimed at increasing the independence and resilience of the people it supports.

First Call is funded by Nesta and the Big Lottery Fund, local Clinical Commissioning Groups, as well as a private donor. It offers flexible and time-limited support to help reduce the likelihood of people being re-admitted to hospital or becoming dependant on statutory support.


*Section 2 of the Care Act (2014), which came into force in April 2015, places a duty on local authorities to ensure the provision of services that prevent, reduce or delay the need for care and support.

Under Section 3 of the Care Act, local authorities also have a duty to promote the integration of care and support with health and health-related services where it considers this would:

  • Promote the well-being of adults with care and support needs or of carers in its area
  • Contribute to the prevention or delay of the development of needs of people
  • Improve the quality of care and support in the local authority’s area, including the outcomes that are achieved for local people.

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