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Social care funding has increased in real terms for the past decade, but there has been considerable variation in how that funding has been spent – in part because spending on social care is handled by local councils, whose circumstances vary. The wide geographical variations in cost and performance across a number of measures – for example, emergency hospital admissions, delayed transfers – reflect different relationships between health and social care. The government has pledged to facilitate closer integration so that people can receive a more joined-up service. Social care funding and the NHS: an impending crisis? examines trends in spending on social care, looking at three scenarios arising from the 27 per cent real reduction in the central government grant to local authorities that between 2011/12 and 2014/15, social care spending will be fully cut, will receive some protection, or receive no protection. This suggests that there could be a funding gap of £1 billion by 2014 unless councils can achieve unprecedented efficiency savings. This would have a knock-on effect on the NHS, with cuts to frontline social care services leading to fewer people getting the help they need, causing more emergency admissions, delayed discharges and longer waiting times. This paper provides evidence on the inter-dependency of health and social care, includes case studies of effective use of resources and recommends four areas for action to achieve better use of health and social resources: adopting a more unified national policy framework, for example, replacing existing separate processes with a single strategic assessment of the funding needs of the NHS and social care; developing a better understanding of local patterns of need, spending and outcomes, with metrics to support shared-investment decisions; closer alignment of resources through pooled and place-based budgets; and a wider role for local government in promoting health and well-being, thus reducing the need for NHS and social care services."],"date_published_tesim":["2011"],"date_published_ssi":"2011","official_url_tesim":["http://www.kingsfund.org.uk/document.rm?id=9027"],"pagination_tesim":["24p."],"place_of_publication_tesim":["London"],"creator_tesim":["The King's Fund","Humphries, Richard"],"date_tesim":["2011"],"date_ssi":"2011","publisher_tesim":["The King's Fund"],"subject_tesim":["joint working","health \u0026 social care","financing","adults","public expenditure cuts","social care","patient emergency admissions","NHS"],"thumbnail_path_ss":"/downloads/6t053f97v?file=thumbnail","suppressed_bsi":false,"actionable_workflow_roles_ssim":["admin_set/default-default-managing","admin_set/default-default-approving","admin_set/default-default-depositing"],"workflow_state_name_ssim":["deposited"],"member_ids_ssim":["6t053f97v"],"file_set_ids_ssim":["6t053f97v"],"visibility_ssi":"open","admin_set_tesim":["Default Admin Set"],"human_readable_type_tesim":["Published Work"],"read_access_group_ssim":["public"],"edit_access_group_ssim":["admin"],"edit_access_person_ssim":["batchuser@example.com"],"nesting_collection__pathnames_ssim":["000098363"],"nesting_collection__deepest_nested_depth_isi":1,"_version_":1714885585626202112,"timestamp":"2021-10-28T17:32:18.587Z","score":1.0},{"system_create_dtsi":"2021-10-27T23:37:56Z","system_modified_dtsi":"2021-10-28T15:21:55Z","has_model_ssim":["PublishedWork"],"id":"000099613","accessControl_ssim":["04d9de2c-8b84-489d-99c0-7fecbea5c856"],"hasRelatedMediaFragment_ssim":["8g84mm284"],"hasRelatedImage_ssim":["8g84mm284"],"depositor_ssim":["batchuser@example.com"],"depositor_tesim":["batchuser@example.com"],"title_tesim":["Routes for social and health care :  a simulation exercise."],"date_uploaded_dtsi":"2021-10-27T23:37:56Z","date_modified_dtsi":"2021-10-28T14:26:56Z","isPartOf_ssim":["admin_set/default"],"biblionumber_tesim":["99613"],"abstract_tesim":["The Routes project was commissioned by The King’s Fund in partnership with the Joseph Rowntree Foundation, the Social Care Institute for Excellence, the Association of Directors of Adult Social Services and the Local Government Association.","The health and social care system is currently tackling three inter-related challenges: coping with rising demand and reduced funding; handling NHS restructuring; and transforming social care. How can these challenges be seen as an opportunity to achieve fundamental change to the system? The Routes project, a simulation exercise created by Loop2, allowed senior managers and thought leaders from across the NHS, local government and the third sector to test out a remodelling of the health and social care system in a safe learning environment. Routes for social and health care: A simulation exercise focuses on Crafton – a hypothetical metropolitan borough in central England – and sets up a number of routes to managing change. During the simulation two contrasting viewpoints emerged. One group took a strongly managerial perspective that recognised the need for immediate decisions to reduce expenditure, while putting in place the conditions for a radical transformation in the way that people receive care and support in the longer term. The other group took a more ‘devolutionist’ approach, arguing that the financial challenges across health, social care and housing could not be managed through a top-down approach; they proposed a radical acceleration of personalisation and community engagement. Participants in the simulation built on the insights they gained to identify strategic routes that might be followed to achieve change on the scale required."],"date_published_tesim":["2011"],"date_published_ssi":"2011","official_url_tesim":["http://www.kingsfund.org.uk/publications/routes-social-and-health-care"],"pagination_tesim":["viii, 30p."],"place_of_publication_tesim":["London"],"creator_tesim":["The King's Fund","Humphries, Richard","McMahon, Laurie","Harvey, Sarah"],"date_tesim":["2011"],"date_ssi":"2011","publisher_tesim":["King's Fund"],"subject_tesim":["leadership","health \u0026 social care","integrated care","social care","health care","service delivery","NHS reforms","NHS","simulation exercises","models"],"thumbnail_path_ss":"/downloads/8g84mm284?file=thumbnail","suppressed_bsi":false,"actionable_workflow_roles_ssim":["admin_set/default-default-managing","admin_set/default-default-approving","admin_set/default-default-depositing"],"workflow_state_name_ssim":["deposited"],"member_ids_ssim":["8g84mm284"],"file_set_ids_ssim":["8g84mm284"],"visibility_ssi":"open","admin_set_tesim":["Default Admin Set"],"human_readable_type_tesim":["Published Work"],"read_access_group_ssim":["public"],"edit_access_group_ssim":["admin"],"edit_access_person_ssim":["batchuser@example.com"],"nesting_collection__pathnames_ssim":["000099613"],"nesting_collection__deepest_nested_depth_isi":1,"_version_":1714885549793214464,"timestamp":"2021-10-28T17:31:44.414Z","score":1.0},{"system_create_dtsi":"2021-10-27T23:37:39Z","system_modified_dtsi":"2021-10-28T15:21:47Z","has_model_ssim":["PublishedWork"],"id":"000105840","accessControl_ssim":["3a186128-b2a7-440d-b687-c14b41ce61ec"],"hasRelatedMediaFragment_ssim":["5t34sj58c"],"hasRelatedImage_ssim":["5t34sj58c"],"depositor_ssim":["batchuser@example.com"],"depositor_tesim":["batchuser@example.com"],"title_tesim":["The roles of leaders in high-performing health care systems."],"date_uploaded_dtsi":"2021-10-27T23:37:39Z","date_modified_dtsi":"2021-10-28T14:26:48Z","isPartOf_ssim":["admin_set/default"],"biblionumber_tesim":["105840"],"abstract_tesim":["Studies in many industries, including health care, suggest that leadership is a critical element in organisational performance. Collins (2001) suggests that disciplined, hard-working leaders are essential to moving organisations from ‘good’ to ‘great’. Such leaders help companies to recruit the right leadership team, develop an effective strategy and create a disciplined culture focused on creating high performance."],"date_published_tesim":["2011"],"date_published_ssi":"2011","official_url_tesim":["http://www.kingsfund.org.uk/publications/articles/roles-leaders-high-performing-health-care-systems"],"pagination_tesim":["27p."],"place_of_publication_tesim":["London"],"creator_tesim":["The King's Fund","Baker, G. 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