Support for Vulnerable People

How can services prevent deterioration in the circumstances of vulnerable people and avoid the consequent effects on their well-being and on costs?

By tracking population cohorts it will be possible to identify trajectories of need, patterns of service use and outcomes. Tracking older people’s care trajectories will identify interventions which maintain independence and avoid unnecessary care home or hospital admission.

Local authorities need to fulfil national policy requirements sometimes designed on the basis of imperfect understanding of local considerations. Policy initiatives for children have focused on early prevention, for example SureStart and the ‘troubled families’ programme. Tracking cohorts of children will allow us to ascertain which children from a range of backgrounds, including the most disadvantaged, come to the attention of children’s services and develop pathway maps and outcome measures. From 2016 there will be a cap on an individual’s liability for care. This will provide rich data and reveal whether assumptions made in designing these policies were correct or identify if reforms are needed. With access to local authority data long term care policy simulation models will be refined, extended and used to provide further evidence for policy development and implementation.

Tight budgets pose challenges for LAs in working with private providers. The ‘mixed economy’ of care involves local authority procurement, direct purchase of care by individuals in a private capacity or via ‘personal budgets’ and private sector supply of care services. This raises concerns over the quantity and quality of supply, the practice of cross-subsidising from private to LA-funded residents and the effects of policy reforms. We plan to use data on local care markets to understand the consequences of different procurement strategies and identify those most likely to safeguard the supply of good quality care services.

There is significant variation in how LAs commission social care services. We aim to investigate the patterns of services they procure, assessing the relationship between these patterns and the needs of service users, various outcome indicators and other factors. We aim to identify the optimal balance of commissioned services, resourcing levels of personal budgets etc.

Previous work suggests significant inter-dependencies and potentials for substitution between health and social care services. We plan to link LA data on social care use with corresponding health care data, assessing why users have different mixes of these services and whether the use of social care reduces the use of health care, and vice versa, and with what outcomes for users.