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Health leaders say that the funding pressure across local government is leaving them unable to offer care packages to help people move out of hospital.
The concerns were voiced after the Department for Levelling Up announced a further £64 billion to shore up council budgets in England to ensure they can deliver frontline services.
The NHS Confederation, however, said that while any additional cash for councils is welcome, its partners in local government have had to manage a decade of funding cuts and it is not yet clear if this is enough to help system leaders avoid having to make difficult decisions over the future of services.
Dr Layla McCay, director of policy at the NHS Confederation, said: “Public health, talking health inequalities and improving prevention are huge priorities for Integrated Care Systems (ICS). Local authorities are key partners in this, and we will not be able to reap the massive opportunities ICSs offer to improve population health without properly funded public health services. This is why we want to see a real-terms restoration in public health grant funding, reflecting the increase in demand after a decade of cuts and rising need.
“With staffing gaps across both health and social care we would also like to see the development of a plan for the social care workforce to mirror the NHS long term workforce plan and ensure that local authorities receive additional funding to deliver it.”
Local government £500 million social care boost
The final local government finance settlement for 2024-25 makes available up to £4.5 billion more for councils in England in 2024-25, an above-inflation increase of 7.5% on the previous year – with £64.7 billion for local government overall.
The package includes the £600 million in extra support for council budgets, including £500 million for social care, announced on 24 January.
The Health Foundation said that unfortunately the 7.5% cash terms increase in core spending power next year will do little to stabilise councils’ increasingly precarious financial situations. It added that to improve the nation’s health, local government funding must be sufficient, sustainable, and proportionate to need. This requires urgent attention from the next government.
Katherine Merrifield, Assistant Director of the Healthy Lives team at the Health Foundation, said this settlement will leave council budgets with an estimated £1bn deficit, with core spending power around 12% lower in real terms than in 2010/11. This shortfall – against a backdrop of long-term underfunding – means councils must make near-impossible decisions to cut services. This will impact local people’s health as they may no longer be able to access many of the services they rely on, such as decent housing, good education, leisure facilities, libraries, community centres and public transport.
She added: “The 7.5% uplift also relies on every local authority increasing council tax by the maximum permitted without a referendum. This will increase pressure on households already struggling with the cost-of-living crisis, raising the risk of mental health issues and leaving many unable to afford the basics, such as food and heating. Furthermore, recent analysis demonstrates that deprived areas tend to receive less funding relative to need; this uplift is no exception, likely exacerbating health inequalities.
“Public health teams will also face financial strain. Despite a 2.1% cash uplift on 2023/24 provided in the public health grant, public health funding per person remains 27% lower in real terms in 2024/25 than in 2015/16, requiring some preventative services to be cut – particularly in more deprived areas where reductions in public health allocations tend to be largest – which will detrimentally impact population health and health inequalities.
“Finally, while extra money for social care is welcome, it will do little to address the huge pressures on the adult social care system, which continues to face increasing demand, significant staff shortages, and rising costs.”