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Publication, Part of

Adult Social Care Activity and Finance Report, England, 2022-23

National statistics, Official statistics, Accredited official statistics

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2016-17 updated cash and real term NCE and GCE figures

Table 4 of the Net Current Expenditure and Gross Current Expenditure Tables the cash and real term figures for 2016-17 have been corrected. The correction has also taken place in Figure 3 Cash vs Real 

16 February 2024 14:37 PM

Activity and Finance Overview


The total number of completed episodes of short term care to maximise independence (ST-Max) for both new and existing clients, where an outcome had been determined within the reporting period was 251,255. 88.2% (221,695) of these completed episodes were for clients aged 65 and over. ST-Max is terminology introduced in the Adult Social Care Data Dictionary to describe a range of services that are of short duration (typically being provided for a few weeks) and that have the explicit aim of trying to minimise the person’s use of ongoing social care services.

The csv files accompanying this report provide a full breakdown of all expenditure and activity figures provided by local authorities as part of the ASC-FR collection.

Figure 1a: Requests for support, 2022-23

Source: SALT collection, 2022-23, NHS England - See Table 9 in Data Tables.

 

Figure 1b: Short term care to maximise independence (ST-MAX) for new clients, 2022-23

Source: SALT collection, 2022-23, NHS England - See Table 21 in Data Tables.

 

Figure 1c: Long term care, 2022-23

Source: SALT collection, 2022-23, NHS England - See Table 34 in Data Tables. The long term support figures in the diagram above relate to all those receiving care at some point in the year.


More on expenditure

Total expenditure on adult social care by local authorities in 2022-23 was £28.4 billion, however this includes capital charges and some of this expenditure is offset by income from other sources such as the NHS. A full breakdown of how total expenditure is split between local authority spend and income from other sources can be found in Table 5 of Appendix C.

In 2022-23 gross current expenditure on adult social care (which accounts for spending by social care departments and also includes client contributions), was £23.7 billion, and this is the measure of expenditure used throughout this report (except where otherwise stated).

There were no specific funding measures in place to address the residual impact of  the coronavirus (COVID-19) pandemic in 2022-23; however these were in place in previous years (2020-21 and 2021-22) so this should be borne in mind when looking at longer term trends.

Why do we use gross current expenditure?

Gross current expenditure covers the amount of spend by local authorities that is not offset by income from clients and does not include a capital charge. It is the fiscal metric used to denote local government spending, so unless otherwise stated gross current expenditure is used as the main source for figures in this report.

It is important to be aware of the constituent parts that contribute to calculating gross current expenditure, as shown in Figure 2, as any year on year changes to gross current expenditure will be driven by increases or decreases in one or more of these areas.

Figure 2: How gross current expenditure is calculated, 2022-23

Source: ASC-FR collection, 2022-23, NHS England - See Table 3 in Data Tables. The sizes of the images are indicative and are not to scale.

 

Gross current expenditure has increased £1.7 billion since 2022-23, which is a 7.9% increase in cash terms and a 1.1% increase in real terms. Figure 3 shows the trends over time in cash terms and real terms.

When looking at changes in monetary amounts over time it can be difficult to see whether more or less money has been spent as the real change is often masked by the effects of inflation. Therefore, it is useful to strip out the effects of inflation so the real change in expenditure can be examined.

Cash Terms versus Real Terms

A comparison in cash terms compares corresponding values between years, without any form of adjustment. A comparison in real terms accounts for the effect of inflation between figures, and so allows for the comparison of corresponding values, whilst controlling for any changes in the value of the pound.

More information on the process of obtaining these adjusted figures using Gross Domestic Product (GDP) deflators is available in Appendix B.


Source: ASC-FR collection, 2022-23, NHS England - See Table 4 in Data Tables, and GDP deflators found here https://www.gov.uk/government/statistics/gdp-deflators-at-market-prices-and-money-gdp-september-2023-quarterly-national-accounts

 

In additional to the usual funding of adult social care through council tax and grants from central government (such as improved Better Care Fund), local authorities are able to use an adult social care precept to raise additional funds.

  • The additional adult social care precept flexibility in 2022-23 will generate £408 million.
  • Of 152 authorities with adult social care responsibilities, 150 utilised some, or all, of their precept flexibility for 2022-23.

Table 2 shows total gross current expenditure and its constituent parts compared to last year.

Table 2: Gross current expenditure, by care type, 2019-20 to 2022-23

  Billions
  2019-20 2020-21 2021-22 2022-23 % change 2021-22 to 2022-23
Long Term Support GCE £15.39 £15.63 £16.57 £18.43 11.2%
Short Term Support GCE £0.61 £0.68 £0.77 £0.95 23.7%
Other GCE £3.65 £4.94 £4.62 £4.32 -6.6%
Total Gross Current Expenditure (GCE) £19.65 £21.24 £21.96 £23.69 7.9%

 

Source: ASC-FR collection, 2022-23, NHS England - See Table 15 in Data Tables.

 

Figure 4 provides a further breakdown of the latest year’s gross current expenditure on adult social care and how this expenditure is allocated.

Figure 4: Overview of gross current expenditure on adult social care, 2022-23

Source: ASC-FR collection, 2022-23, NHS England - See Table 14, 19, 20 and 46 in Data Tables. Numbers may not add up due to rounding.


Overall public spending on adult social care

The overall estimate of public spending on adult social care consists of the net current expenditure (local authority spend, and equivalent to gross current expenditure minus client contributions) plus planned spending on the minimum Better Care Fund for social care or direct with social care providers. It gives a total of £22.9 billion in 2022-23. A full time series of the estimated public spend on adult social care can be found in Table 5 of Appendix C.

Why might you use net current expenditure?

Net current expenditure is useful for understanding how much of adult social care is funded from local authority monies – whether they are raised locally such as council tax (including the adult social care precept), business rates, etc, or where they are centrally funded such as the improved Better Care Fund or the local government finance settlement.

Net current expenditure removes capital charges and external income and is thus not impacted by changes in client contributions and income from the NHS, the two largest income components.


For users specifically interested in using this metric, an additional set of Net Current Expenditure data tables based on data collected in the ASC-FR are also available accompanying this report.

Net current expenditure on adult social care is also collected by the Department for Levelling Up, Housing and Communities (DLUHC) as part of the Local Government Revenue Outturn (RO) returns, and published here: https://www.gov.uk/government/collections/local-authority-revenue-expenditure-and-financing

Totals are expected to reconcile between the two collections (with a small number of exceptions).

 


Income – how is social care funded?

Of the £28.4 billion total expenditure in 2022-23, 71.6% (£20.3 billion) is funded directly by the local authority (this includes capital charges and is known as net total expenditure, as seen in Figure 6 below).

One area of central funding is the Improved Better Care Fund (iBCF). The value of the iBCF in 2022-23 was £2.14 billion.

What is the improved Better Care Fund?

The improved Better Care Fund grant was announced in the 2015 Spending Review and was introduced from 2017-18 onwards. The grant provides local government with new funding for adult social care. The fund is paid directly to local government and must be used to support social care activity.

Source: NHS England

The total allocation of the iBCF in 2022-23 is £2.14 billion. The iBCF grant determination was issued on 22 April 2022.

Source: GOV.UK

Expenditure funded by the improved Better Care Fund and other Specific and Special Grants is captured in the data, but those grants are not reported as income in this collection. Figure 5 below shows how income from Specific and Special grants increased between 2016-17 and 2021-22, with a big jump in 2020-21 and 2021-22 due to COVID-19 funding such as the Infection Control Fund, and Workforce Capacity Fund which were reported and recognised as Specific and Special Grants in ASC-FR. In 2022-23 Specific and Special grants decreased by 15.7% (to £2.5 billion) since the previous year.

Source: ASC-FR collection, 2022-23, NHS England.

 

The remaining 28.4% (£8.0 billion) of total expenditure is funded by income from other sources. This includes ‘Client contributions’ which has increased since last year, ‘Income from the NHS’ (including the Better Care Fund (note: this is different to the improved Better Care Fund)), ‘Joint arrangements’ and ‘Other income’ which have all decreased.

This collection cannot be used to consider the financial pressures on local authorities as it does not reflect the full picture on all income streams available to fund social care.

In the 2017-18 adult social care finance return, recording of the income from the Better Care Fund became mandatory. This year local authorities stated they received a combined total of £2.2 billion income from Better Care Fund, which accounted for 55.8% of their Income from NHS. This relates to actual expenditure reported by local authorities in the ASC-FR return when considering it against the planned minimum Better Care Fund spend for social care or direct with social care providers.

What is the Better Care Fund?

The Better Care Fund (BCF) creates a local single pooled budget to incentivise the NHS and local government to work more closely together around people, placing their wellbeing as the focus of health and care services, and shifting resources into adult social care and community services for the benefit of the people, communities and health and care systems.

Source: https://www.local.gov.uk/our-support/our-improvement-offer/care-and-health-improvement/integration-and-better-care-fund/better-care-fund

 

 

Whilst Health and Wellbeing Boards use the Better Care Fund to support integrated health and social care, finance data is available on how local authorities spend this funding but data on the associated activity, or lower-level detail on how this funding is spent is not included within the NHS England data collections.

Figure 6: Overview of total local authority expenditure and income on adult social care, 2022-23

Source: ASC-FR collection, 2022-23, NHS England - See Table 3 in Data Tables. Net estimate of total public spend is based on local authority expenditure plus NHS Better Care Fund spend, some of which is spent directly by the NHS and so would not be included in the ASC-FR return made by local authorities. Although the Income from the NHS reported by local authorities in the ASC-FR return does include some Better Care Fund spending, it will also include local arrangements with the NHS. Therefore, the Income from NHS and Better Care Fund figures in the diagram above are related but are not directly comparable.



Last edited: 5 March 2024 10:23 am