District councils should seize local government reorganisation as opportunity to redesign adult social care services: report

The report, published by District Councils Network in partnership with INSPIRE, claims that attributes such as a “localised focus” on communities and a “close knowledge” of their people and places give smaller councils an advantage for redesigning the future of adult social care (ASC).

While district councils are not statutory ASC authorities under the Care Act 2014, services such as housing, benefits, and community wellbeing are often necessary for enabling independence and delaying or avoiding the need for formal care.

Outlining the current challenges and pressures in the system, the report notes that adult social care is “by far” the largest component of any unitary council’s budget.

It notes: “Recent years have seen ongoing challenges for these councils in meeting demand, while managing the spiralling costs for commissioned services from the provider market.

“Alongside the established services required for older adults (65+) the emerging needs of younger adults with complex neurological conditions or physical support needs are defining a whole new approach to lifelong independence and the type of interventions required.”

The report counters the view that size is the most decisive factor in driving successful ASC services and that smaller social care footprints are bound to be less effective.

It notes that analysis by IMPOWER shows “no clear link between scale and overall quality of adult social care”, and claims there are “no economies of scale in delivering personal care”.

The report says a redesign of adult social care services should draw on the strengths that districts and smaller councils bring through their “proximity to place and focus on prevention”.

Further, the report states that shared services, lead authority models or joint commissioning arrangements may be useful, especially in the short term, to ensure “safe transition” or deliver efficiencies in areas such as strategic commissioning or back-office functions.

However, it warns there should be “no room for doubt about accountability” for services that will consume a significant proportion of the budgets for new organisations.

Local government reorganisation is the process in which the structure and responsibilities of local authorities are reconfigured.

Proposed structural changes to local government in England were set out in the English Devolution White Paper published by the government on 16 December 2024.

Cllr Hannah Dalton, health spokesperson for the District Councils’ Network, said: “This report highlights that district councils have much to bring to the table in designing the future of adult social care – in particular, our unrivalled links to our communities and our unwavering focus on prevention.

“District councils are specialists in adapting housing to ensure older people can remain independent for longer, running planning systems that encourage development to boost physical activity and overseeing wellbeing programmes to tackle obesity or mental illness. Following reorganisation, this work should be enhanced to complement and support more traditional social care work.

“Reorganisation should inject a strong sense of place into adult social care services – tailoring them to the unique needs of communities – and it must bring about a greater focus on prevention, which is the only way we can hope to tackle rising demand."

She added: “This is where smaller councils have a natural advantage – with a localised focus on communities and close knowledge of their people and places. These attributes should be essential ingredients of redesigned and reimagined social care services.”

Cllr Dalton said: “IMPOWER’s report confirms district councils should be confident to use their unique attributes to devise new approaches for adult social care. Services cannot go on as they are, with demand rising faster than budgets, unmet needs and low wages. It would be a mistake to simply carry forward the existing failing model at a wider scale, when a shift in approach towards prevention is desperately required.”

The Department for Health and Social Care has been approached for comment.

Lottie Winson