County Hall is being left to foot the bill for care that should be paid for by the NHS, a senior official has said.
Principal social worker Mark Howe told a scrutiny management board there was a near-daily battle over where the dividing line should be drawn for some care costs.
It comes after it also emerged savings the authority had intended to generate by securing a greater contribution from theNHS towards a joint funding pot for adult social care were proving difficult to achieve.
The difficulties come against the backdrop of increased demand for care services.
Mr Howe said particular problems were caused by the “complexity” of cases and how these were then funded – especially in relation to mental health and so-called “continuing healthcare”. The latter is the system via which the NHS provides for patients who are primarily considered to need ongoing help as a result of a health issue, rather than simply requiring social care.
“We are fighting daily, almost, with our health colleagues over cases where we believe health should take that responsibility, but social care end[s] up having to shoulder it, which has a really big impact in terms of [the] cost of packages of care,” Mr Howe added.
“I think there’s some big challenges…in terms of…cost shunting…and we’re being left with the bill when we shouldn’t be,” he said separately.
County finance director Noel O’Neill added: "The funding is there in the NHS and in social care. Some of it is for health stuff, some of it’s for social care – [and it is] that split we‘re struggling with.
“We can’t afford to pick up and pay for the health element of that care. But at the moment, that is the way it is working – and we have to get to the bottom of that.
“That is one of the issues [facing the authority, but] it’s not the only issue – we can do things more effectively and that is what we are going to do,” said Mr. O’Neill, who stressed he was not “belittling” the demand pressures also being placed on the NHS.
When the county council set its budget last year, it included a plan to save £28m by improving 'cost sharing' practices with the NHS, including increasing the amount the authority claims from the health service for residents’ continuing healthcare needs.
Increased NHS investment into the Better Care Fund (BCF) was also sought. The fund pools some NHS and local authory resources across an area in an attempt to better integrate care at a local level.
But NHS chiefs then warned there could be “unintended consequences” of County Hall’s savings plan – and highlighted the potential implications of “joint-funded package” schemes.
Deputy county council leader Alan Vincent, earlier this month, said the proposal had “not worked out as we would have preferred” – but talks remained “amicable”.
“We are having ongoing discussions with the NHS about what’s a fair and equitable share of the pot for who does what – but we haven’t achieved the share that we think is due to us."
Kevin Lavery, Lancs and South Cumbria Integrated Care Board (ICB) chief exec said: "We are in discussion with Lancashire County Council about whether the ICB should contribute more to the BCF. It is already a very large fund, in excess of £200m per annum, and the ICB is the largest funder.
“The whole point of the BCF is to focus on keeping people at home, ignoring our organisational boundaries, joining our services up, focusing on prevention rather than sickness and doing the right thing for patients.
“Any extra contribution will need to deliver better value for money.”
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