A national grant to digitise and streamline adult social care assessments has been used to progress innovative practice in local authorities

Most local authorities report that they are experiencing increasing pressure on adult social care (ASC) assessment processes, alongside pressure on care services. As a result, some local authorities have a large backlog of assessments which can delay access to care and mean that some people already in receipt of ASC are not receiving annual reviews as planned, increasing the risk that they receive inappropriate levels or types of care. This also puts pressure on other services, such as hospitals.

Through collaboration between the sector and central government, digitising and streamlining assessment processes had been identified as offering the potential to manage increasing demand for support and support a reduction in waiting lists for social care support. The Grant to Streamline Local Authority Adult Social Care Assessments (‘the grant’) represents one aspect of a programme intended to support progress within local authorities across these areas.

‘The grant’ was a one-off non-ringfenced grant of £27 million shared across all local authorities with responsibility for adult social care (ASC) in the 2022-23 financial year. It was intended to support local authorities to build capacity and generate efficiencies in their assessment processes. The grant supported activities to digitise and streamline assessments as well as the introduction of innovative approaches to optimising the use of workforce such as those in assistant and trainee roles carrying out assessment functions where appropriate, and implementation of trusted assessor models.

The Department of Health and Social Care (DHSC) commissioned Ipsos, in partnership with the Institute of Public Care at Oxford Brookes University (IPC), to conduct an evaluation of the grant.

The evaluation explored the extent to which the grant supported local authorities to continue the progress they had already made in innovating their assessment approach and processes across 3 key impact areas:

1. reducing waiting lists;
2. maintaining and improving the quality of ASC assessments; and
3. moving assessments to digital platforms, where appropriate, to improve access, choice and flexibility for people.

Amongst the local authorities which took part in the survey, the grant was used mainly for activities which were prioritised in the grant guidance:

• purchasing digital tools such as self-assessment and screening portals;

Without it [the grant], almost certainly, we would not be in the position we are now, having worked with a software company to develop this online self-assessment, we would not be in this position. The need was always apparent, the strategy was always there, but we would be further behind than we are now.

• funding transformation of ASC processes such as moving paper-based forms online; 
• funding staff roles in transformation or to provide screening and triage functions; and

The trusted assessor initiative, where social care providers do the review instead of local authority staff, would have been difficult to fund without the grant. This trusted assessor initiative is also expected to improve the quality of reviews and make a significant difference, even if it's only able to be implemented for 10% of the service user population.

• training and wider support to enable the use of digital tools and manage ASC demand.

The grant was used by many local authorities for its intended purposes within a relatively short timeframe, with many others planning to use it for these activities. Only a minority of local authorities reported using it for competing priorities.

The most commonly reported use of the grant from surveyed local authorities was investing in digital tools or transformation work to streamline processes.

Local authorities reported that the grant has contributed to some outputs and outcomes across a range of areas linked to digitising and streamlining and is likely to continue to do so:

• Outputs included improved data management in terms of access to and quality of data, investment in new technologies and digital tools, transformation of ASC assessment process including moving to digital platforms and increased resources to work on digitising and streamlining activities.
• A small number of local authorities recorded measurable outcomes such as reductions in backlogs and waiting lists, improvements in the speed of processes.

We have seen an improvement in terms of waiting times because people do have that self-assessment option and although it's not the final product, they still have the option to complete the tool that we have currently in place. So, we've seen a reduction from the numbers that we had, you know, last year or a few months back to what we're seeing today.

• Whilst longer-term outcomes and impacts had generally not been reported during the evaluation period because of the short period since the grant was dispensed, some local authorities were confident that the activities that the grant had supported would lead to sustainable reductions in waiting times, and an increased focus on personal needs and choice for those seeking ASC assessments in the future. 
• Barriers to achieving outcomes included the grant not being of sufficient size, wider funding pressures across local authorities, difficulties implementing digital tools, and a lack of certainty around the correct approach to take.
• Local authorities would like further support for streamlining and digitising assessments including additional funding and sharing of learning and guidance.

The funding model for the grant was viewed favourably by many local authorities.

The grant provided non-ringfenced funding with guidance and ideas on how it could be spent. There were limited monitoring and reporting requirements. This offered local authorities the flexibility to innovate or pool with other capital spending, which could increase overall spending on digitising and streamlining ASC assessments in some local authorities. This enabled local authorities to progress existing plans more quickly than they would have done or add additional activities to their plans.

This grant is one of a number of initiatives related to supporting local authorities with innovation and improving social care assessments which have been introduced in the last two or three years. The full impacts of the grant will only become apparent over a longer time period than this evaluation. The Ipsos social care research and evaluation team recommends ongoing analysis and exploration of the impacts of social care policies over a long time period, even as individual initiatives end, and policy evolves. This evaluation provides valuable insights into effective models for funding and supporting local authorities to tackle specific challenges through digital technology and process transformation.

Technical details:
This evaluation was commissioned under the previous administration (11th May 2010 to 5th July 2024) and therefore does not reflect the policies of the current government.

The final report also included seven ‘pen portrait’ case studies demonstrating a range of different ways individual local authorities had used the grant, and the emerging outcomes associated with these. The full research report is published on gov.uk.

• The evaluation employed the following evaluation methodologies to address the agreed evaluation questions:
  a full scoping and evaluation design phase including the co-development of theories of changes for both the grant and wider adult social care (ASC) assessment digitising and streamlining work at a national level;
• a survey of all 153 local authorities with responsibility for ASC (of which 40 responded fully and 10 provided a partial response), covering wider progress in streamlining ASC assessments, their awareness and use of the grant and its impact; and
• 23 case study interviews across 7 local authorities (3 to 4 per local authority) exploring in more detail implementation of ASC digitising and streamlining activities, their use of the grant and the outputs, outcomes and impacts linked to the grant.
   

The sample of local authorities included in the survey and interviews should not be considered representative of all local authorities, and therefore findings can only be considered robust when ascribed to those local authorities which have engaged with the evaluation. Those local authorities which chose to engage in the evaluation may have had a different experience of spending the grant from those which did not. However, it should be noted that the participating local authorities included a good mix of local authorities from across the country and of different types, including counties, metropolitan and unitary local authorities.