Fair access to care services (FACS): prioritising eligibility for care and support

The social care and NHS policy context - What is current local authority practice?

The Department of Health (DH) commissioned SCIE in September 2012 to prepare a report on the current position in adult social care assessment and eligibility. It was interested in questions of practice, process, decision-making and consistency in assessment and eligibility. The SCIE survey, alongside other work, provides information about the current situation for the government to consider when implementing its plans to introduce a national minimum eligibility threshold and ‘to develop and test options for a potential new assessment and eligibility framework, in consultation with people who use services, carers, academics, local authorities, social workers, and health and care professionals’. [3]

SCIE used a range of evidence including:

Published research

The 2012 report of a survey of FACS assessment criteria among local authorities in England by the Personal Social Services Research Unit, [13] based on responses from 85 local authorities (57 per cent of English social services authorities), provides a thorough and detailed analysis of the relationships between the FACS bandings, central and local government priority-setting, individual needs assessment and variations in care manager decision-making.

The 2012 SCIE report Crossing the threshold by Melanie Henwood [14] examines the implications of the Law Commission and Dilnot Commission reports for eligibility and assessment in care and support. The report explores the rationale for moving to a ‘more objective’ model of assessment and a national eligibility threshold, as recommended by the Law Commission [6] and Dilnot Commission. [12] It examines the benefits, and some potential risks, in these moves.

Other relevant studies include a forward-looking ADASS report, ‘The case for tomorrow: facing the beyond: a joint discussion document on the future of services for older people’ (2012). [15] This examines the pressures on the care system for older people of increasing demand, rising expectations, restricted resources and trends in provision and the market. It looks at the changes needed in the way services are shaped and delivered and identifies an action agenda for the government to support local management and innovation.

The Audit Commission has also produced ‘Reducing the cost of assessments and reviews’ (2012) [16] an adult social care briefing for councils, setting out its analysis of spending on these activities, and how some authorities have achieved low-cost approaches through reconfiguring services and staffing.

The key findings emerging from the SCIE study [14] were as follows.


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  • Fair access to care services (FACS): prioritising eligibility for care and support