Comprehensive Investment Appraisal (CIA) model and guidance

Department of Health and Social Care, April 2019

The CIA is a model for the NHS to use to support economic appraisals in business cases. It replaces the Generic Economic Model. The user guide shows how the CIA model can be used to support economic appraisals in business cases. It provides guidance on the key economic principles, how these are used in economic appraisals and how the outcome of these appraisals is interpreted.

Click here to view the guidance.

Early access to mental health support

Children’s Commissioner, April 2019

This report looks at the amount spent on “low-level” mental health support for children in England. “Low-level” mental health services are preventative and early intervention services for treating problems like anxiety and depression or eating disorders, such as support provided by school nurses or counsellors, drop-in centres or online counselling services.  The report reveals that local areas, which included both local authorities and NHS spending, were allocated a total of £226 million for low-level mental health services in 2018/19, just over £14 per child.  The report also found large variations between geographical areas in the funding available, and where spending on services has fallen locally it has been driven by reduced spending by local authorities.

Click here to view the full report.

Fair funding for mental health: putting parity into practice: Briefing

Institute for Public Policy Research, November 2018

The NHS is currently in the process of authoring a long-term plan that will set out what it wants to achieve with additional funding and how this funding will be allocated. This Institute for Public Policy Research briefing argues that it is crucial that this plan raises our ambitions on mental health, what parity of esteem looks like and how much it will cost to get there.

Click here to view the full report.

Making the money work in the health and care system

HfMA and PWC, June 2018

Joint report from the HfMA and PWC identifying how financial flows could be redesigned to find a better way to make money work in the health and care system. The report sets out why the current complex system of funding flows do not support the proposed new models of more integrated care introduced in the Five-year forward view and therefore need to change. It proposes:

  • Financial flows should be aligned with the emerging place based architecture
  • Systems should be provided with more clarity through longer-term funding
  • Money should be focused towards achieving better outcomes.

Click here to view the full report.

Securing the future: funding health and social care to the 2030s

Institute of Fiscal Studies, May 2018

Report from the Instistute of Fiscal Studies and the Health Foundation that looks at the future funding needs of Health and Social Care. It suggests that UK spending on healthcare will have to rise by an average 3.3% a year over the next 15 years just to maintain NHS provision at current levels, and by at least 4% a year if services are to be improved. Social care funding will need to increase by 3.9% a year to meet the needs of an ageing population and an increasing number of younger adults living with disabilities. If the widely acknowledged problems with England’s social care system – of limited eligibility, low quality and the perceived unfairness of the current, uncapped, means test – did result in reform, spending on social care would need to increase at a faster rate.

Click here to view this report.

Social care funding options: How much and where from?

The Health Foundation, May 2018

Report from the Health Foundation and Kings Fund that considers the costs associated with:

  • continuing the current social care system
  • introducing free personal care as exists in Scotland
  • raising the means test for receiving publicly funded care (the ‘floor’) and introducing a cap on total lifetime costs, as proposed in the Conservative Party manifesto for the 2017 general election.

It finds;

  • For the cap and floor model, cost above current pressures is £4.0bn in 2020/21 (taking account of the reduced spending on domiciliary care) rising to £5.8bn by 2030/31. The funding gap would be £5.5bn in 2020/21 and £11.9bn in 2030/31.
  • Free personal care would cost an extra £5.5bn in 2020/21 and £7.9bn by 2030/31. This would increase the estimated funding gap to £7bn in 2020/21 and £14bn in 2030/31.
  • The additional funding required for social care is large. To raise the funds in a sustainable way without cuts to other public services options include adding 1p to the main rate, higher rate and employers’ National Insurance contributions (NICs) by 2030/31, this would raise enough to fund the introduction of the cap and floor model. By means of winter fuel payments, this could be enough to introduce free personal care.
  • Additional revenue will need to be raised for adult social care services even without a change in the model. The question for government is whether, given that additional tax revenue will be required to protect the range and quality of care services, it would be better to aim for a sufficiently large increase in taxation to be able to provide a better model of care to those facing the burden of the cost.

Click here to view the full report.

Dementia – the true cost: fixing the care crisis

Alzheimer’s Society, May 2018

In the UK today, two thirds of people using homecare and 70% of people in care homes live with some form of dementia (UKHCA 2013 and Alzheimer’s Society 2014). Dementia is potentially the most complex and challenging condition social care has to support.   It calls for:

  • The cost of extra care charges for a health condition such as dementia must be covered by the state
  • All health and social care workers must be given the training and support they need to deliver quality dementia care.
  • Everyone with dementia should have a care navigator to support access to timely, preventative and integrated support.

Click here to view the full report.