Where We Are Now and What We Know

Resources - Budget and Funding

In West Sussex all social care services for adults of working age with mental ill health are funded through longstanding formal Pooled Budget arrangements between the Council and the NHS Sussex Integrated Care Board (ICB). NHS Sussex ICB funds 86.87% of all expenditure and West Sussex County Council funds 13.13%. Through this arrangement the NHS is the lead commissioner and contractor of all NHS and block contracted mental health services and the Council is the lead commissioner and contractor of all individually contracted social care services for people of working age with mental ill health. Both the ICB and the Council are reviewing these longstanding Pooled Budget arrangements to ensure they are still fit for purpose and provide the best arrangements for the commissioning of mental health services in West Sussex.

In the 2023/2024 financial year, the Council budgeted to contribute to the Pooled Budget and spend £23m on social care services for adults of working age with mental ill-health (of a total of £381m on all adult social care services).

There are significant challenges for the NHS Sussex ICB and Council in meeting the increasing costs of eligible social care needs for individuals of working age with mental ill health. This is because demand for social care services for adults of working age with mental ill health is increasing (see 4.3). In addition, the cost of care services is also increasing through the impact of inflation, increases to the National Living Wage and other cost of living pressures making the provision of services more expensive and also because the needs of individuals needing care are becoming more complex.

To illustrate this, Table 1, below, shows how the costs of mental health residential and nursing care placements funded from the mental health pooled budget have increased between 2019 and 2024.

Table 1 note: Each £ figure is a snapshot value taken from a day in first week in January of that year.

And Table 2, below, shows how costs of community support packages funded from the mental health pooled budget (mostly contracted through Lots 1 -3 of the Supported Living Framework) have also increased.

Table 2 note: Each £ figure is a snapshot value taken from a day in first week in January of that year.

The increasing costs in this sector of the market pose significant challenges for both the ICB and Council given the financial pressures which are being faced by both organisations. In order to ensure that the budget for adults of working age adults with mental ill health remains sustainable in the long term the Council, therefore, has to ensure that resources are used to deliver the best possible care outcomes for people at maximum value for money and that the current models of care and support available in the market can deliver this.

Workforce

Social care services for adults of working age with mental ill health also face challenges around the recruitment and retention of workforce and shortages of care workers which also provides further challenge. To address this West Sussex County Council is taking a proactive approach to supporting care providers. The Council reviewed how it supports providers to deliver good and sustainable services and as a result, developed a new Quality Assurance and Market Support team to build on the previous Care and Business Support and Proud to Care teams. The new team works collaboratively and supportively with providers to improve the quality of all care services. The Council also continues to participate in the Proud to Care national initiative which supports the external care market with recruitment and retention in order to strengthen and enhance the market to meet increasing demand. 

For more information visit West Sussex Proud to Care website where people can find and apply for a variety of jobs across the county. Retention and recruitment remains a challenge and this prompted the development of the Great Care Employer scheme, which was co-produced with West Sussex Partners in Care and market providers. This enables providers to highlight what they can offer to job seekers focussed on four themes: pay and benefits; job security and flexibility; learning and development; and supported and valued. The scheme has been recognised as good practice by both Skills for Care and NHS England. This is further explored, linked to funding issues, below in the section - Challenges and Issues We Are Facing in Meeting Social Care Needs of Adults of Working Age with Mental Ill Health - Resources.