March 1, 2018
By Lesley Curtis, Research Fellow at PSSRU Kent
The Unit Costs of Health and Social Care 2017 is now available online, bringing the costs of a wide range of health and social care services for both adults and children. Thanks to funding from the Department for Education, once again this year, we have been able to add new services to chapter 6, which focuses mainly on children’s social care. Here you will find unit costs for children’s care homes, adoption, end-of-life care at home, parenting programmes and many more.
Chapter 8 which focuses on care packages also contains some children’s service costs; for example in 8.3.1, we present some case studies for pre-school children with autism and in table 8.7, illustrations of examples of the support given to families during residential parenting assessments from independent providers are given. Of particular interest to readers this year, in view of the review of foster care recently carried out for the Department for Education, may be tables 8.5.1-8.5.2 which provide the costs of support care; short-term preventative foster care aimed at families in crisis. On page 86, we have also estimated the cost per child per week in foster care (£646). This includes the costs of boarding out allowances, administration, social workers and other support staff.
Costs of advocacy and counselling
New in the volume this year, thanks to a collaboration with a national children’s charity, are the costs of advocacy and counselling. The children receiving the advocacy intervention (see table 6.17 shown below) either have additional/multiple needs, are in need of immediate care and protection, are looked after or are care leavers. Those receiving counselling (see table 6.18) were identified as having a mental or emotional health difficulty. Both service models are considered to be ‘typical’ for young people aged between 10 and 21.
You will see that we estimated that a 10-hour advocacy intervention costs £724. Although 85% of cases require up to ten one-hour sessions of advocacy or less, some children will receive more, so the hourly cost per client-related hour (£72) is also provided. A 12-hour counselling intervention is estimated to cost £1,055 per case and £88 per client-related hour. Both tables contain detailed notes which explain the calculations, and also help those who want to calculate the costs of similar services. As ‘promoting positive mental health’ and ‘prevention’ are important themes running through the new Green Paper: Transforming children and young people’s mental health provision, these costs could be useful to service providers and commissioners.
New sources of information have been used to update the land costs this year which form part of the capital calculation along with the cost of buildings and offices. As the cost of land accounts for only 2% of the total costs of, for example, a children’s social worker estimated in table 11.3, this has not had a big impact on the unit cost of an hour of a children’s social worker’s time. Other work includes an adjustment to the superannuation rates paid by employers of staff working in local authorities. We have also included some information drawn from the CIPFA social care benchmarking activities in tables 6.2 and 6.8. Further work is planned this year to reflect these findings in the costs of local authority-provided services. More details of this new information, which underlies several service cost estimates, can be found in this year’s Preface.
This year, an exciting improvement to the Unit Costs work has been the creation of a database containing all articles published in the Unit Costs volumes since 2003. Judging by the number of visits to the database (4,200 since October 2017), this has been useful to many of our readers. Examples of articles focusing on children’s services are: the costs of residential child care (Stanley & Rome, 2013) and the costs of Sure Start Local Programmes services (Tidmarsh & Schneider, 2005). As new articles are published in our volumes of the Unit Costs of Health and Social Care, they will be added to the database.