Financial forecasting

The financial challenge webpage details the current gap between our expected funding streams and the estimated expenditure were we to continue to commission services in the same way.

To address these gaps several strategic transformation projects are in train which will help to identify opportunities to re-shape the market to ensure that we deliver services in the best way to secure best value for the system.

The realignment of resources to achieve our key aims will continue to be the main focus for commissioners. The main transformation projects continuing, or being progressed, during 2023-2024 are:

• Connecting communities to unlock the potential and opportunity of the voluntary, community and social enterprise (VCSE) in supporting the care market and supporting people's needs at the right time
• The strategic review of home care services: A review of the current models for commissioning and delivery of home care services within Norfolk
• The collaborative care market review project: Which is reviewing the current arrangements for commissioning and contracting funded nursing care and continuing health care with a view to delivering closer alignment across nursing provision
• Day services strategic review: Reviewing service demand and looking at the most effective service models and approaches for people to access the care and support that they need to remain living at home for longer
• The transformation and integration of learning disability and autism commissioning, with the ambition of delivering a pooled budget to better meet some of the needs of the learning disabled and autistic population
• Redeveloping the working age adult residential sector, to provide greater sustainability, a reduction in bureaucracy and improvements in quality
• Working with the national development team for inclusion (NDTI) to deliver small supports in partnership with the local government association (LGA) and the national health service executive (NHSE), to create more locally based provision to support people with complex needs arising from their learning disability and/or autism
• Continued transformation of day services for people with a learning disability, to drive enabling opportunities such as, work, training, and employment. To promote the independence and achievement in activities of daily living and provide high quality care and support to those with the most complex needs.

Further details of these transformation projects are included in the market analysis webpages. All of these projects are being delivered in co-production with providers, people accessing services and other key stakeholders.

Future risks

Provider failure and market stability

Future risks around provider failure and market stability include:

• Financial viability of providers
• The challenges that providers are facing relating to the recruitment and retention of the workforce. Read more about workforce challenges. 
• Higher than predicted, and funded, inflation over the short to medium term

Social care reform

Future risks around the social care reform include:

• The current uncertainty on the level of funding that will be available to support the implementation of the charging reform element of the social care reform

Visit our impact of the social care reform webpage for further information.

How we spend the money allocated for adult social care

The gross spend (before income is netted off) for adult social care at the end of 2022-2023 is £395m. This is split across the different service areas:

• Residential care: £195,435,584 - 49%
• Nursing care: £25,545,141 - 6%
• Supported housing (housing with care and independent living): £54,158,208 - 14%
• Home care: £54,042,800 - 14%
• Direct payments for home care: £27,490,842 - 7%
• Day services: £21,055,103 - 5%
• Direct payments for day services: £6,538,350 - 2%
• Other: £11,112,554 - 3%

The majority of spend is on residential care (£195m), home care (£54m) and supported housing (£54m).