1. Social care and support services in Barnet –activity, demand and trends
During 2007/08, Barnet Adult Social Services dealt with 6119 referrals for adults of which over
3400 resulted in assessments of individual need. This activity has increased steadily over the
last 5 years for each of the care groups, however with a decrease in 2007/8.
Table 1 Referral and assessment volumes 2003-2008 Barnet Adult Social Services
Referrals and Assessments Adult Social Services
100%
2835
2217 3626 2022 2438
90%
80%
70%
2388
3183
3406 5310 4932
60%
New assessments leading to service
50% Passed for further assessment
Dealt With at point of contact
40%
30%
6119 5133 5734 4680 4799
20%
10%
0%
2007/08 2006/07 2005/06 2004/05 2003/04
The type of activity relating to adults in contact with social services has changed according to
how the system has managed demand. In general there has been an increase in ‘signposting’
to alternative sources of help. In common with the national picture for councils, Adult Social
Services has developed more filtering mechanisms for screening people at the point of referral
so that some people have been excluded from services at an earlier stage. There has been
greater reliance on the voluntary sector to offer low level support and interventions where direct
referral by the council is not necessary. The council has continued to strengthen relationships
with the voluntary sector through a steady funding stream and the numbers of people helped
through the grant funded sector have increased.
What is not fully known is how people with ‘low or moderate needs’ are able to get their needs
met and what level of unmet need there is in the general population. It is important that more is
known about the consequences of unmet need both in terms of assessing the outcomes for
those individuals and their families, and in terms of predicting the numbers of adults who may
develop care needs which are ‘substantial and critical’ over the next 10 to 20 years and where
an earlier intervention may have prevented referral to social services, acute or specialist care
for longer.
The data shows that the number of new assessments each year which led to a service
provision has varied from year to year and from client group to client group for example

2. historically Barnet has always had high numbers of ‘self funders’, particularly older adults, many
of whom in the past would have contacted social services for an assessment. Increasingly
there are alternative sources of help and advice for people who pay privately for care and an
increasing consumer awareness of private equity schemes and other types of financial
arrangements. However the total activity levels in terms of referrals and assessments have
increased by 32.5% over the period 2003/04 to 2007/08 the cumulative impact of which is
increased demand on care management and assessment capacity and purchasing budgets.
New Assessments leading to Service
3000
2666
2500
2278
2000
No of Assessments
1703 Physical & Sensory
1592 Learning Disability
1518
1500
Mental Health
Adults 65+
1000
616
490
500
421 281
272
288
213 180 253 213
49
36 29
23
17
0
2003/04 2004/05 2005/06 2006/07 2007/08
More analysis is required of referral
patterns for social care and support
services by ward / locality, however
there are some identifiable trends in
needs and demand by location. Use of
services by older people tends to be
spread across the borough however
with higher demand in the more
deprived wards. A recent analysis of
homecare referrals showed that there
was a lower turnover of service users in
deprived areas indicating that people
may start using services earlier
because of higher rates of illnesses and
the lack access to alternatives sources
of support for those individuals.
Map of homecare service users by ward

3. The demand for mental health services correlates with wards known to be more deprived. The
Joint Commissioning Strategy for mental health is targeting interventions in the wards of Burnt
Oak, Colindale, West Hendon and Coppetts where there are known to be higher levels of
mental illness.
Table 3 Sources of referrals to Barnet Adult Social Services
2007/08 2006/07 2005/06 2004/05 2003/04
Primary care 1612 1466 1627 1278 1377
Secondary health care 2674 3532 3561 2605 1487
Self referral 1919 1760 1588 1373 741
Family/friend/neighbour 1639 1649 1545 1380 1046
Barnet Adult Social Services 494 522 575 3 4
Housing 200 209 173 99 84
Local Authority 240 351 541 427 346
Criminal Justice Agencies 50 186 374 153 66
Other 677 716 506 377 571
Not known 20 52 176 168 1465
There has been an overall increase in referrals from healthcare services, reflecting trends in
hospital care for shorter stays and more rapid discharges and the need for a joined up
response across health and social care. The importance of this has been reflected through the
inclusion of a performance measure related to intermediate care in the Barnet LAA. Demand
for intermediate care services, equipment and rehabilitation /enablement have increased as a
result as set out below
Number of people funded by the council receiving intermediate care in a residential setting (rapid response) to
prevent hospital admission
2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 Plan
Barnet 6 10 8 9 42 46
IPF Data 37 52 49 40 37 41
Number of people funded by the council receiving intermediate care in a residential setting (supported
discharge) to facilitate timely hospital discharge and / or effective rehabilitation.
Barnet 34 38 43 32 482 530
IPF Data 70 91 105 130 162 166
Number of people funded by the council receiving non-residential intermediate care to prevent hospital
admission.
Barnet 194 206 163 181 823 905
IPF Data 214 205 219 256 313 336
Number of people funded by the council receiving non-residential intermediate care to facilitate timely hospital
discharge and / or effective rehabilitation.
Barnet 568 603 684 843 523 575
IPF Data 440 449 461 519 512 527
Number of places funded by the council in non-residential intermediate care schemes.
Barnet 50 65 85 95 130 143
IPF Data 125 149 165 164 170 178
Increased focus on upstream interventions across health and social is essential to reduce
longer term dependency on health and social care. The prevention of falls remains a key
priority due to the associated mortality, physical injury, loss of function and loss of
independence experienced by older people. Falls are a major contributor to hip fractures and
are also associated with a significantly increased risk of many other fractures, including wrist,
pelvis, and upper arm. As the average age for a fracture of the hip is 83 years; 80% of such

4. people are likely to be women and 68% of patients will have fallen within their own home we
can expect without upstream interventions for a higher demand for health and social care
services related to falls. More effective prevention of falls will reduce the demand for acute and
community health care and on social care services such as homecare and residential care.
It is also interesting to note the considerable increase in self referrals and from informal carers.
These have grown in line with changes in access to social services supported by developments
in advocacy and more recently the introduction of self assessment tools and a policy of
increasing access to advice and services for carers.
The above table also demonstrates that referrals to Adult Social Services from housing have
also increased as people wish to remain living in their own homes in the community as
opposed to a move into more formal care settings such as registered care requiring access to
personal care and housing related support.