Social care: challenges, funding and reform
There is widespread recognition that the formal adult social care sector in England has faced multiple challenges over many years. The Government has set out proposals for a levy to raise funds for the sector alongside reforms to how people pay for adult social care in England. Further detail on the Government’s plans for sector reform are expected in a white paper due later this year.
On 14 October 2021, the House of Lords is due to debate a motion moved by Baroness Pitkeathley (Labour) that “(1) this House takes note of the challenges facing social care in England following the pandemic, and (2) further notes the effect that (a) the health and social care levy, and (b) Her Majesty’s Government social care plans, may have”.
‘Social care’ can include all forms of personal and practical assistance for children, young people and adults who need extra support, including those who care for others. Much of the recent debate on social care in England has focused on adult social care, particularly for older adults. This may include personal care (such as assistance with eating, washing or getting dressed) or help with domestic routines (such as cleaning or shopping).
There is widespread recognition that the formal adult social care sector in England has faced multiple challenges over many years. A wide range of bodies and sector organisations have highlighted these key challenges over time. Many issues were subsequently exacerbated by the Covid-19 pandemic and may yet increase in severity as demand for care rises. In summary, key issues include:
- Funding and market fragility: local authorities continue to face financial pressures and funding issues can mean care providers go out of business or hand back contracts.
- Costs and means testing: unlike the NHS, social care is not free at the point of use and many see this as unfair. Some people can end up facing very high costs for their care.
- Quality of care and unmet need: many people do not get the support they require or go without the care and support they need completely.
- Integrated care: the integration of health and care could be improved to reduce the impact of issues such as delayed transfers of care from hospital.
- Sector workforce: care staff can face poor pay and conditions. This is among factors that can lead to high vacancy rates and/or turnover.
- Unpaid care: most care is delivered by unpaid carers who may be relatives, friends or neighbours of the recipient and may lack support.
On 7 September 2021, the Government published a command paper entitled Build Back Better: Our Plan for Health and Social Care. It set out details of a proposed levy, based on national insurance contributions, to raise additional funding for health and social care. The document also included details of reforms to how people would pay for adult social care in England