Anna’s Blog – Adult Social Care Sector Reform
It’s fair to say that in welcoming a new government, most people within the Health and Social Care sector were hopeful that reform would follow. Last week, Health and Social Care Secretary Wes Streeting promised to “grasp the nettle on social care reform,” launching a commission chaired by Baroness Louise Casey. Casey will invite people within the care system to “make clear recommendations for how to rebuild the adult social care system to meet the current and future needs of the population.”
However, these recommendations and any accompanying reform are not expected until 2028.
This is starting to sound familiar. Other politicians have made similar promises – Tony Blair pledged reform in 1997, and Dilnot proposed a cap on care costs in 2011. Yet these promises have always been broken, with the only consistent action being further cuts to funding. This has left local councils and care providers struggling to meet growing demands.
Nadra Ahmed, executive co-chair of the National Care Association, said, “We’ve got a sector that can’t wait that long. There is a concern that waiting for the commission to report back is kicking the social care crisis into the long grass.” Care England chief executive Prof. Martin Green called the commission “yet another report that gathers dust while the sector crumbles. This commission will simply confirm what we already know – how many more reports must we endure before action is taken?”
One reason many people aren’t getting the support they need is that councils are on their knees. Nearly three-quarters (72%) of councils in England overspent on their adult social care budgets in 2023/24, compared to 63% in 2022/23. This highlights a severe mismatch between local funding and local needs, even as the adult social care sector continues to grow.
Streeting underscored the urgency of the issue: “By 2050, there will be four million more people over the age of 65 in England than there are now. Many more people will be left without the care they need, the burdens will fall on the health service, and our NHS will be overwhelmed.” Yet, his plans do not reflect this urgency.
In the meantime, the government has announced a couple of short-term solutions – training care workers to perform health checks at home so that more older people can stay out of hospital, and offering thousands more disabled people home adaptations. Whilst welcome, these two measures and the extra £600m announced in the October Budget will not suffice, especially where an analysis by the Health Foundation suggested that more than £1bn extra would be needed in 2025 to meet growing demand for adult social care.
While Casey writes her report, serious concerns will remain largely unaddressed. The CQC report, ‘The State of Health and Adult Social Care in England 2023/24’, noted that waits for care home beds and home-based care accounted for 45% of delays in discharging people from hospital. It further notes that many people are waiting for an assessment of their needs and not receiving vital care and support. Some of these people will be at risk of serious harm and the failure to meet their needs will further increase the strain on the NHS and other hard-pressed public services.
As we wait for reform, we risk history repeating itself, with people continuing to suffer. Adult social care does not need to await review – the issues are already well known and understood. It is a question of national priorities. People’s lives depend on immediate action, and the sector desperately needs significant investment and reform to right these wrongs.