Comment Blog 21 February, 2019

Action is needed now on adult social care

Winter always represents a particularly challenging time of the year for councils arranging social care and support. The Government has recognised this and has attempted to address this with much-needed extra funding for under-pressure local services over the winter period. But these are one-off injections and not a sustainable solution.

However, the pressures faced are not simply confined to the winter period; they are all year round. Adult social care is in crisis and the current system is unsustainable and will buckle under the weight of demand unless the Government acts.

Councils want to ensure that people are able to live the life they want to lead and are able to access the right care in the right place at the right time. With people living longer, increases in costs and decreases in funding, this is becoming more and more difficult.

While one-off funding injections may help curb the severity of immediate pressures, they are only short-term and the problem has become year round.

Councils have proven that they can make the most of new funding, managing to reduce Delayed Transfers of Care by 37 per cent since July 2017, a figure that is all the more impressive when compared with the NHS which has managed to reduce delays by 13.6 per cent.

However, that example also reveals another serious problem within the social care system. It is important that future social care funding avoids top down, target chasing control, as this hinders local health and social care leaders who are best placed to develop their own plans and care and support services.

If we are to really relieve winter – and all year-round – pressures, we need a much greater emphasis on treating the causes of these pressures, not just the symptoms.

The NHS Long Term Plan does attempt to address some of the health problems affecting the social care system with a much-needed focus on prevention, early support and reducing health inequalities as well as promising investment in primary, community and mental health services. However, it is a plan for the NHS rather than a comprehensive plan for the wider health and care system so, inevitably, it offers only part of the solution to the health, social care and wellbeing challenges facing our communities.

The social care system helps support people’s independence, strengthens communities, reduces pressures on the NHS, supports around 1.5 million jobs and contributes as much as £46 billion to the UK economy. It needs to be properly supported.

Councils have protected social care relative to other services. But the service still faces a shortfall of £3.6 billion by 2025. This is what is needed simply to keep on providing existing support at current levels and would not meet the cost of changing the current model of provision, or include the funding needed to tackle under met and unmet need.

It was therefore disappointing that the Government chose not to also launch its long-awaited adult social care green paper and proposals for the sustainable funding of these services and represents a serious missed opportunity.

The Government needs to be bold in the upcoming Spending Review and urgently invest in these essential services, which protect health, prevent sickness and are the surest way to reduce hospital admissions.

The Government must also use its upcoming green paper to make a serious case for national tax rises, including either increases to Income Tax and/or National Insurance to provide long term sustainability for the vital social care services that are central to helping people to live fulfilling, independent lives.

Further delays will only deepen the crisis in adult social care. Action is needed now.