The government has published its white paper outlining proposed reform of the NHS and social care.
The white paper points to a new legal framework for the NHS and local government to provide integrated care systems but contains little concerning the reforms that are so badly needed in social care. The white paper acknowledges this, indicating that further reforms are still in the offing “this year”. Significant reforms have been promised for years but have again yet to materialise.
The white paper, whilst welcome, demonstrates the Government’s lack of understanding of the care sector, says the dedicated Social Care team at law firm Royds Withy King.
Mei-Ling Huang, Partner, Royds Withy King comments.
“Care providers will welcome a truly integrated care system but will want to know what this will mean in practice. Care providers need a voice that is equal to that of the NHS in the provision of health and social care. If the system is to be truly integrated, then social care will need to be given an equal seat at the table. The white paper seems to acknowledge this, but fails to explain how this will be achieved.”
Some of the proposed reforms relate to the collection of data, yet says Mei-Ling Huang, the fact that the Government has no good way of communicating with care providers has become painfully apparent during this pandemic.
“The Government wants to implement new ways of collecting data from care providers so they can gain a better understanding of the services that are being provided, including services for those who pay privately for care. This seems to be an acknowledgment that the Government does not have a good handle on what is happening in social care.
“They clearly need to learn more, but we are concerned that the imposition of yet more data reporting requirements will push care service managers over the edge. The requirements for the provision of data during the pandemic have been extremely onerous. The systems are difficult to use and time-consuming. If the Government is going to ask care services to do more reporting, then they need to ensure that the systems work and cut down on the bureaucracy that they appear to be trying to reduce with these new proposals.”
Amongst the proposals that will be welcome is the idea that there will be oversight of local authorities when carrying out the commissioning of care.
“Care providers have been calling for this for over a decade,” says Mei-Ling Huang. “Poor commissioning practices can lead to real problems in the system.”
“Related to this is the issue of hospital discharges. Poor hospital discharge practices were arguably at the heart of the high COVID rates in care homes in 2020. The white paper proposes the greater use of ‘trusted assessors’ to oversee discharges.
“It also proposes that people be discharged from hospital and into care before a determination is made about a person’s eligibility for FNC or CHC funding. This is likely to pose problems for care providers, who will be expected to accept a new client without knowing what fee rate will be paid for the person. Because the margins in care are so low, I anticipate that this will be met with some resistance. This demonstrates that there is a lack of understanding of the sector within central Government.
“This white paper does not offer the reforms that care providers have been waiting for for more than a decade. However, the Government does appear to acknowledge that social care has been overlooked and they need to engage more with it to create a truly integrated health and care system.”