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DHSC “Struggling to Deliver Care”

Sector leaders have responded to finding in NAO’s recent report, ‘Reforming adult social care in England’ which revealed that rising inflation compounded long-standing pressures has led the Department of Health and Social Security to reprioritise money and activity to provide local authorities and care providers with some much-needed financial stability.

This has resulted in the DHSC struggling to deliver even “limited reforms in adult social care says The Kings Fund.

Responding to the publication of Reforming adult social care in England by the National Audit Office (NAO), Simon Bottery, Senior Fellow, The King’s Fund, said:

‘The National Audit Office report shows that Department of Health and Social Care is struggling to deliver even the limited reforms to adult social care that it has promised. It is particularly worrying that progress on workforce reform – the scale of which had already been reduced – is glacial, with the only real action being in international recruitment. Development of a career pathway for care workers – a critical reform given vacancies in the sector – has stalled. Plans for the Care Quality Commission to assess local authorities’ social care performance have also been delayed.

‘The only positive news is in digital and data, where digitisation of social care records is progressing, albeit more slowly than planned. Altogether, with the introduction of a cap on lifetime care costs already delayed to 2025, this programme of reform represents only a small sliver of what was promised by the government in 2021. The NAO raises serious doubts about whether even this will be delivered before the next election. At a time when adult social care has never faced more profound problems, with record numbers of people requesting support, this is an utterly inadequate response.’

Martin Green OBE, Chief Executive of Care England, said: “The report unearths an alarming parallel narrative. While the need for care is on the rise, the plans and funding for system reform are being scaled back. This is symptomatic of a broader issue Care England has long since called to be addressed. The solution to the adult social care puzzle is long-term thinking, yet the NAO report finds government over-reliance on short-term policies.”

A key finding of the report is that the Department of Health and Social Care (DHSC) has scaled back its short-term plans for system reform and associated funding to £729 million, compared with the £1.74 billion agreed with HM Treasury when DHSC published its white paper in December 2021. This equates to a 58% fall in the budget for system, reform between 2022-23 and 2024-25. Shortfalls such as this present a task to a sector already operating against a backdrop of demographic change, workforce shortages and pressure on local authority finances.

Furthermore, the NAO finds that the DHSC has not established an overarching programme to coordinate its reforms, thereby making it difficult to know if the DHSC is on track to achieve its objectives, and putting additional pressure on local authorities. Implementing policies to make social care an attractive sector to work in, and to ensure providers can continue to deliver fulfilling care to all those who need it is vital for the long-term economic health of the nation. Recent findings from Skills for Care show the adult social care sector adds £55.7 billion per annum to the English economy, making the sector one of the key drivers of the national economy.

Care England’s recent roadmap Care For Our Future, recognises the importance of pragmatic long-term steps to ensure the long-term sustainability of the sector, and recommends that within the first five years of the next Government taking office:
• Consolidate reforms within a fully-funded, long-term adult social care workforce plan
• Deliver a long-term adult social care funding settlement, with a £10bn annual funding boost
• Deliver a fully mapped prevention and integration plan
Care England reiterates the need for future governments to consider the implications of short-term thinking on those who rely on care and support, and those who provide it.

Martin Green continues: “This report underscores the need for long-term investment into the social care sector with clear measures of success. Care England implores the government to heed this warning ahead of the Autumn Statement this month. With the NAO’s report painting a picture of a broken system, the government must make true on their manifesto promise to fix social care not just for now, but for the long-term.”