Lack Of Social Care Reform Could ‘Destabilise’ Health Care
Local authority leaders have warned that the absence of a long-term, fully funded social care plan could destabilise other health and care reforms.
The report by the Health and Social Care Committee into Government reforms of the NHS and social care calls for new legislation that would impose a duty on the Government to publish a 10-year social care plan with detailed costings, within six months of the Health and Care Bill receiving Royal Assent.
The committee warned that the lack of a fully funded plan for social care could undermine the success of the creation of Integrated Care Systems (ICSs) throughout England.
The inquiry into the White Paper, Integration and Innovation: working together to improve health and social care concluded that that the creation of Integrated Care Systems throughout England has the potential to improve the delivery of care services for patients.
The Report welcomes a commitment from the Secretary of State to act on the Committee’s suggestion to include in the Bill provisions for independent ratings of the ICSs, to be carried out by the Care Quality Commission.
MPs also call for a more detailed framework that sets out the roles and responsibilities of both the NHS Body and the Health and Care Partnership, with clear lines of accountability to ensure success.
On social care, the Committee urges that new legislation should impose a duty on the Secretary of State to publish a 10-year plan with detailed costings, within 6 months of the Bill receiving Royal Assent.
Funding should be at the levels set out by the Committee in its Social care: funding and workforce Report. The absence of a fully funded plan for social care has the potential to destabilise Integrated Care Systems and undermine their success, and without secure long term funding problems that have bedevilled the care sector for decades would not be resolved, say MPs.
Rt Hon Jeremy Hunt MP, Chair of the Health and Social Care Committee, said: “We broadly support the proposed changes provided the new Integrated Care Systems are held accountable for the quality and safety of care delivered through transparent CQC assessments. But we remain concerned about glaring omissions, including the lack of social care reform, and a much-needed overhaul of workforce planning.
“If such issues are addressed the government has an opportunity to deliver a post-pandemic watershed ‘1948 moment’ for the health and care system, matching the significance of the year the NHS was founded. But if they are not, it will be a wasted opportunity to deliver the truly integrated care required by an ageing population.”
Richard Murray, Chief Executive of The King’s Fund, said: “The Committee rightly acknowledges the possible benefits of the government’s health and care reforms, whilst also identifying the significant pitfalls ministers must avoid.
“By sweeping away clunky competition and procurement rules, the government’s NHS reform plans could give the NHS and its partners greater flexibility to deliver joined-up care to the increasing numbers of people who rely on multiple different services. Whether these benefits are realised will critically depend on how the reforms are implemented.
“However, these reforms only deal with part of the problem facing health and social care. The government has yet to say how it will tackle staff shortages, redress deep-seated health inequalities, or bring forward long-overdue reform of the social care sector.
“As part of their inquiry, we told the Committee that the government’s White Paper proposals to improve workforce planning are wholly inadequate. Reformed services are no good without the staff to run them. As staff emerge from the pandemic physically and emotionally drained, there is an increasingly urgent need for a fully funded workforce strategy to increase recruitment and tackle staff stress and burnout.
“The reforms will place greater power in the hands of the Secretary of State, but ministers should be careful what they wish for. Political expediency should not trump clinical judgment so we support the Committee’s call for greater clarity on why these new powers are needed and how they will be used.”
Cllr David Fothergill, chairman of the Local Government Association’s (LGA) Community Wellbeing Board, said: ‘As the committee’s report rightly states, the absence of a long-term, fully funded plan for social care has the potential to destabilise other proposed health and care reforms.
‘A clear timeline is urgently needed from Government on when concrete proposals will be brought forward. We are keen to work with the Government and other stakeholders on a cross-party basis to ensure the millions of people of all ages across the country who draw on social care are able to access the support they need to help them live the life they want to lead.’
Cllr Fothergill also said that the LGA supports the aim of greater transparency in social care but has ‘significant concerns’ about the report’s recommendation for Ofsted-style ratings for councils’ social care services.
‘Assurance needs to build on existing sector-led improvement support, recognise local democratic accountability and give a meaningful voice to people who draw on social care,’ he said.
‘We favour a review-driven approach looking at care as a whole, based on a shared agreement of what ‘good’ looks like, a person-centred approach and locally flexible care and support.’
