Long-Term Ambition Not A Quick Fix-Says NCF

With mounting pressure on the Prime Minister, Boris Johnson, to make good his promise of social care reform at the State Opening of Parliament on 11^th May, the National Care Forum (NCF) – the leading association of not-for-profit care providers – has published a paper detailing what an ambitious plan for social care reform must include. The paper sets out 8 ambitions for reform of social care.

Vic Rayner, CEO of the National Care Forum says:

“The government must take this opportunity to be ‘ambitious for social care’, a once in a generation chance to reform and invest in social care so it can continue to make a transformational difference to the lives of the millions who use it now and the millions more who will need it in the future, their families and carers and those who work in it. Social care helps millions of people to live their best lives – with the right focus, support and investment, this government can be the one that delivers for social care.”

The unique perspective and in-depth experiences of NCF members have developed specific reform ambitions for the government. Namely:

1. Think Social Care First

Fundamental reform of social care must be a priority and not just a recovery from the experiences of the last year. The NCF calls on the government to take the opportunity to use its reform plans to put social care at the heart of policy planning, to think Social Care First and design a social care system that is person-centred, fair and fit for the future.

2. Invest in Adult Social Care to ensure it has sustainable funding and contributes to economic recovery

COVID-19 has highlighted the importance of finding a long-term funding solution to stabilise, sustain and grow the choice of high quality, resilient and accessible care and support services.

Data from Skills For Care found that the net economic benefit of the care sector in England alone was £41.2bn. Government policy must recognise social care as a vital contributor to the economy and seize the opportunity to end the short-termism over investment.

3. Invest in the social care workforce

There has been no dedicated national workforce strategy for social care since 2009. Investing in social care also means investing in the workforce. This is not something individual organisations can do on their own. The government must develop a fully funded People Plan for Social Care that provides clear career progression, better recognise and value staff, invest in their training and support, and introduce professionalisation and registration where this is appropriate.

The Social Care Taskforce Workforce Report in 2020[1] recommended that the ‘Government should instigate a review involving employers, commissioners, and employee representatives with a view to implementing a new career-based pay and reward structure, in-year, for social care which will be: (a) comparable with the NHS and equivalent sectors; (b) fully-funded by Central Government; and (c) mandatory on employers and commissioners of services.’ This remains a very clear NCF ask.

4. Recognise the benefits of the not-for-profit sector

Social care delivers public good, and much of it is funded by the public purse. Primary legislation such as the Social Value Act also exemplify the importance of using public money to invest in services that support wider community ambitions. Not-for-profit care provision ensures that all of the funding from either government or citizens is directed towards the delivery of care now and in the future, ensuring that the money remains in the sector and is reinvested to improve the quality of care.

The not-for-profit model places a strong emphasis on the long-term sustainability of their care and support services in the local communities they serve, often having deep roots due to their origins and history in local areas, alongside their focus on person-centred care.

5. Create a Fair Price for all Care

The current system puts a huge burden on those who need care and support and are able to pay for their own care and support under the current means-testing arrangements (usually older people). The system is fundamentally unfair and creates uncertainty and anxiety about the future care costs people may incur.

A Fair Price for care needs to be met by the state when commissioning care on behalf of people and this in turn will enable providers to rebalance the prices paid by individuals who fund their own care and create a sustainable care offer for the future.

Looking to the future

6. Housing matters to social care

Social care reform plans must be underpinned by an understanding of the need for effective integration of care, health and housing. Reform must recognise the relationship between social care and housing, where housing is a key element in sustaining the independence, choice and dignity amongst people of working age and older adults.

7. Futureproof social care

Reform plans must include the future proofing of social care with specific measures to encourage innovation, digital transformation and new models of care. Technology is a key element in the reform of social care if there is to be a successful and long-lasting reform.

8. Ensure integrated health and care systems work for social care

Local integrated health and care systems must ensure meaningful partnership between health and care if they are to meet the care and support needs of their local populations. The new Integrated Care Systems (ICS) and Integrated Care Partnerships will be an important part of the landscape for social care in the years ahead. It is essential that the legislation and guidance for ICSs put the voice of those that use care and those that provide it at the top table of decision making and fund this as necessary. Simply involving Local Authority and NHS commissioners is not enough, as they cannot, alone, be the voice of social care.

These ambitions are further supported by these key principles that underpin the recommendations in the paper.

Reform must:

1. Promote people’s independence, wellbeing and dignity.
2. Ensure choice of good quality person-centred care and support which responds to the wishes and needs of all the people who make use of it.
3. Be co-produced with people who use care and support now and people who will use it in the future.
4. Focus on prevention, offering people with the care and support they need, when they need it, where they need.
5. Provide fairness for people who need to use care and support now and in the future.
6. Deliver long-awaited reward and recognition for staff who work in social care.
7. Maximise the social and economic value of care and support.
8. Enshrine a rights-based approach for people receiving care and support and people working in social care.

Rayner concludes:

“Our paper calls for ambitious plans for social care reform backed by evidence and the experience of providers from across the sector. Ambitious social care reform can make a transformational change for millions of people, with the profound effect of principled change supporting positive change that will be felt in all communities across the country.  It will require bold commitment and investment from the government for social care reform fit for now and in the future. We need to move forward from the place of rhetoric to action – specific action that will propel the sector from the position of recovery to sustainability and growth. Now is the time for long-term ambition not yet another quick fix.”

[1]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/919164/8_Workforce_Advisory_Group_report_accessible.pdf