Sector Reacts to King’s Speech
The adult social care sector has responded with cautious optimism — and no shortage of concern — to this week’s King’s Speech, as the government set out its legislative agenda for the parliamentary session ahead.
Centre stage was the announcement of the NHS Modernisation Bill, a flagship piece of legislation that ministers say will drive fundamental reform across health and care services in England.
But it was the broader sweep of the Speech that caught the attention of care providers and sector bodies, as the government positioned cyber security, digital identity and public service modernisation not merely as administrative priorities, but as pillars of national resilience and economic security.
“Slim Pickings”
Vic Rayner OBE, CEO of NCF said: “Whilst no great surprise, there are slim pickings for adult social care in the King’s Speech. The timeframes set by the government around the Casey Commission have served to undermine the government’s commitment to any urgency attached to desperately needed reform and the development of a National Care Service.
“With this second parliamentary term now underway the clock is ticking on progressing many of the government’s election manifesto pledges that would create positive change in the care and support system. We can only hope that the government can find a way through the current maelstrom and start to provide tangible detail on how wider reform of adult social care might take shape.
“In the absence of specific legislation directed at social care, there are a number of areas that are directly connected to the delivery of care, and reflecting on these, Vic Rayner stated:
“We welcome the core goals of the government’s 10 Year Plan for England, particularly the focus on digital and data. We are pleased to see reference to the Single Patient Record which brings together health and social care records in one place. We urge government to recognise the key role that social care will play in the government’s entire strategic vision across health and care.
“At the same time, we are concerned that the reforms to the NHS, alongside local government reorganisation, will create a challenging operating environment for social care and support providers, as they strive to navigate this while enabling people to live their best lives. Equally, given the Bill’s emphasis on Integrated Care Boards’ strategic commissioning role, social care must continue to be fully embedded in ICB governance and plans at neighbourhood and strategic level.
“Solid details and timescales for the development of a National Care Service are starkly absent from the King’s Speech and we need urgent clarity from government on how they intend to take forward Baroness Casey’s recommendations. NCF and our not-for-profit members have used every opportunity to engage with the Casey Commission and we will continue that representation at every step to ensure the voices of providers, the care workforce and people for whom social care is a crucial lifeline are heard loud and clear, so they too can take an active role in shaping these ambitions.”
“Important Questions”
Deputy chief executive of The NHS Alliance, Sarah Walter, said: “The NHS Modernisation Bill, included in the King’s Speech, will be key to delivering the government’s vision as set out in the 10 Year Health Plan.
“The abolition of NHS England with functions transferred either to the secretary of state or devolved to integrated care boards (ICBs) will provide an opportunity to streamline decision-making from the centre and must be accompanied by measures and ways of working which empower local leaders to design services for their communities. In doing this it is important that the government recognises the need for a decisive shift of authority from ministers and national bureaucracy to local leaders.
“The government is also looking to rationalise bodies responsible for patient safety and experience. It should be mindful of concerns about the practicability of absorbing local Healthwatch functions into ICBs when the number of these bodies has already been halved, and of the risk of conflicts of interests which could erode patient confidence.
“A further key proposal is the plan to establish a single patient record (SPR). This should make the NHS work better, helping different services join up more efficiently and giving patients more control over their own care. But there are important questions over where data controllership will reside and what safeguards will be in place.
“We are expecting substantial reforms to the governance of trusts and ICBs. These should ensure appropriate checks and balances while supporting local empowerment.“
“Public Confidence”
Nuffield Trust Chief Executive, Thea Stein said: “We know from previous reorganisations of the NHS that their benefits are often overstated, and disruption underestimated. The scale and timing of these changes – which clash with major cuts to local health boards – means the NHS is tied up reorganising itself precisely when it needs to be improving patient care.
“But it’s true that there was duplication and clashing targets between NHSE and DHSC, which are now merging, and that cost savings could be made.
“MPs will need to carefully scrutinise whether cutting the merged workforce by 50% is necessary, as getting rid of important operational roles could do real damage. So far, we have yet to see a case for why some of the extra restructures and mergers expected in the Bill, like stopping the independence of the safety body HSSIB, are really needed.”
“The aim to pull together a Single Patient Record, so that patient data can be more easily shared across different NHS services, is laudable and long overdue. At the moment, patients are too often faced with onerous or outright dangerous situations, for example because an A&E department can’t see medical information held by their GP.
“However, the sorry history of similar initiatives suggests things will fall apart quickly if public trust is lost. The crucial test for this part of the Bill will be whether the safeguards are strong enough to prevent patient data being used in ways that could harm public confidence by future governments or private firms. MPs should carefully scrutinise whether the Bill gets this right.”
Cyber Security
Michelle Corrigan, Chief Executive of the Digital Care Hub, said: “Although adult social care was not a major focus of the Speech directly, many of the proposals could have important implications for the sector over time.
“What stood out was the way cyber security, digital identity and public service modernisation are increasingly being framed as issues of national resilience and economic security, not just technology policy.
“For social care providers, this reinforces the importance of cyber security, good data protection practices, and being involved in wider conversations about interoperability and neighbourhood health services.
“There is still a great deal we do not yet know about the detail behind these proposed Bills, and there will rightly be significant discussion and debate as more information emerges. It will be important that the voice and realities of adult social care are part of those conversations from the start.”
Increasing Demand
Helen Walker, Chief Executive of Carers UK, said: “Whilst making reforms to the NHS, the Government has a significant opportunity to improve identification and support for carers throughout our health system who are more likely to be in poor health than non-carers. The care they provide is a staggering £184 billion a year, the same as the NHS, and yet they often feel unseen and invisible.
“With an ageing population and increasing demand for care, it is more important than ever that the NHS recognises, involves and supports unpaid carers. Doing so leads to better outcomes for both carers and the people they care for, while also making sound financial sense at a time when funding remains under constant pressure.
“Our recent Tipping Point research shows that the NHS also has a key role to play in supporting those juggling work and care to stay in employment. Carers who experienced a lack of coordinated support from the NHS say this increased stress levels and resulted in them taking on greater levels of caring responsibilities themselves.
“According to our research, carers are twice as likely to face poverty as non-carers and there are real challenges for carers trying to juggle work and care. It is positive that the Government intends to ease the cost of living for working people, but we also need to see a focus on addressing the needs of unpaid carers who live on low incomes and are at the sharp end of the cost-of-living crisis. We welcome the new package of legislation designed to strengthen the UK’s youth employment programme which will support young adult carers.
“Carers UK would like to see the government bring forward positive change for Carer’s Allowance following the Independent Review into Carer’s Allowance overpayments by Liz Sayce OBE – this includes an earnings taper to replace the current Carer’s Allowance ‘cliff edge’. We are seeking clarification on how these changes can be progressed as quickly as possible to ensure carers are not left waiting for support.”
