Care England Budget representation 2020

Care England, the largest representative body for independent providers of adult social care, has submitted evidence to the Chancellor’s Budget process urging him to act on the Prime Minister’s pledge to tackle the social care crisis within 100 days of his election. The Government has until 22 March to act upon this pledge. Care England, as a critical friend of the Government, can help deliver on this pledge. The stabilisation of the adult social care sector should be the Government’s first priority in the coming months. Further Government inaction is no longer viable.

Care England’s representation chose to focus on the following key policy areas which are of fundamental importance to the future sustainability of the adult health and social care sector:

Funding Pressures

Analysis shows that there will be a social care funding gap of £4.4bn in England in 2023/24 to meet rising demand and address critical staffing shortages in the sector.[1] Investing a percentage of the £4.4bn needed to meet the rising funding gap in England will help mitigate the adverse implications of growing demand for social care services and central/ local government.

-          Care England can help ensure that the pledged £1bn per year over the course of the Parliament to adult and child social care services is allocated and utilised as part of a clear plan.

The co-dependency of social care and the NHS

The crisis within the social care sector is fundamentally intertwined with the NHS’ future fortunes. The NHS and social care are two interdependent parts of the system; without addressing the issues prevalent within the social care system, there can be no lasting improvement to the NHS. By improving the parity between the NHS and social care sector, costs borne by the NHS and social care sector will be reduced and access to effective and timely care will be improved.

-         The Government should seek to create greater parity by better equivalating current social care and NHS staff pay rates, whilst also investing greater levels of resources into social care training/learning. Such steps will enable social care providers to better recruit and retain staff, but also help recognise the value of the work that social care staff do.

Social care workforce crisis

The adult social care sector is gripped by a multifaceted workforce crisis that represents a threat to the future sustainability of the social care sector. This growing problem is partly centred upon the recruitment difficulties which care services currently face. This is evidenced by the high vacancy and job turnover rates. Without better funding for the sector these problems are likely to be exacerbated and persist into the future. Continued inaction to provide the funding necessary, recruitment and retention problems will persist and will diminish the size of the workforce and thus the size of its contribution to the economy.

-          Building upon uprating social care staff pay rates and training, migration policy must recognise the importance of EU care staff to the future sustainability of the UK social care system. In this vein, we would ask the Home Secretary to develop a points based system, which would see social care roles getting extra points and not to assign a salary level to these roles, but just to see them as shortage occupations.

Commissioner and social care provider relations

At present the relationships which exist between social care commissioners and providers are not satisfactory. The social care sector is subject to public sector commissioner delays to health and local authority assessments, delays to payments, complex system requirements across contracting and payment arrangements, and LA/CCG disputes over who pays. Such commissioning has the capacity to impact on cash flow and sustainability.

-          Care England believes that the CQC should monitor and rate LA and CCG commissioning practices, whilst the Department of Health and Social Care should review the guidance on commissioning which accompanies the Care Act 2014.

Technology, digital transformation and the social care sector

Improving the integration of technology in social care has the capacity to not only benefit care quality, but also the NHS, and society as a whole, as people will have better access to appropriate care and reduce reliance on acute and emergency services.

-          The Government should incentives social care providers to invest in technology with innovative new care systems, thereby allowing some of the growing need to be met.

 Social care, the economy and society

Ensuring the future sustainability of the social care sector is of fundamental importance for the social care sector itself, and also, for England’s society and economy in broad terms. Across England millions of individuals future well-being and economic stability is contingent upon ensuring the future sustainability of the social care sector.

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[1] The Health Foundation (2019). The real cost of a fair adult social care system.