Again, we find the headline debates about social care reduced to debates about money. Time and time again, it is made clear that money and funding is critically important for social care, and for the people who draw on it and work in it.
Whether social care providers are for profit, not-for profit or charitable, all need more income than outgoings to pay and develop teams, to invest in existing and new services and to fulfil governance and fiduciary duties. Call it profit or surplus, the numbers simply must stack up in any organisation for it to survive and grow.
In my 36 years of working in various spaces across social care, there have been many years where challenges have presented that seem insurmountable. Time and time again, we all think that the latest ‘crisis’ simply cannot fail to capture public support or political action. Sadly, we are yet to see meaningful public support or political action.
The Employers Rights Bill 2024 had already concerned employers, including those in social care, not because of the spirit of it, but the known reality of implementing it. Providers now face critical times with increased tax costs announced in the Autumn Budget, which add to existing cost pressures.
Many services, most notably homecare, live-in care and supported living (all services already not understood by Government), will simply not withstand such a huge increase in wage costs, mainly caused by the lowering of the National Insurance threshold, not the National Minimum Wage uplift.
Those that do will face withdrawing from many low margin public contracts and find the already difficult position of team retention risked further. Already degraded pay differentials between experienced workers and new entrants will be even more unaffordable, and why should people stay where they do not feel recognised and appreciated for their experience and skills?
Where providers, like Agincare, mainly deliver care under public contracts, it has already been said that there is no provision for local authorities to provide the extra funding needed to uplift the price of care to cover any extra costs. The NHS, for all the public rhetoric of recognising and needing social care, continues to be an unreliable commissioner with a woeful lack of fee uplifts applied to the increasingly complex work they ask social care to undertake.
More money for the NHS being a headline rationale for much of these employer tax rises makes this feel even more insulting to social care. £21bn for the NHS and £600m for social care. This money makes headlines but sadly does not touch the sides of the ongoing deficit in local authorities, let alone cover these new costs. Political and public drive exists to ‘save our NHS’ yet continues to ignore social care’s £68bn contribution to the economy and its 1.8 million adult social care workers.
As reinforced in Social Care Future’s lobbying, this should not all be about more money to do the same things, in the same way. We should be asking how we can spend our money better in social care, into strengthening communities, into changing the system to make it better and stronger and people more independent.
Work in some areas, like Sussex Integrated Care Board, shows how better integrated working has radically altered services in localities, not by spending more money but by spending the money differently. What if we actually did have enough funds across health and social care and we just need to allocate and manage them differently? What a game changer that would be for society.
For more Homecare Headlines, read the November edition of CMM, where Dr Jane Townson OBE, Chief Executive Officer at the Homecare Association, launched the new column.
Raina Summerson is Group Chief Executive Officer at Agincare.
Email: [email protected]
X: @Agincare