Joining forces initially in 2015, to provide an independent assessment of social care’s financial needs for last year’s Spending Review, the Nuffield Trust, King’s Fund and Health Foundation have issued an updated review to ministers.
In its joint statement on health and social care, the combined think tank states that, ‘the urgent priority for the Autumn Statement is to address the critical state of social care’. In reference to the prospect of a £1.9m shortfall in 2017, they call for the Government to recognise as a minimum ‘the immediate funding pressures facing the sector’ and call for promised additional funding to be brought forward.
The briefing considers the Department of Health’s real-term funding increase of £4.2bn between 2015/16 and 2020/21 as inadequate to maintain NHS care standards and deliver service transformation as outlined in the Five Year Forward View. It is anticipated that demand on NHS services ‘will peak in 2018/19 and 2019/20, when there is almost no planned growth in real-terms funding’. It goes on to state that the ‘pace of change required to deliver £22bn of savings by 2020/21 is unrealistic’.
In direct reference to social care, the update makes a number of key points:
- After six years of unprecedented budget reductions, the number of people over 65 accessing publicly-funded social care has fallen by at least 26%, imposing significant human and financial costs on older people, their families and carers, and exacerbating pressures on the NHS.
- Even if the vast majority of councils choose to use the new powers to levy the 2% precept on Council Tax as they did this year, the publicly-funded social care system faces a £1.9bn funding gap next year.
- New measures announced in the last Spending Review to increase funding for social care are welcome, but will still leave a funding gap of at least £2.3bn by the end of this parliament.
- Despite the ageing population and rising demand for services, UK public spending on social care is set to fall back to less than 1% of GDP by the end of this parliament, leaving thousands more older and disabled people without access to services.
The joint statement is clear that, ‘the social care system needs fundamental reform – this will not be quick or easy and will require cross-party consensus’.
Richard Humphries, Assistant Director for Policy at the King’s Fund, makes recognition of the struggle that councils face when trying to deliver their Care Act duties. He does, however, express concern about the potential for individuals to begin taking legal action against them for unmet care needs, based upon the rising number of complaints to the Local Government Ombudsman.
Is it just me?
It is, of course, imperative that social care’s funding crisis be addressed; the promise of additional money through the Better Care Fund, though deemed inadequate, at least eases the issue. This goes for the 2% Council Tax precept too.
My concern is that the current avenues of funding have, historically, shown to be ineffective. Quoting the joint statement, ‘The existing Better Care Fund, which is largely composed of money transferred from the NHS, does not offer adequate protection to social care services, with just 33% of the fund used for this purpose in 2015/16’.
If social care’s dire financial situation is compounded by the fact that, when additional funding is made available, it isn’t all spent on its true purpose; surely we need to look at more effectively managed mechanisms to deliver the investment into our sector, not just pour more water into leaking buckets.