Social care is on the brink of crisis. The figures show the scale of the catastrophe we face: yearly cuts since 2010 come to £6.3bn; planned savings in 2017/18 are a further £824m; the additional £150m in the latest local government finance settlement is welcome, but inadequate. Little wonder that the National Audit Office recently described social care as a ‘Cinderella service’.
Add to this precarious situation a sector-wide bill of £400m, and it is easy to see how social care will be tipped into collapse. And yet this is what we face, thanks to the Government retrospectively forcing providers to pay six years’ worth of back pay for sleep-in shifts. Following a significant public affairs lobby, the sleep-in crisis has now been recognised by Government, but the big unanswered question is who should foot the back pay bill?
It beggars belief that the Government has failed to identify how the bill will be paid. This challenge is uniting the sector. Government must take responsibility and fully-fund all back pay – this is what the Stop Sleep-in Crisis Alliance is arguing for. The Alliance brings together trade bodies challenging Government to plug the funding gap. It includes the Association for Real Change, Care England, Learning Disability England, Learning Disability Voices and VODG.
Why is this issue so crucial? Because 350,000 of the 1.5 million learning disabled people in the UK need 24-hour support from sleep-in staff. Faced with footing a significant bill for which they are entirely unprepared, some providers face closing services. At best, people supported will experience massive upheaval to their support. At worst, entire organisations will hand-back contracts.
There will be an impact on future support, given the reduced funding for new services and fewer providers to deliver them. Charities could be forced to use their reserves where, in some instances, liabilities exceed reserves. This is despite the fact that reserves exist to maintain stability and to encourage new developments in care.
Other providers may choose to exit the market because cash is king, and the back pay liability could exceed the cash balance, or if not, providers may be left with inadequate liquidity to service regular bills. Could providers borrow in order to pay the bill? Only if there are sufficient assets to charge it against and/or contract income is secure and reasonably long. But are banks prepared to take risks associated with the sleep-in crisis?
There are also workforce issues. Some providers cannot fund six years’ worth of back pay and are not adept at the complexities of tax and back pay calculations. Providers have a year to self-assess the back pay owed and then three months to pay it. Another challenge is tracking down past employees who are owed money.
Sleep-in support is a public service, for which Government has statutory responsibility. People who need it are assessed and funded by the State. So, why must providers pick up an unexpected tab brought about by changes in case law and government guidance?
We are determined to resolve the situation, and our lobbying is having an impact.
Heidi Allen MP has questioned the Prime Minister on the subject at Prime Minister’s Questions (PMQs). As a result, the Prime Minister agreed to discuss the issue with back-benchers. Dan Kawczynski MP also asked a question of the Prime Minister at PMQs, while Nicky Morgan MP, Chair of the Treasury Select Committee questioned Liz Truss MP, Chief Secretary to the Treasury on it at the recent session of the Treasury Committee.
While the Department of Health and Social Care is seeking to establish a figure for the back pay liability, it is imperative that we understand the full impact of the crisis on the future sustainability of services, the workforce and, most crucially, care and support for those that need it most. It is for this reason that the Alliance is launching an independent survey to discover the true picture. All affected providers are encouraged to complete the independent survey to assess the impact of sleep-in pay crisis on future of social care.
Overnight support is an essential service. The staff who provide it are entitled to their back pay. But imposing a huge and sudden bill further threatens an already beleaguered system, and the people who depend on it.