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Riding the storm: The challenges facing the social care sector

What happens when Government does not ‘Think Social Care First’? Liz Jones, Policy Director at The National Care Forum (NCF), reviews the recent policy updates for the social care sector and outlines the pressing challenges for the months ahead.

Writing this article on 11th November, the day that all care home staff must be double jabbed to continue to work there, gives cause for reflection on how the social care sector finds itself in such a difficult position, where Government policy has exacted such a heavy price.

Let us look back at the last few months of policy announcements – it is clear to see that things could have been so different if real social care reform was at the heart of Government policymaking.

A promising start

The Health and Social Care Levy announced in the Plan for Health and Social Care was a bold move – it broke a manifesto commitment and raised taxes to pay for the problems resulting from the pandemic in health and social care. It came with a strong statement about taking the difficult decisions about social care reform that other Governments have dodged. But then, the promise it offered started to tarnish as it became clear that, in fact, the plan was to carry on prioritising the funding of the NHS backlog over social care with only £5.4bn of the estimated £36bn earmarked for social care.

To anyone looking at the challenges being faced by social care, it seems really clear that the interdependencies between the two bits of the system are still not fully grasped by policymakers. If the £36bn generated by the Levy was equally shared between health and social care, it would go a fair way towards providing much of the additional £7bn that the Health and Social Care committee concluded social care needs now, just to keep going.

While there were some things to welcome in the announcement, such as an increased focus on prevention in health, a White Paper for adult social care to be developed with care users, providers and other key stakeholders and a £500m commitment to help the social care workforce with support in professionalising and developing the workforce, it offered nothing to tackle the immediate workforce crisis in social care (see our recent surveys for November, October, August).

Individual impact

The workforce crisis in social care really matters because social care matters to people. It matters to the millions of people who draw upon it every day; it matters to the 1.54 million-strong workforce supporting people every day; it matters to millions of unpaid carers and to the 18,200 organisations providing it.

Indeed, it matters to the NHS workforce who are facing huge pressures because without social care, people are forced to remain in hospital, even though their acute healthcare needs have been met, preventing others from gaining access to vital healthcare. It matters to all the people and their families who are struggling at home and are in need of care and support to help them continue to live safely and well.

We looked in hope to the budget and the Comprehensive Spending Review at the end of October. This should have been an opportunity to hear more about how the Government plans to support social care and how the Treasury sees this sector as an important contributor to the economy and growing sector.

There were no new announcements for social care, only a confirmation that social care will receive £5.4bn over the next three years from the Health and Care Levy. Again, the budget was silent on immediate support for the social care workforce pressures being experienced right now, affecting people and the NHS every day; silent on how the very welcome increase in the National Living Wage is going to be funded for the social care workforce.

The Spending Review was also silent on calls to re-apportion the Health and Care Levy to properly fund social care reform and silent on the economic contribution of the £50.3bn the sector already makes to the economy. It fails to recognise that social care is a large and growing sector, which employs more people now than the NHS and will need to employ 490,000 extra people, on top of the current workforce vacancies (105,000), by 2035. Neither the budget nor the spending review help us explain to our workforce why they are paying for a Health and Care Levy that does not appear to benefit them at a
time when the need for investment is greatest.

A much bigger problem

And then, in early November, we had the Adult Social Care Winter Plan. At NCF, we have been calling on the Government to use the Winter Plan as the opportunity to take some immediate action to support the social care workforce now. Actions include paying a retention bonus to care staff which is not taxed (and not subject to Universal Credit rules), in line with the other countries in the UK.

Once again, the plan made disappointing reading. It largely rehearsed all the things that the Department of Health and Social Care (DHSC) had already done or announced. Repeating small funding packages, such as the Infection Control and Testing Fund and Recruitment and Retention Fund, sadly does not increase them. Again, it didn’t acknowledge the scale of the workforce crisis at all nor did it offer much new in the way of resources and practical support for the winter. The Government’s response is simply not proportionate to the sheer scale of the workforce crisis.

And with reference to the policy on vaccination as a condition of deployment, the Winter Plan did not recognise the impact this policy has had and is having. In a recent survey to members operating care homes, our findings show that care providers fear they will lose around 8% of their care home staff as a direct result of this policy. This is a very serious loss of staff and one which, given the enormous workforce pressures now, the care sector can ill afford.

The national roll out of the policy has been chaotic. Our survey respondents have been critical – stating that their experience on the ground is one of a policy ‘badly thought through’ and that the timing of the policy is ‘out of touch’ with the enormous pressures experienced by the care workforce.

Neither the Winter Plan nor the Impact Assessment (only published on 9.11.21!) of this policy recognise the unnecessary high cost it has had – in terms of human costs, financial costs and the loss in trust and goodwill amongst care staff and their employers as a direct result of this policy.

A new narrative

Let us reimagine what the policy for social care could have looked like over the last few months if the Government did indeed Think Social Care First. It could have seen social care as equal partner to the NHS, an essential part of the health and care system that people rely on. As equal partners it would have been easier for both parts of the health and care system to work together and actively support each other through the current winter pressures, such as shared workforce planning and joined-up recruitment initiatives. It could have given the social care workforce the recognition and reward they deserve.

It could have created a different narrative for social care – person-centred and looking towards the future, with innovation and new ways of shaping how we provide social care, supporting us to understand and respond better to what people say they want from social care, both now and in the future. It could see the sector as a key part of the economy, one that needs investment and support to keep helping people to live their best lives every day, making a difference to families and communities across the country.

As a society, it is time to reimagine what social care can be.

Liz Jones is the Policy Director of the National Care Forum. Email:  Twitter: @NCFCareForum @NCF_Liz 

About Liz Jones

Liz Jones is the Policy Director of the National Care Forum and has a strong background in social policy, care and support and health and housing, with over 20 years’ experience across the civil service, local government and the charity sector.

Liz has strong research and analytical skills and is passionate for ensuring that the voices and views of the people and communities we serve are central to our policy development and implementation.

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