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The social care green paper
what can we expect?

Social care has been expecting a Green Paper since Summer 2017. With promises from Government that it will be released by the end of the year, Minister of State for Care, Caroline Dinenage MP reflects on the changes the sector has seen over the last year and looks at the areas we can expect the Green Paper to explore.

This year has already shown itself to be a decisive one for the social care sector with the creation of my role as a dedicated Minister of State for Care, alongside the renamed Department of Health and Social Care. This reflects a recognition within central Government of the importance of finding a sustainable and effective solution for social care, given the increasing pressure of our ageing population.

We are all living longer – around 15,000 centenarians currently live in the UK and, by 2050, we expect over 56,000 people to reach this milestone. This is clearly something to celebrate, but it’s important to think about how we need to adapt our health and care system to meet the changing population’s needs. As a society, we need to think not just about living longer, but ageing well and how we can support older people, as well as people with disabilities, to live independently for longer. You could say it’s about not only the years in our life but the life in our years.

Across Government, we are already working on the Ageing Society Grand Challenge to ensure Britain remains at the forefront of the technological revolution around ageing. This is supported by a £98m ‘healthy ageing programme’ which will drive the development of new products and services to help people to live in their homes for longer, tackle loneliness, and increase independence and wellbeing.

A sustainable health and care system is central in supporting independence and wellbeing. The upcoming Green Paper will set out reforms so that people of all ages – including some of the most vulnerable in society – can be confident in the system, knowing that their care needs will be met now and in the future. The reforms seek to address the main challenges and responsibilities facing the sector, including quality, integration, more individual control over people’s own care, workforce, supporting families and carers, and ensuring a sustainable social care system.


When it comes to quality, 82% of adult social care providers are now rated Good or Outstanding by the Care Quality Commission (CQC) – testament to the hundreds of thousands of hardworking and committed professionals working in care. But still too many people experience care that is not of the quality we would all want for our own mum or dad; and there is too much variation in quality and outcomes between different services and different parts of the country.

In the short term, we are working closely with the sector on a range of measures to improve quality and sustainability. This includes Quality Matters – a shared agreement published last year to deliver high-quality adult social care that is person-centred, safe and responsive to individual needs. This joint commitment, created by commissioners, providers, staff, national bodies and people who use services, remains a great example of our collective endeavour to make quality personal.

To this end, the Quality Matters partners have recently published a new digital resource, ‘Unlocking capacity: smarter together’ which provides valuable advice and support to providers to help them achieve closer collaboration between health and care in local areas. I hope local leaders across the health and care system will use this resource to help drive up the quality of adult social care in their area.


Another vital issue is the need for better overall integration of our health and social care system. We know that across the country there are impressive examples of innovative working. There are examples of partners using the Better Care Fund as a catalyst to develop a clinical response team to take emergency calls from 999/111, GPs and care homes, helping to reduce A&E attendance.

We are also working towards joint health and social care assessments and support plans, with £1m to run pilots in three areas to implement these for all adults accessing adult social care over the next two years.

Individual control

A truly universal health and social care system must put people at its heart to be successful, and this is where personalisation comes in. It empowers people to get the specific care and support that will meet their needs – rather than simply what’s available. There are already huge numbers of people benefitting from personalisation. In social care, the number of personal budgets totals over 400,000. And in the NHS, over 28,000 people now have a personal health budget; a 200% increase in the last two years.

We recently consulted on extending the right to a personal budget to more people, including people with learning disabilities and wheelchair users. We know that fully integrated, person-centred care allows people to stay longer at home, and to live healthier and more independent lives, with fewer visits to acute care. The Green Paper will set out our intention to address this opportunity to enable personalised care to become a reality for more people.


One of the biggest priorities is how we sustain and grow our most important asset: the 1.47 million people who work in adult social care. We want to do more to promote social care as a positive career choice for people of all ages, including better opportunities for progression into areas like nursing which span both the health and social care sectors. To grow and retain a quality care workforce, care workers must be afforded the same respect and motivation as those they are tasked to help. Recruitment must be based on positive shared values, skills, professional development and the promise of career progression.

In February of this year, we launched the adult social care workforce consultation with Skills for Care to explore potential solutions to challenges including recruitment, retention and professional development. The aim was to seek new and better ways to expand, enhance and diversify the care workforce in England. The consultation closed earlier this year and we’re working with stakeholders to analyse feedback and collaborate on a new workforce strategy to be published later this year.

This autumn, the Government is also launching an adult social care recruitment campaign to raise the image and profile of the sector. We want to build awareness of the rich variety of roles, opportunities and careers on offer. We want to attract the right people, with the right values, to deliver the very best care to the most vulnerable members of society. If we can do this effectively, the 110,000 social care vacancies will become gateways to rewarding careers and myriad opportunities to change many lives for the better.

With this in mind, we recently launched the Department’s new workforce engagement platform, TalkHealthandCare. This online platform is specifically designed to reach out to those on the very front line of care and health, to hear about what matters to people, what’s working well, and what more we can all do to improve things. I encourage everyone working in adult social care to join in that conversation.

Families and carers

There are not only thousands of care workers in England, but also hundreds of thousands of unpaid carers – the ‘hidden army’ of family, friends and community volunteers that make each day possible. Without them, the health and care system would simply grind to a halt.

Many of us will become carers at some stage in our lives. Indeed, around one in ten adults are in that position right now. It’s a profound change in personal circumstances – a change many embrace willingly, but nearly always without sufficient recognition or support. In June, we published the Carers Action Plan, which sets out a two-year programme of tailored work to support unpaid carers. This is the just the start of the journey though, and the Green Paper will look at long-term, sustainable solutions to supporting unpaid carers within the social care system.

A sustainable system

We now also have a new Secretary of State, Matt Hancock, with new thoughts and ideas and seemingly endless energy! We will see his priorities reflected throughout the work of the Department. One of these priorities is prevention, by which we mean empowering people to remain healthy in their homes for longer, treating problems quickly and delivering care in the appropriate settings. There is a role for everyone in prevention, not just the health and social care sector.

This will be complemented by the recently announced NHS 10-year Long-Term Plan. Health and social care are two sides of the same coin and any reforms must be aligned – that’s why both the social care Green Paper and the long-term plan will be published later in the year. Both will ensure we can cope with the pressures of a growing and ageing population and ensure everyone has access to the highest quality health and social care.

Building a sustainable care and support system will require some big decisions, and we need to get these right. The result is a better system that everyone can have confidence in, where people understand their responsibilities, can prepare for the future, and know that the care they receive will be of a high standard. We want to help everyone maintain their independence and wellbeing throughout their lives.

Building together

The Green Paper has an important place in jump-starting a debate and I am keen to hear a wide range of views from everyone in the adult social care sector. Ensuring a long-term, sustainable approach is too important a task to complete in isolation and we must get it absolutely right.

Caroline Dinenage MP is Minister of State for Care. Twitter: @cj_dinenage

What do you want to see in the Green Paper? What changes need to be made to make social care sustainable? Share your thoughts below.

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