Ensuring social care meets changing needs

22 May 2018

Reform held a roundtable discussion on 17 May with the Rt Hon Damian Green MP, sponsored by Age UK, to discuss how to fund social care to cope with changing pressures. From the discussion it became clear that funding should be a partnership between the state and the individual and care should be available to those who need it.

The discussion also recognised that since the last time government reviewed this issue in the 2011 Dilnot report there have been two systemic changes in the supply and demand of social care.  These changes mean government should rethink the model of social care.

The first change is that many providers have left the social care market. Last year, a survey found 44 per cent of councils had residential care providers cease trading and 39 per cent of them saw home care providers close down. In part this has been because of the rising wage costs for providers making contracts unaffordable. This change in supply matters because councils purchase around 70 per cent of home care from private providers, leaving many vulnerable people exposed to a future lack of care.

The second change is the demographics of social care users. Social care is usually associated with the elderly, however 28 per cent of those needing social care are now aged 18- 64. The cost of providing this group with care now almost equals that of over-65s, almost doubling over the last two decades. These people are an important consideration in the model of funding the Government chooses because they do not have the savings or assets to pay for care and will be more reliant on government funding.

The challenge for government in the forthcoming Green Paper is to fund a model of social care that does two things. First, it has to encourage new providers to enter the social care market. Second, the funding solution has to address those who do not have the equity to pay for care.

What the Prime Minister described as a “long-term plan” for health and social care relies heavily on the early success of those already integrating care. The ‘Integrated Care Pioneers’ are 25 diverse areas where the NHS and local government are working together to commission “person-centred better coordinated care, deliver more efficient services that improve outcomes for individuals, and provide better value for money.” These pilots tell us what practical steps toward integration look like with “care navigators, care planning, multi-disciplinary teams” working across care settings. In light of this, it is welcome that Jeremy Hunt has announced an “NHS and social care 10 year workforce strategy with the needs of both sectors considered together and fully aligned.”

There is also an important role for technology to help with greater demand and more complex patient needs. Already 95 per cent of social work staff use some form of technology in their roles. NHS Digital are supporting councils to devise more innovative uses of technology in social care. Councils in Wigan and Hampshire have already installed voice-activated assistants to operate lighting and heating to make life easier for those with mobility problems. The success of technology like this has led Essex County Council to ring-fence over 40 per cent of its social care precept for digital services.

Whatever funding solution the Government decides on will have to support a new model of service delivery. This model should embrace the opportunities of technology and join up the workforce. The new challenges of more diverse users and a shrinking provider market means these are essential.

Daniel El-Gamry, Researcher, Reform

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