UK Government must start fixing social care

“COVID emergency means the UK Government must no longer delay its promise of fixing social care”: The social care system must be drastically overhauled, and the Government urgently needs to deliver on its manifesto commitment to fix the failing social care sector.

Launching its new report, Let’s do this: The promise of fixing social care, the Health for Care coalition is calling on the  UK Government to deliver on its promise to address the failures of the social care system.

The COVID-19 pandemic has served to highlight again the important relationship between health and social care. The NHS relies heavily on its social care colleagues, including in helping to ensure timely hospital discharge to community settings, and in guarding against unplanned emergency admissions. More crucially, social care provision is an essential ingredient in supporting independence and quality of life for our family members of all ages.

There are 1.4 million older people currently estimated to have unmet need for social care, yet without a comprehensive and properly funded long-term plan for the sector, this important infrastructure is jeopardised.

Health for Care – a coalition of 15 national health organisations, led by the NHS Confederation – warns that the COVID-19 pandemic has thrown into stark relief the failings and underlying weaknesses of the social care system, which have left health and social care services struggling to cope.

Central to the report are proposals for a better funding model and a restructured social care system. Report authors lament the ongoing repercussions of the failure to plan properly for vital services and the dramatic falls in spending on social care in England, with figures showing a 12 per cent decrease per person over the decade to 2018/19.

They also warn of very high staff vacancy numbers, with 112,000 social care posts left empty, and very low pay, status and career opportunities.

Danny Mortimer, chair of the coalition and chief executive of the NHS Confederation, said: “When Boris Johnson delivered his first speech as Prime Minister on the steps of Downing Street eighteen months ago, he promised to ‘fix the crisis in social care once and for all’, but despite decades of delay, the Government has not made any visible or tangible progress on this issue.

“While addressing the immediate COVID emergency has rightly been the UK  Government’s top priority, there is a real risk that allowing the current circumstances to excuse further delays to social care reform will mean that an opportunity is missed once again.

“The NHS and social care are sister services and have been supporting one another and working closely together throughout the pandemic. However, when one service does not work, the other suffers, and the past few months have brutally exposed how fragile and under-resourced England’s social care system has become.

“The Government must now deliver legislative proposals to fix social care, once and for all. A well-funded and good quality social care sector is fundamental to a healthy nation and a well-performing NHS. Without social care reform, with a clear and transparent timetable for delivery, backed up by a long-term funding settlement, not only will the NHS and social care continue to run at near breaking point through the pandemic, but they will struggle to address the long-term health and social care issues the crisis leaves in its wake.”

Commenting on the report, Professor Helen Stokes-Lampard, chair of the Academy of Medical Royal Colleges, said: “The Academy of Medical Royal Colleges strongly supports the drive to fix social care once and for all. It is imperative that we engage with this as a matter of urgency, because high quality social care is vital for so many people and has been neglected for decades. If we don’t have effective social care, we cannot have an effective, efficiently functioning NHS.”

Rachel Power, chief executive of the Patients Association, said that the social care system is “simply not set up to meet people’s needs today.”

“More people are living for longer with conditions that can’t be treated by the NHS, and they rightly expect care and support to allow them to continue to live well and play an active role in society. The current system creates an enormous disparity between people with some health conditions who are treated for free on the NHS, and others who struggle to access care at all and are charged when they do. A clear, equitable offer that people can count on to provide care and support when they are in need is absolutely imperative,” she added.

Imelda Redmond CBE, national director at Healthwatch England, said: “The provision of social care services is crucial in helping disabled people and frail older people live the best life they possibly can. Yet under the current system, many people’s needs are not met and services remain underfunded, with the COVID-19 pandemic having laid bare deep fault lines. We must see the promised significant reform if we are to tackle this.”

Isobel McMillan, a retired teacher, said: “I’m ardent about the care system and linking it up into an integrated system, ever since I had my own experience of it.

“The social care system and how it joins up with health is a complicated puzzle and so difficult to navigate. We need a properly integrated system that is well-funded so that both carers and health care staff are properly paid.”

Anna Severwright, who uses social care services, said: “For too long, myself and many others I know have described social care as a fight to get the support needed to be able to live the life we want and do the things that matter to us. But I am also aware that the NHS sees the negative impacts of the current social care system – whether hospital admissions due to lack of support or adaptations, or delayed discharge as support is not in place – health and social care are interdependent to our health and wellbeing. We need brave and radical reform now.”

Professor Andrew Goddard, president of the Royal College of Physicians, said: “There are no two ways about it – social care needs funding now, not least so more staff can be hired, better paid and better supported. The impact of the pandemic is a reason to find a sustainable solution as quickly as possible, not to delay reform that has been needed for years.

“Only when we have an agreement on how we are going to fund social care can we develop new models of care that ensure people get the joined-up care they need. The NHS Bill expected later this year will be an important step towards greater integration, and social care cannot work as an equal partner to the NHS unless it is recognised and funded as such.

“But something the government could do immediately is extend the health and care worker visa to include social care staff. It’s the least they can do in recognition of their critical role in keeping people safe and healthy.”

James Bullion, president of the Association of Directors of Adult Social Services, said: “It’s great to have such solid support for social care from our health colleagues. Some people may be surprised to see one sector campaigning so passionately for another, but we are both part of a single care and health system and each depends utterly on the other.

“The case for significantly increased long-term funding to enable us to access the care we want was clear before the pandemic, but is now even more stark.  Those of us with care and support needs, families, carers and all who work in health and social care urgently need the government to bring forward its promised plans.”