The Five Pillars of Social Care Reform

Of all the major crises facing this country, the care of our oldest and most vulnerable is one that cannot wait any longer for solutions. We have been warning for more than 30 years that social care was not being funded properly to provide a good, sustainable service for people who need that care every day to help them live a full life. Those years of under-funding left social care in a perilous state and Covid-19 then hit it hard.

Now the sector finds itself facing a massive staffing shortage and huge increases in costs, including rocketing fuel and utility prices. There is a very real risk of significant provider failure with a loss of care provision and a subsequent, knock-on impact upon NHS healthcare.

But it doesn’t have to be this way. In these five pillars we set out the urgent measures that need to be taken.

If adopted we can, together, begin to build a Health and Social Care service that provides proper, sustainable cradle to the grave care for everyone who needs it, when and where they need it. And a care sector that properly rewards the amazing staff who time and time again deliver wonderful care, against the odds, to grateful recipients.

I commend the five pillars of social care to you.

I present the Five Pillars of Social Care Reform upon which the Independent Care Group believes the sector can be saved, rebuilt and improved to provide care that we can be proud of. 1 2 3 4 5

The Five Pillars of Social Care Reform

Ring fence a percentage of GDP to be spent on providing social care to those who already receive it and the 1.6m who can’t get it.

Create a unified National Care Service, incorporating health and social care.

Set a National Minimum Wage per hour for care staff on a par with NHS, regardless of national financial cuts.

Set up an urgent social care task force to oversee reform.

Fix a ‘fair price for care’ tariff for things like care beds and homecare visits.

Mike Padgham, Chair

The Five Pillars of Social Care Reform

1 Spend a percentage of GDP on care

Only by committing to spend a percentage of GDP on care can the sector get the funding it needs to progress. By ring-fencing this at a specific level for the future this would give providers the security they need to plan long-term. 2

1

2 Create a National Care Service

At the moment, NHS healthcare is administered nationally and delivered locally whilst social care is administered and delivered locally. This makes for a disjointed approach. The creation of a unified National Care service, incorporating NHS healthcare and social care, would remove the boundaries and enable joined up care. A decision would need to be made how this unified care service was to be administered.

3 Set a National Minimum Wage per hour for care staff on a par with NHS

The recruitment of staff is the single biggest issue facing social care providers, with 160,000 vacancies on any one day. Whilst it remains more financially attractive to work in retail, social care will continue to struggle to recruit. A minimum wage on a par with their NHS counterparts, allied to a better career structure for care staff, would make the sector more competitive and attractive to employees, begin to address the staffing shortages and reward existing staff for the amazing work they do. This is vital and non-negotiable, regardless of pressures to make financial savings.

4 Set up an urgent social care task force to oversee reform

The social care sector has many bodies and individuals within it that can offer support and advice to the Government on how to effectively carry out the reform it needs. A task force would be an excellent vehicle to oversee and manage reform, draw upon the expertise within the sector and set deadlines and milestones for the delivery of that reform.

3 4 5

5 Fix a ‘fair price for care’ tariff.

Across the sector, providers need consistency in terms of the price commissioners pay for care. Setting an agreed cost per bed and cost per homecare visit, based on the true cost of delivering that care, would provide the sector with the much-needed investment it needs to protect it for the future and spark investment in growth.

Our Blueprint for

Social Care

• A ‘root and branch’ overhaul of the way social care is planned and funded

• NHS health care and social care to be merged and managed either locally or nationally

• Extra funding for social care, funded by taxation or National Insurance

• A guarantee that people receiving publicly-funded care can receive it in their own home or close to where they live

• A minimum wage and career pathway for social care staff, on a par with their NHS equivalents

• A streamlining of the bureaucracy that slows overseas recruitment

• A commissioner for older people and those with Learning Disabilities in England

• A properly-costed national rate for care fees

• Dementia to be treated like other high profile, high priority illnesses, like cancer and heart disease

• A fixed percentage of GDP to be spent on social care

• A cap on social care costs, including ‘hotel’ charges

• Local Enterprise Partnerships to prioritise social care

• A national scheme to ensure people save for their own care, as they do for a pension

• A new model of social care delivery based on catchment areas – like GPs

• A social care loan scheme, like the ‘bounce back’ loans, to support care providers

• Social care businesses to be zero-rated for VAT so that they can claim it back, as other business sectors do

• CQC to have much greater powers to oversee all commissioning practises such as per minute billing and 15-minute visits

• Less duplication of inspection between CQC and local authorities/NHS

• Greater recognition of the role of the independent sector and utilisation of its expertise, via secondment for example, in the overall planning of social care in the UK

• A voice for social care providers on the integrated care boards

• Guaranteed equal partnership working on the new Integrated Care System Networks

• Giving providers and CQC greater flexibility in delivering services

• Providing incentives to care providers to diversify and invest in their services, like telemedicine, for example

• Allowing nurses and social care staff from overseas to work in the U.K. including lowering the salary cap

• More nurse training and bursaries to encourage recruitment and end the shortage of nurses

• Long term measures to integrate older and younger people in care settings and change the perception of the generations

• Investment in research and development into new models of social care delivery

• Funding to help upgrade older care homes to maintain a range of choice for the public and investment in domiciliary care

• Funding for leadership training

The failure

2021 saw the 25th anniversary of Stephen Dorrell, the Conservative Secretary of State for Health, launcing a consultation on a ‘partnership’ approach to reforming the funding of social care.

Since then there have been...

8 4 2

Overseen by...

Fourteen Secretaries of State for Health

to fix social care 14 17

Seventeen Ministers for Care Services

... but still a failure to ‘fix the crisis in social care once and for all’.

For more information on the development of social care funding, see ‘A history of social care funding reform in England: 1948 to 2023’ at: www.kingsfund.org.uk/audiovideo/short-history-social-care-funding

In January 2023, Prime Minister Rishi Sunak made a speech where he outlined his top 5 priorities.

Could we have a sixth priority, Prime Minister?

6

SAVE SOCIAL CARE

Help the 1.6m who can’t get care

Social Care in the last 20 years

The 17 social care ministers we have had during the past 20 years.

Just some of the numerous documents produced to tackle social care during the past 20 years.

What will Rishi do?