The long-awaited proposals surrounding adult social care funding, in England, are not expected to be delivered until at least 2028. Health and Social Care Secretary, Wes Streeting, confirmed an independent commission, chaired by Baroness Louise Casey, would be launched in April, with the report due to conclude in 2028. The long delay has caused widespread concern, with councils and care providers highlighting the need for swift reform. Government announcements did state that care workers will conduct more health checks, as well as funding for services allowing elderly and disabled individuals to remain in their homes. Social care assists older or disabled people with their medication, dressing, washing and eating. Those with the most complex health needs are provided with social care free of charge by the NHS, which means that most care is council-funded. In England, only those individuals with high needs, and savings or assets of less than £23,250, are eligible for council-funded care. As a result, an increasing number of individuals have to fund their own care. Some have to pay hundreds of thousands of pounds, which can force them to sell their homes. Streeting’s stated the government’s ultimate goal is a “new National Care Service, able to meet the needs of older and disabled people into the 21st Century”.
Baroness Casey is renowned throughout the government for sourcing solutions and leading high-profile reviews, including the Rotherham child exploitation scandal, the Metropolitan Police, and homelessness. Ensuring the establishment of a National Care Service that is affordable to an aging population, however, remains her biggest challenge. Widespread agreement exists regarding the fact that the care system has been in crisis for a number of years due to under-funding, increasing demand, and staff shortages. The primary issue the government faces is agreeing upon how overdue reform will be funded. Earlier plans by Labour to fund social care services were labeled a “death tax” in the 2010 election, whilst Conservative proposals were labeled a “dementia tax” in the 2017 election. An endless number of commissions, inquiries and reviews have been undertaken over the past 25 years but their implementation has never taken place. The closest undertaking, the 2011 Dilnot Commission plan, proposed a cap on personal care costs and was even legislated for but never implemented. Last summer, it was ultimately abandoned by a new Labour government due to the Conservative administration’s failure to set aside the money to fund the reform.
The government provided little detail on the National Care Service in its manifesto but promised its establishment. The independent commission will collaborate with care service users, staff, families, politicians, and the public to identify the best way to establish a care service capable of meeting both present and future requirements. The King’s Fund independent health think-tank is urging the government to “accelerate the timing”. Councils are under huge financial pressure and are responsible for funding available care services for most individuals. Melanie Williams, the Association of Directors of Adult Social Services president, believes the timescales are too long, stating she believes much of how to reform adult social care is already identified, and waiting for a report will be to the detriment of people’s health and safety. Nearly 835,000 individuals received publicly funded care in 2022, according to the King’s Fund, with around two million in England having unmet care requirements. Skills for Care, a workforce organization, reveals that while England has 1.59 million adult social care workers, almost 131,000 vacancies currently exist. Helen Walker, the Carers UK head, contends families face “intense pressure and providing more care than ever before”. The government has confirmed an additional £86m spending in the current financial year, ending in April, to support thousands more elderly and disabled individuals in remaining in their own homes. The money would allow 7,800 disabled and elderly individuals to make important home improvements which can enhance their independence and reduce hospital admissions. The government also proposed various other changes, such as improved career pathways for care workers, promoting the usage of innovative technology and national standards to enable elderly individuals to live at home for a more extended period, up-skilling care providers to deliver basic checks as well as introducing a digital platform to share NHS and care staff’s medical information
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