Care sector calls for crisis talks following Spending Review

Four agencies representing care providers and commissioners across the health and social care sector have requested urgent crisis talks with the Treasury and Whitehall Departments, following a growing crisis in the care of older people and those with disabilities.

Writing in a letter to Chancellor George Osborne, Secretary of State for Health Jeremy Hunt and Secretary of State for the Department for Communities and Local Government, Greg Clark, four influential voices in the care sector - ADASS, the NHS Confederation, the Care Provider Alliance (CPA) and the Care and Support Alliance (CSA) stress that the recent Spending Review ‘is not sufficient to resolve the care funding crisis’.

They write: “Ultimately the package put forward for social care will not enable us to fill the current gap in funding, cover additional costs associated with the introduction of the National Living Wage, nor fully meet future growth in demand due to our ageing population.”

Their letter follows the publication of research conducted by think tank, The King’s Fund, the Care Quality Commission (CQC) and think tank ResPublica, highlighting the current cash crisis faced by the adult social care sector.

The four agencies highlight their concerns that the current funding package will not allow them to fill the current funding gap, nor support any additional pressures that arise from the cost of regulation, emerging policy or pensions.

Significant implications for older people, disabled people and their carers

In addition, they warn that many resources are back-loaded, citing that the Better Care Fund (BCF) would not reach a level of significance until the end of this Parliament, adding: “This has significant implications in terms of the vital support needed by older and disabled people and their carers. And it also puts the delivery of the NHS Five Year Forward View – and implementation of the Care Act - at risk.”

The letter raises several immediate points that need to be addressed, including:

• What happened to the £6bn originally which was earmarked for the full implementation of the Care Act?

• What steps can be taken to ensure that the proposed two per cent levy per year on council tax in the form of a social care precept delivers the money required to ensure the right levels of social care and does so equitably?

• What steps can be taken, given the wider Spending Review settlement for local Government, to support councils to address the shortfall?

The letter concludes: “If we do not collectively address the highlighted issues relating to levels of and phasing of funding, there is the potential for significant and adverse impacts, including:

• An increasing number of older people, disabled people and their carers without any, or without sufficient support to meet their needs;

• An acceleration of the failure of domiciliary, residential and nursing home providers. This is likely to accelerate fastest in those areas of the country where providers are predominantly reliant on state funded clients. These are exactly the areas of the country that additionally will raise the least areas of council tax. The impact of this will be the compounding of the number of people who do not have their needs met, or who are avoidably admitted or remain in hospital;

• An increasing pressure on the NHS with more people admitted to hospital and more delays to get people home safely.

“As you made clear in your speech to Parliament ‘a civilised and prosperous society like ours should support its most vulnerable and elderly citizens.’ This is a goal that we all share and we are keen to work with you and your colleagues to ensure that this becomes a reality.”

Sticking plaster solutions

Writing in a joint letter in the Guardian earlier this month, think tanks, the King’s Fund and the Nuffield Trust warned that the most deprived areas of the UK with high care needs would suffer the most as a result, due to their low council tax bases.

They said: “As the dust begins to settle on last month’s Spending Review, it is now clear that it represents another setback for people who need social care.

“New powers to raise council tax will provide local authorities with some financial flexibility, but will not raise as much as the Government suggests and, given wide variations in how much councils can raise through their tax base, will disadvantage deprived areas with high needs for publicly funded care. Additional money provided through the Better Care Fund towards the end of the Parliament is welcome, but social care is in crisis now.

“These are sticking plaster solutions and no substitute for adequate funding. By the end of the Parliament, public funding for social care will fall as a percentage of GDP. In the face of a growing older population, this defies demography and will reduce publicly funded social care to a threadbare safety net available only to the most needy and vulnerable members of our society. Meanwhile, social care providers face huge pressures, with at least one of the big care home operators reportedly close to collapse.

“400,000 people have been denied access to the care they need over the last five years. Thousands more older and disabled people now face this prospect, further increasing the pressures on families, carers and the NHS. A new settlement which provides adequate funding for health and social care is needed now more than ever.”