Long term funding of adult social care Contents


The combination of rising demand and costs in the face of reductions in funding has placed the social care system under unsustainable strain. In its present state, the system is not fit to respond to current needs, let alone predicted future needs as a result of demographic trends. After successive attempts at reform the social care Green Paper must be the catalyst for achieving a fair, long-term and sustainable settlement. Failure to do so will undermine the effectiveness of the welcome recent announcement of an uplift in NHS England spending.

Spending on social care needs to rise to: meet the funding gap for the provision of social care by local authorities in 2020; provide the additional funding to meet future demand; meet the care needs of everyone, whether critical, substantial or moderate; and to improve the quality of care delivered, which includes ensuring the stability of the workforce and care providers.

Future spending on social care

The following principles should inform and direct the forthcoming discussions about how to reform social care and how to raise the additional funding needed:

Costings of future provision of social care need to begin with a clear articulation of what good care looks like and costs for both older adults and working age adults—simply extending the current, inadequate provision of social care to more people is not a tenable long-term position.

We support the provision of social care free at the point of delivery as a long-term aspiration. In principle, we believe that the personal care element of social care should be delivered free to everyone who has the need for it, but that accommodation costs should continue to be paid on a means-tested basis. This should begin by extending free personal care to those deemed to have ‘critical’ needs. However, particularly for younger adults, it is essential that social care is viewed more holistically and funding for ‘preventative’ social care for adults with moderate social care needs is reinstated.

Raising additional funding

There is a clear need for increased funding for social care. Given the scale of the additional funding likely to be needed, a combination of different revenue-raising options will need to be employed, at both a local and a national level.

Local level

National level:

Health and social care integration

Health and social care are highly interdependent. While it will not of itself generate funding to address the social care shortfall, further integration has the potential to improve outcomes and we recommend that local attempts to better integrate services continue apace. There is a strong case for the local delivery of social care, which brings the important benefits of links with housing and other local services, as well as local accountability. Given the interdependencies between the provision of health care, social care, and also public health, we also recommend that in its discussions of future funding settlements the Government should consider all these in the round.

The mechanism for achieving consensus

There has been failure in the past to make progress on reform and a cross-party approach on reforming social care funding is now essential. The concept of a cross-party parliamentary commission currently has the support of more than 100 MPs from all English political parties. As a proven mechanism for building and maintaining political consensus on difficult issues, and following other unsuccessful attempts at reform, we strongly recommend that a parliamentary commission offers the best way to make desperately needed progress on this issue and that it should use the principles and proposals set out in this report as a basis for proceeding.

Published: 27 June 2018