Reforming adult social care in England – Report Summary

Summary

We have reported on adult social care many times and have repeatedly highlighted the need for reform. We have also stressed the importance of long-term funding and the need for the Department of Health and Social Care (the Department) to urgently tackle the problems faced by the social care workforce.

Two years on from its long-awaited white paper People at the heart of care—a 10-year ‘vision’ for adult social care—plans for reform have once again gone awry. Charging reform is delayed, system reform scaled back and funding for both has been diverted, including from areas such as supported housing, towards addressing urgent pressures. Meanwhile, waiting lists are rising, workforce vacancies exceed 150,000 and local authority finances are under sustained pressure.

The Department, which has overall responsibility, is not providing the leadership needed to deliver a social care sector that is sufficient to meet the country’s future needs, particularly in relation to the workforce. We welcome recent initiatives to ‘professionalise’ the workforce, including a care workforce pathway, but progress is too slow and too reliant on a ‘novel’ payments system. While we now have some short-term initiatives to support the workforce, these are not underpinned by a long-term, comprehensive workforce plan, unlike in the NHS. Along with differences in the way NHS and adult social care are funded, this contributes to a sense that the two sectors are not equal partners, and unless health and social care are sufficiently integrated people requiring care will continue to lose out.

The Department’s ‘vision’ was generally welcomed by the sector. But the Department has not set out a clear path for achieving its ambitions, has scaled back its first efforts at reform and is behind even on that. As the Department returns to charging reform, it must produce a clear plan for achieving its vision and report publicly on progress against it.