The National Audit Office (NAO) has urged the government to reform its approach to social care, warning too many families are resorting to unpaid care.
Its report ‘The adult social care market in England’, out yesterday (March 25), found there are 7.3m carers in England, many of whom are unpaid family, friends and neighbours in informal arrangements.
Although most care is good quality, the NAO found that short-term funding settlements had hampered long-term planning, innovation and investment in care.
The report read: “The sector has long called for a sustainable, long-term funding solution for care.
“We have previously emphasised the importance of long-term planning and clarity beyond the end of a spending review period.
"Government’s increasing emphasis on raising permanent funds via increases in council tax through the precept could disadvantage those areas with a lower tax base and a greater demand for local authority-funded provision.”
Although the NAO found the Department for Health and Social Care had increased its focus on care and oversight in response to Covid-19, it argued in the report that these efforts needed to be capitalised upon.
In pushing for reform and long-term strategy, the NAO criticised what it sees as a lack of foresight and oversight at the department. This included the lack of a workforce strategy and cost projections not being adapted.
The report added: “Despite many years of government papers, consultations and reviews, the department has not yet brought forward a reform plan.
“The Covid-19 pandemic has underlined the need to address some of the long-standing issues, such as limited data; workforce investment; and the visibility of provider finances. However, it has also delayed promised reforms as government prioritises the Covid-19 response.”
Priorities for reform
The NAO has concluded that, as a priority, the Department of Health and Social Care needs to set out a cross-government, long-term funded vision for care.
This will require a workforce strategy with a plan to recruit, retain and develop staff.
At the same time, the NAO recommended the department – in conjunction with the Ministry of Housing, Communities and Local Government and Department for Work and Pensions – should develop a cross-government strategy for the range of accommodation and housing needs people in care have.
Based on current demographics and expected population growth, the NAO estimates that 57 per cent more adults aged 65 and over will require care in 2038.
The cost of more care is expected to surge by 90 per cent to £18.3bn for those under 64, and by 106 per cent to £37.7bn for those who are older.
The findings have been welcomed by the Independent Care Group (ICG) which estimates 1.4m people are living without they care they need, following £8bn of social care budget cuts since 2010.
ICG chairman Mike Padgham said the report was another call for action from a government which has been repeatedly criticised for a lack of action on this issue.
“We welcome these conclusions and hope that the government makes good on its long-overdue promise to reform the social care sector,” said Padgham.
“It is time we put social care at the front of the queue and serve the millions of frail and vulnerable people with the care they need and give those providing that care the pay and recognition they have worked so hard to merit.”
Criticism of the government’s inaction on social care has intensified since prime minister Boris Johnson admitted reforms could take five years to implement.
The ICG has stressed reforms have to happen urgently and has identified a number of areas that need to be addressed.
These included an overhaul of how social care is planned and funded for, with a merger with NHS care.
On top of a fixed percentage of GDP for this cause, the ICG also wants extra funding to be diverted towards social care (from taxation or National Insurance) and social care businesses to be zero-rated for VAT.
Jon Yarker is a freelance reporter for FTAdviser
