UK social care reform plans focus on long-term change

The government’s white paper, People at the Heart of Care, backs up previous commitments to increase state funding to the social care sector. For the first time, the government is proposing to set a lifetime cap on the cost of care while increasing pay for workers.

The government said it would initially spend £1 billion over the next three years on reforming the social care system, including funding supported housing, new technology, and career progression for those working in the sector.

Health and social care expert Joanne Ellis of Pinsent Masons said care providers struggling with immediate challenges such as competition for staff, inflationary pressure and the April 2022 increase in the minimum wage, vaccine mandates, and the pandemic, would not find fast solutions in the white paper.

However, Ellis said the paper could help providers set themselves up for the future, as it highlighted issues such as digitisation, working with local authority partners, and how better use of internal data can support residents and staff alike.

Industry associations welcomed the white paper but cautioned that delivering on its promises would be challenging.

“We are all committed to starting on a journey that will deliver better outcomes for citizens and long-term sustainability for social care providers,” said Care England chief executive Martin Green.

Age UK charity director Caroline Abrahams said over time, the paper could help build a “less intensively fragile system”. However, she added: “Rather than the Formula One vehicle that was required, the paper is an underpowered saloon car at best.”

The white paper revolves around three objectives: that people have the choice, control and support to live independent lives; people have access to quality and tailored care and support; and people find adult social care fair and accessible.

Digitisation is at the heart of the plans. The government said by March 2024 at least 80% of social care providers will have a digitised care record in place that can connect to a shared care record. The paper promised a partnership between the Department for Culture, Media and Sport and the telecommunications industry to ensure home care providers have the infrastructure they need to work digitally.

A universal knowledge and skills framework for the care sector will be developed alongside a career structure for the social care workforce. The government said this would be rolled out in 2022 and 2023.

The funding allocated also includes more support for unpaid carers, and funding for local authorities to be more innovative in the care they offer and widen the options available.

These proposals are backed by the health and social care levy announced in September 2021, which pledged £5.4bn for adult social care in the next three years.

The white paper also confirms that £3.6bn will be allocated to reform the social care charging system, as first announced in November 2021. Nobody in England will have to pay more than £86,000 for their personal care costs, alongside more generous means-tested support for anyone with less than £100,000 in chargeable assets.

Self-funders will be able to access the same rates for care costs in care homes that local authorities pay. The government said this would bring an end to self-funders having to pay more for the same care, while ensuring local authorities move towards paying a fair cost of care to providers.

Fees for care will also be made more transparent to allow people to make informed decisions.

“A consequence of the cost cap and transparency is that it exposes the fact that private top-up fees have been used to cross subsidise local authority rates. The imposition of the cost cap could put operators at risk of having to ‘level down’ their offering,” Pinsent Masons’ Ellis said.

BBC Panorama is to address issues with social care funding in a programme on Monday 6 December, with a report investigating how international investment in social care leads to money being taken out of the system.

The white paper also confirmed that the secretary of state for health and social care will be given new legal powers to intervene in local authorities in order to improve services where there are significant failures to deliver their duties under the Social Care Act 2014.