Over the last two years, the Government has produced a white paper on the future of adult social care (December 2021), a follow-up plan to the white paper (April 2023), and made additional funding available, most notably £7.5 billion across 2023/24 and 2024/25 as announced at the 2022 Autumn Statement. However, much of the Government’s attention in recent times has been on older people, hospital discharge and winter. As important as these issues are, adult social care is about so much more, including services for working-age people with a learning disability or mental health problem, unpaid carers, and the dedicated care workforce which delivers services to thousands of people every day. Although we accept the Government has taken meaningful steps to address the financial issues in adult social care, the Government still has some way to go to address the challenges faced by local authorities.
Councils are all too aware of the impact on their residents: the person of working age waiting more than six months for an assessment of their needs; the unpaid carer struggling to balance work with caring duties; the care worker working long hours but finding it difficult to make ends meet; or the care provider owner who has ceased trading. We all know these people are real and we all know they would very clearly state that adult social care is far from fixed.
The additional funding made available in the 2022 Autumn Statement is helpful but much of the funding will be absorbed by meeting pay and inflationary pressures.
The 2023 Autumn Statement is a critical opportunity for the Government to signal that its understanding of, and commitment to, adult social care extends far beyond a focus on hospital discharge of older people.
Actions the Government should take now:
- Provide funding to enable improvement in pay (parity with comparable roles in the NHS), conditions and career development opportunities for the frontline care workforce not directly employed by councils.
- Introduce an independent review of care worker pay for those not directly employed by councils.
- Provide substantial new investment to help tackle unmet and under-met need through an expansion of provision, including preventative services, and in new models of care, including housing, and funding for the voluntary and community sector.
Facts and figures about adult social care
- 76 per cent of directors of adult social care services are concerned their budget is insufficient to meet statutory duties around market sustainability in 2024/25. 52 per cent are similarly concerned about their ability to meet statutory prevention duties in 2023/24, up from 40 per cent in 2022/23.
- Directors are planning savings of £806 million in 2023/24, up from £597 million in 2022/23, but only 17 per cent of directors are fully confident in delivering those savings.
- Despite some improvement on last year, the workforce vacancy rate remains stubbornly high at 9.9 per cent, equivalent to 152,000 vacant posts being advertised on an average day. Turnover rates also remain high at 28.3 per cent (a slight improvement on last year when the rate was 29 per cent).
- From 2015/16 to 2021/22 the number of working-age adults receiving long-term care increased by 1.4 per cent while the number of older people receiving long-term care fell by 10 per cent.
- In 2021/22 councils spent approximately the same amount of money – £8.3 billion – on long-term support for both working-age adults and older people despite many more thousands of older people being supported (529,000 older people supported long-term, compared to 289,000 people of working age).