Adult social care and support is a vital service in its own right. It helps people of all ages to live the life they want to lead. It binds our communities, helps sustain the NHS and provides essential economic value to our country. Too often health and social care are set on unequal footings, with the latter viewed (sometimes solely) in terms of the role it can play in supporting the former.
Key messages
- The Economic Affairs Committee’s report supports many of our own calls for adult social care to be given a long-term, sustainable funding settlement for the benefit of the millions of people who use and work in these services.
- COVID-19 has put adult social care firmly in the public, political and media spotlight. This emergency has begun to highlight the essential value of social care to the wider public and this interest needs to be harnessed in the debate about the future of care and support. Long-term reform is urgently needed and we are calling on the Government to set out its thinking at the earliest opportunity.
- Adult social care and support is a vital service in its own right. It helps people of all ages to live the life they want to lead. It binds our communities, helps sustain the NHS and provides essential economic value to our country. Too often health and social care are set on unequal footings, with the latter viewed (sometimes solely) in terms of the role it can play in supporting the former.
- Years of significant underfunding coupled with rising demand and costs for care and support have combined to push adult social care services to breaking point. Over the past decade, we estimate councils have had to bridge a gap within adult social care of £6 billion to keep funding the services. Councils were able to do so by making £4.2 billion of savings to adult social care and by diverting £1.8 billion from other council services, meaning these services were reduced by more than they otherwise would have been so that councils could fund adult social care. These pressures have been exacerbated by the response to COVID-19.
- This underfunding puts the workforce and unpaid family carers under further strain, creating unmet and under-met need and impacting on social care’s ability to help mitigate demand pressures on the NHS.
- The COVID-19 pandemic has clearly shown how important it is to have a highly skilled, well equipped, and supported care workforce which has parity of esteem with the NHS workforce. There needs to be tangible improvements in the pay of the adult social care workforce, potentially more in line with comparable roles in the NHS, as well as investment in training and workplace development and career progression. The LGA is calling on Government to establish an independent process to gather evidence and make recommendations as soon as possible so that planning for the future of pay and reward in adult social care can begin.
- In our submission to the Comprehensive Spending Review (CSR), we called on Government to provide an additional £10.1 billion per year in core funding to councils in England by 2023/24. This additional funding would cover the funding gap facing councils, improve services and reduce inequalities.
LGA response to the Committee
Responding to the report (in early July 2019), Cllr Ian Hudspeth, Chairman of the Local Government Association’s Community Wellbeing Board, said:
“This significant report echoes many of our own calls for adult social care to be given a long-term, sustainable funding settlement for the benefit of the millions of people who use and work in these services.
Adult social care faces a £3.6 billion funding gap by 2025. Councils are having to make incredibly difficult decisions within tightening budgets and cannot be expected to continue relying on one-off funding injections to keep services going. What we need is certainty for both the immediate and long-term.
That is why the Government needs to commit to meeting our 10-week deadline, before the party conferences start, to finally publish its much-delayed and long-awaited green paper outlining what the future funding options and possible solutions to this crisis are.
Local government stands ready to host cross-party talks to kick-start this process and make sure we get the answers and certainty we need, so that people can continue to receive essential care and support.”
Funding and long-term reform
Years of significant underfunding coupled with rising demand and costs for care and support, have combined to push adult social care services to breaking point. Over the past decade, we estimate councils have had to bridge a gap within adult social care of £6 billion to keep funding the services. Councils were able to do so by making £4.2 billion of savings to adult social care and by diverting £1.8 billion from other council services, meaning they were reduced by more than they otherwise would have been so that councils could fund adult social care.
Councils are also facing significant extra costs from the demands created by COVID-19 as well as a significant loss of income. Estimates by the Institute for Fiscal Studies (IFS) suggest that another £2 billion might be needed this year to meet all the pressures and non-tax income losses that councils have experienced and will experience as a result of COVID-19, but that this could rise to £3.1 billion depending on whether councils’ assumptions about the end of the pandemic are correct. In relation to adult social care, councils are supporting care providers who face additional costs in ensuring continuity of care for those who rely on their support, as well as seeking to protect staff and the people they support from infection by COVID-19, and then providing care to this who fall ill with the virus.
The 2020 ADASS Budget Survey shows that the onset of the pandemic, and the additional financial and demand pressures faced by local authorities as a consequence, has led to a significant change in the Directors’ confidence in meeting their statutory duties relating to adult social care. For the current financial year (2020/21) only 4 per cent of Directors are fully confident that their budget will be sufficient to meet their statutory duties; this compares to 35 per cent in 2019/20.
The LGA has used its submission to the Comprehensive Spending Review (CSR) to call on Government to provide an additional £10.1 billion per year in core funding to councils in England by 2023/24. This additional funding would:
- Cover the funding gap facing councils in England of £5.3 billion by 2023/24. This funding gap figure is based on analysis we commissioned from the Institute for Fiscal Studies and is just to maintain services at today’s level – their upper estimate of the funding gap figure is as high as £9.8 billion.
- £1.9 billion is for services struggling under increased demand, such as adult social care.
- Finally, the LGA’s submission sets out how a further £2.9 billion could be used by councils to help improve services and reduce inequalities, such as investment in early intervention and prevention and reforming adult social care worker pay.
One of the only positives to come out of COVID-19 is that it has put adult social care firmly in the public, political and media spotlight. It has also shone an important light on the tireless work of our invaluable social care workforce who are providing care and support to all who need it in the most challenging of circumstances. This emergency has begun to highlight the essential value of social care in its own right to the wider public; this debate needs to be harnessed in thinking about the future of care and support.
The legacy of COVID-19 for social care – and most importantly the people who use social care services – must be a reset, not simply a restart. This impetus should spur our thinking around long-term reform of care and support, which we have always said should be built on cross-party cooperation. We are committed to working with Government and all parts of the social care world – particularly people with lived experience – on a way forward that is informed by the many valuable lessons from the response to COVID-19 on the role and value of social care in all our lives.
Our submission to the CSR called for action from Government on three fronts:
- provide additional funding to shore up social care ahead of winter and a likely second wave of the virus, with a look to this continuing in future years;
- provide additional funding for the medium term to help address the long-standing challenges that have faced social care, many of which have been exacerbated by the pandemic; and
- use the above funding as a ‘down-payment on reform’ and to pave the way for changes that will finally put the funding of social care on a sustainable footing for the long-term.