Health and Social Care, is the answer in the next Spending Review?

We are pleased to hear the government has made a commitment to health and social care with the implementation of means testing for those with assets of more than £20,000. Previously the assets threshold was set at £14,000. We recognise that for those in receipt of care, the application of Dilnot proposals, in which the Government will implement a cap of £86,000 on care costs, may offer some protection. However, the UKHCA suggest only 1 in 7 will benefit from these measures. Combined, these proposals will provide some much-needed financial assistance to people in receipt of care.

Beyond the cap and means testing, the big question remains, ‘what funding will be left for social care?’

Social Care needs more than the Health and Social Care Levy.

As an employee-owned, not for profit business, we cannot see how this levy will make a positive difference to care being delivered, or help make an impact on the transformation the sector so badly needs. One of the greatest challenges is recruiting and retaining Care Workers, who are not paid fully for their time at work. As a result, providers struggle to meet the needs of the elderly and vulnerable in the communities and in their own homes.

As Richard Murray in a recent Kings Fund blog put it, “social care has been allowed to drift into such a perilous state that there is (at the very least) a question mark over whether this is enough to truly ‘sort’ social care.“

Increasing costs, increasing pressures and no recognition for the workforce

The Health and Social Care Levy will simply exacerbate the pressures that already exist.

Stephen Chandler, president of ADASS raised two concerns regarding the Levy, firstly, the Levy provides no additional funding to help providers or commissioners deal with the workforce pressures, which subsequently leaves the market unable to respond to the increasing levels of need. Secondly, it appears that from the 1st April 2022, there will be little, if any funding for adult social care to improve the delivery of care and support.

The means of raising funds through the NI contribution only serves to make the sector more challenging for commissioners and providers, and less attractive to Care Workers. A Care Worker may work 50 hours per week, and only get paid for 40 hours, due to funding and commission practices. At £9.00 p/hr, a Care Worker will be £115 worse off every year. Combined with the extra demands and expectations of home care, e.g. medication and other health related care and support, working in a supermarket or retail may seem much more appealing.

As a provider, we employ 750 Care and Support workers across the North of England. Our costs will increase by £112k per year for employers NI contributions as a direct result of this Levy, an increase of 0.75%. The cost to our Care Workers through their NI contributions will be the same, requiring us, as a provider to foot the bill to ensure they are not worse off. In total, this results in increased costs of £224k pa, an increase of 1.5% just to maintain the status quo.

Given most home care providers costs are through payroll, the Local Authorities commissioning care will have to subsequently increase the funding by a minimum of 1.5-2% before any further increases are applied for cost of living and inflationary increases.  Homecare providers will have little confidence going into 2022/23 given the state of local authority finances.  This has the potential to destabilise the market and put more pressure on the NHS due to the lack of homecare capacity at a local level.

Will the next Spending Review have more answers?

We await the detail of the Spending Review and urge those who can influence, to fully layout the impact of these proposals on providers, Local Authorities, and the social care sector.

We urge the government to consider these issues and provide assurances to Local Authorities and providers alike.