Government policy


Turning up the volume on social care


The noise around recent key policy and fiscal events – the King’s Speech, the Autumn Statement, the recent Cabinet reshuffle – has masked the deafening silence from the government on the urgency of social care reform. With a general election on the horizon, Liz Jones, policy director of the National Care Forum, outlines what the sector requires – and expects – from a future government


The new secretary of state for health and social care, Victoria Atkins, has been quick to engage with health sector colleagues, but seems less alive to the urgency of social care. Even the recent list of ‘commitments to make the health and social care system faster, simpler and fairer for patients’ seems very social care lite. If she were not already sighted on the challenges facing the sector, or the snail’s pace of reform, then the recent National Audit Office report puts on record that ‘Adult social care reform has been an intractable political challenge for decades, and in 2019 DHSC raised expectations that it would be addressed. Working with the sector, DHSC now needs to demonstrate how it is delivering on these plans.’ This report made crystal clear how many areas of reform, particularly those focussed on workforce, had not made anywhere near the progress needed to address this fundamental agenda, which the government purports to view as urgent. This year’s Skills for Care workforce


report shows that vacancies continue to be far too high, at 152,000 posts, and that the slight improvements in workforce capacity have been driven largely by an increase in international recruitment. The report also highlights the continued trend of high turnover and offers insights into what works to reduce this turnover and improve retention, including being paid more than the minimum wage; not being on a zero- hours contract; being able to work full-time; being able to access training; and having a relevant qualification. This data portrays a sector under ongoing strain and pressure, with unacceptably high turnover impacting those receiving care and support, as well as the remaining workforce. And since then, we have had a wholesale overhaul of the legal migration system which looks


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to be bringing an end to the essential international workers who have been proving so valuable to a sector hamstrung at every turn in its ability to recruit a bigger domestic workforce. Additionally, the CQC’s State of


Care report highlighted the profound inequalities that now exist in the provision of adult social care due to state underfunding and a flawed ‘care market’ model. It, too, highlighted the immense workforce pressures across the social care sector, as well as very real challenges for people trying to access care and support but being unable to.


Joined-up action, now The Chief Medical Officer in his report on health in an ageing society highlights again that policy makers and our society


It is vital that the urgency of social care reform does not return to the wilderness


must tackle the reality that our population is ageing with all the opportunities and challenges that brings. He particularly calls for joined-up action now: ‘The NHS, social care, central and local government must start planning more systematically on the basis of where the population will age in the future, rather than where demand was 10 years ago. This includes building or adapting housing and transport to be appropriate for an older population. And he points out again that the state has a key role in ‘delaying or preventing ill health and disability over a lifetime and into older age.’ All of this creates an urgent need for action in relation to social care reform that has very real impacts on people and communities, and which seems to be systematically ignored by the government. Being unable to access timely care and support really matters to people who are in need of it. Where care and support are not available, the burden inevitably falls upon unpaid carers, almost always women. Carers UK estimated in 2022 that the number of unpaid carers could be as high as


www.thecarehomeenvironment.com January 2024


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