New government reforms won't solve social care funding challenge

New government reforms alone will not solve the challenge of funding social care, according to a new report published by The King’s Fund, Paying for social care: Beyond Dilnot.

The government's Care Bill, before parliament for the first time today, would introduce a cap on the amount individuals contribute towards the cost of their care, a central recommendation of the Dilnot Commission in 2011. The report, Paying for social care: Beyond Dilnot, argues that, while this will provide welcome protection for people from the catastrophic costs associated with long stays in residential care, much more should be done to meet mounting financial pressures.

With spending continuing to fall and demand for services increasing due to demographic pressures, the report calls for a stronger focus on the challenge of eligibility – ensuring that more people are able to access the right level of support. It also raises concerns that unmet need, and its impact on carers, will place further pressure on an NHS already under significant strain, arguing that it is time to look beyond the Dilnot report at how to secure enough resources to meet current and future needs.

The report identifies four main priority areas, which build on the foundations of Dilnot to provide a new roadmap for social care reform.

  • The government should ensure proper preparation and planning for implementing the Dilnot proposals, to establish a new framework for planning and cost-sharing.
  • The 2015/16 Spending Review should be used to move towards a single strategic budget settlement for the NHS and adult social care, and closer alignment of local authority and clinical commissioning group (CCG) budgets around individual needs.
  • Health and wellbeing boards have a crucial leadership role to play in ensuring care reform is part of a wider transformation of local health and care services.
  • There should be a fresh debate about the options for funding the quantity and quality of care needed in future, and how to overcome dividing lines between the ways health and social care are paid for.

Richard Humphries, Assistant Director, Policy at The King's Fund, said: 'The government's reforms are an important milestone – but there is much more to be done. There needs to be an informed debate so that people understand how they benefit from the changes, and to address the difficult long-term choices that remain about how much we spend on care, and how to fund this.

'We must also think boldly about removing the unhelpful fault lines which exist across health and social care spending. Instead of 'robbing Peter to pay Paul' by raiding the NHS budget to bail out social care, we need a more ambitious shift towards single-budget settlements for NHS and social care.'

Notes to editors: 

For further information, obtain a copy of the report or request an interview with Richard Humphries, please contact the Press and Public Affairs team on 020 7307 2585 (if calling out of hours, please ring 07584 146 035).

The Commission on Funding of Care and Support, chaired by Andrew Dilnot, reported in July 2011. It recommended the introduction of a £35,000 cap to individual contributions to the cost of social care. The government announced in February 2013 that it would introduce a cap, which the March 2013 Budget set at £72,000 from 2016.

The Care Bill receives its second reading in the House of Lords on 21 May. It is largely on the draft Care and Support Bill, which received pre-legislative scrutiny in parliament in 2012-13. It modernises the legal framework for social care, implements the proposals in the Dilnot report and takes forward some elements of the government's response to the Francis report.

The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.