Key points
- In launching its plans to reform social care last year, the government accepted that the present system was ‘unsustainable’ and forecast a £6 billion funding shortfall by 2028 if nothing changed. The key issue is a growing elderly population with increasing levels of disability and need – by 2025 the number of people aged over 85 is expected to rise by two-thirds, according to the Wanless Social Care Review. Current funding arrangements cannot cope with this – a new solution has to be found.
- Shaping the Future of Care Together, the government's Green Paper on reform of social care funding and delivery, was published in July 2009. Read our summary of the key points and our analysis.
- The Green Paper put forward several options for change. It aimed to answer three central questions:
- What is needed to make the vision of independence, choice and control a reality?
- What should be the balance of responsibility between the family, the individual and the state?
- What is more important: local flexibility or national consistency?
It considered a number of funding options, including an insurance scheme and co-payments where everyone has a basic entitlement which can then be topped up. - The government is committed to making all services more personalised. It wants most users to have access to personal budgets by 2011 and has suggested these budgets could include funds from health care as well as social care. Personal budgets are already helping many people – including many with learning disabilities – to transform their lives. But the latest Commission for Social Care Inspection (CSCI) annual report indicates there is still a big gap between vision and reality and that most users still experience ‘one size fits all’ care.
- A growing number of people are missing out on state-provided social care services as a result of councils’ ever-tightening eligibility criteria. Although 1.75 million people receive adult services another 750,000 may be losing out, CSCI suggests. Its own review last year recommended the scrapping of eligibility criteria and the introduction of a national points system.
- Turnover and vacancies in many parts of the social care workforce are high, according to latest CSCI figures. Meanwhile those receiving direct payments now hire 12 per cent (113,000) of all employed carers and helpers. Many in the field are concerned these personal assistants are not regulated or monitored like the traditional workforce and this could increase the risk of user abuse.
- The government is promoting a number of initiatives to encourage greater co-ordination and planning between health and social care, including Local Area Agreements and the new joint commissioning of well-being and prevention services. But they can still founder because of the different cultures and structures as well as the underlying imbalance between the two sectors.
- Critical to any social care strategy will be the estimated 6 million carers who look after frail or disabled relatives on a largely unpaid basis. Carers UK estimate that carers’ unpaid work saves the UK £87 billion a year. The government launched a revised carers’ strategy last year which set out its vision for the next 10 years. This includes annual health checks, better information, more support for carers wanting to return to work and more short breaks and respite care.
- The current economic slump is having an impact on social care in several ways. It means that demands on its services from those with job, housing or health problems is growing while its funding is contracting – and is set to contract further with public sector cutbacks forecast. However, many within social care would argue the recession only strengthens the case for change.
