The King’s Fund responds to Baroness Casey’s speech at the Nuffield Trust Summit

Responding to Baroness Casey’s speech at the Nuffield Trust Summit, Sarah Woolnough, Chief Executive of The King’s Fund, said:  

‘Baroness Casey’s intervention marks the welcome moment her Commission switches into a higher gear. It is a sound analysis of the broad social and demographic issues facing social care and it should provide a stable launchpad for a thorough and radical review of the current failing system. The Commission will now need to convert understandable outrage about the state of adult social care into actionable recommendations for wider reform that live up to the language of a ‘moment of reckoning’ Baroness Casey put forward today.

‘Baroness Casey is right to say that the country needs a much clearer sense of social care’s identity and purpose. The planned national conversation is an essential step towards putting people and families who need care - now and in the future - at the heart of a reformed system. The King's Fund has shown previously the power of deep public engagement in building awareness of the pressures in the system and what the public think about the potential solution. Given that around a third of the public think, wrongly, that social care is provided by the NHS and/or free, this discussion is sorely needed.

‘Lack of clarity in these areas helps explain why, in part, more recent attempts to reform social care have not survived contact with the reality of public opinion and why politicians have become hesitant to touch reform given the previous consequences politically. It was a key finding in The King’s Fund’s new report into public attitudes towards social care.

‘We also clearly recognise some of the key problems identified by Baroness Casey today, particularly the power imbalance between social care and the NHS and the fragility of the provider markets and the social care workforce. Central to these is the funding of the current system and we support Baroness Casey’s call for much greater transparency of the level of funding required to meet identified need for care and support. For too long, local authorities have had a mismatch between the amount of demand they face and the level of funding they have to meet it, resulting in too many people being denied the care and support they need.

‘We can see the value in the focus on better dementia care and the idea of a ‘dementia czar’, though much would depend on whether they are given sufficient remit to drive the change and improvements needed across the whole health and care system rather than just the NHS.

‘We continue to hope that the Commission’s overall review can be completed at speed so that final recommendations can be discussed, refined and implemented as quickly as possible . There remains a real risk that, even if the Casey Commission delivers robust proposals, they cannot be delivered until the 2030s. That is too long for the people who rely on care and support to wait.

‘The speed at which reform can be delivered is not the only concern about the pace of the Commission. Its recommendations are currently scheduled to be delivered in the run up to another potentially fractious General Election. It emphasises the need for the proposals to be delivered ahead of the election and should place greater cross-party working to achieve broad political support at top of mind for the Casey Commission. A repeat of the 2010 ‘death tax’ and 2017 ‘dementia tax’ controversies must be avoided.

‘The consequences of this Commission’s success or failure will be felt by both the current and future governments for decades to come and makes this an opportunity for change that cannot be missed.’

Notes to editors     

The King’s Fund has made reform of adult social care one of our key priorities as an organisation. We have started a major programme of work in this area, beginning with the publication of our report into public attitudes towards social care this past Monday 2 March: Not My Priority: How The Public Sees Social Care (And What Can Be Done About It) | The King's Fund. We hope this work can assist Baroness Casey and her Commission in helping to fix this failing system.

The next piece of work as a part of this series will be ‘Social Care 360’, which lays out the current state of play for the sector including its finances, which is currently scheduled to be published in the coming weeks.

The King’s Fund previous work on the social care system’s lack of evolution alongside the NHS and greater life expectancy: Why We Should Celebrate The Birth Of Social Care? | The King's Fund.

The King’s Fund previous work on the power of deep public engagement in building awareness of the pressures in the system and what the public think about the potential solution: A Fork In The Road: Next Steps For Social Care Funding Reform | The King's Fund.