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Paying for social care: beyond Dilnot

The government's commitment to implementing the proposals of the Dilnot Commission has been included in the Care Bill that is now before parliament. This paper considers the planning and funding needed to meet the social care needs of the future and calls for the total quantity of resources to be assessed to ensure that people have access to the right level of support.

Paying for social care: Beyond Dilnot discusses the history of social care reform and considers the present and future funding pressures on the system. The paper calls for health and social care services to be considered as a single system with a new framework being put in place for planning and cost-sharing. It suggests health and wellbeing boards should play a key role in ensuring that care reform is part of wider transformation of local health and care services.

Key findings

  • The government's decision to implement the proposals of the Dilnot Commission is a significant stepping stone to wider reform, but the Care Bill currently before parliament will not on its own solve the social care funding challenge.

  • The cap on care costs for individuals is an important achievement in the current economic climate and will protect people from catastrophic personal costs previously associated with social care.

  • Social care reforms will be challenging to implement and will involve substantial extra work for local authorities when they are facing the most severe financial challenge in their history.

  • There needs to be debate about the options for funding the quality and quantity of future care and about overcoming current divisions in health and social care funding. The King’s Fund will shortly announce a fundamental review of the way that health and social care entitlements, benefits and funding are organised.

Policy implications

  • Robust and detailed planning arrangements will be needed to implement the Dilnot proposals.

  • The relationship between the NHS and the social care system and funding divisions between them needs to be reassessed: the 2015/16 Spending Review should be used to move towards a single strategic budget for the NHS and adult social care.

  • The role of local government through its new public health responsibilities will be crucial in tackling the underlying causes of ill health and reducing future demand for health and care services.