The King’s Fund welcomed this debate which provided an important opportunity to discuss the pressures facing social care.
This briefing draws on three main sources:
- The report of the Barker Commission (Commission on the Future of Health and Social Care in England 2014), an independent commission established by The King’s Fund to consider the future of health and social care in England.
- Social care for older people: home truths (Humphries et al 2016), a report published jointly with the Nuffield Trust based on research in four local authority areas.
- A statement on health and social care ahead of the Autumn Statement, published jointly with the Nuffield Trust and The Health Foundation (2016).
- The inability of successive governments to reform social care has resulted in a failing system that is increasingly unable to meet the needs of those who depend on it. England remains one of the few major developed countries that has not reformed the way it funds long-term care in response to the needs of an ageing population.
- After six years of unprecedented budget reductions, the number of people aged over 65 accessing publicly funded social care has fallen by at least 26 per cent. This is placing an unacceptable burden on families and carers and leaving increasing numbers of older people who have difficulty with the basic activities of daily living without any support.
- These problems are also exacerbating pressures on the NHS. Nearly 570,000 bed days were lost during quarter two 2016/17 as a result of delays in discharging patients from hospital, with problems in arranging social care now the main reason given for these delays.
- Despite the ageing population and rising demand, UK public spending on social care is set to fall to less than 1 per cent of GDP by the end of this parliament, leaving thousands more older and disabled people without access to services.
- Reductions in fees paid by local authorities and other cost pressures, such as the National Living Wage, are squeezing the incomes of care providers. An increasing number are likely to leave the market or go out of business as a result, jeopardising the continuity of care on which older people depend.
- Measures announced in the Spending Review 2015 to increase funding for social care are welcome but will still leave a funding gap of at least £1.9 billion in 2017/18 and £2.3 billion by the end of this parliament.
- As a minimum, the Autumn Statement must recognise the immediate funding pressures facing the sector by bringing forward to 2017/18 the additional funding that will be provided through the Better Care Fund, which is planned to reach £1.5 billion by 2019/20.
- Beyond this, the social care system needs fundamental reform. This requires cross-party consensus and a frank and open debate about how to fund health and social care in future.
- The King's Fund continues to believe that the report of the Barker Commission, which recommended a new settlement for health and social care based on ending the historical divide between the two systems and moving to a single budget and a single local commissioner of services, provides a starting point for this debate.