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On the 1st December 2021, the British government published the long-awaited White paper: ‘People at the Heart of Care’.

A week on, we have had opportunity to digest its contents, and to form our thoughts about it. Here is a link for you to read or download the full document. We think it’s really important that people are able to access and understand clear information about things which affect them. Below, we have included a summary of some of the key elements of the paper.

What are the headlines?

The paper is heralded as a ten year vision for adult social care, and it covers three core objectives:

1. People have choice, control, and support to live independent lives.
2. People can access outstanding quality and tailored care and support.
3. People find adult social care fair and accessible.

Person-centred care is a recurring theme throughout the paper. There is acknowledgement that…”the ambition of the Care Act has not consistently been achieved in the way we would have liked”.

Key policies

There are some key policies to be introduced over the next three years:

The proposals set out within the White paper are backed by the Health & Care Levy announced earlier this year in September, stating that £5.4 billion is being invested into adult social care over the next three
years.

Further detail

The paper then goes out to break down the three core objectives into finer detail. Under each objective, there is a set of statements, which could be used as a benchmark to demonstrate whether the objectives are being met and embedded at a local level. The statements are written in the ‘first person’ and should be able to stated by anybody drawing on care & support, anyone in an unpaid carer role, or any wider organisations or professionals involved in the delivery of care & support.

The next section of the paper refers to ‘strong foundations’ and makes reference to underpinning legislative frameworks such as:  Mental Capacity Act 2005; Health and Social Care Act 2008, 2012; Care Act 2014 and the Health & Care bill which is currently going through parliament.

In addition, there is further reference to Mental Health Act 1983 (which is currently going through reform); Autism Act 2009; Children & Families Act 2014 which add to the wider legislative framework surrounding Social care.

There is also a statement of intention to publish a further White paper on the integration of health & care services.

The paper sets out some of the current challenges such as:

The next section of the paper emphasises the concept of ‘Right care – Right place – Right time’, with an emphasis on improving the range of housing options available to people and ways to support people to live in homes and communities they choose.

There are a range of case studies throughout the paper which illustrate the themes being presented.

One of the really stand-out elements is the emphasis on unpaid carers (including young carers being recognised), and the willingness to explore models of support for carers that are working well in other countries such as Germany & Australia.

The White paper states the intention for the Department for Education to amend their schools census to clearly include ‘Young carer’ data; to raise the visibility of young carers within the school system. This will also help to build the picture of the impact of  ‘caring’ on school attendance, educational progress and attainment.

There is also a section on supporting people with autism and learning disability into employment.

The paper goes on to lay out further details about improving the Health and Social Care workforce (including support with recruitment, retention and skills/training); and finally how it is going to work with Local Authorities to stimulate new and innovative ways of providing support and a good range of choice for people at a local level.

Independent assessment of Local Authorities within the Health & Care bill

The CQC (Care Quality Commission) as a regulatory body will have a new duty to review how partners of Integrated Care Systems (ICSs) are working together and also to review how Local Authorities deliver Adult social care functions. Under the Health & Care bill (currently going through parliament) the CQC will assess how Local Authorities are meeting people’s needs.

There is an example set of assessment criteria given within this White paper:

The paper concludes by outlining next steps, which mainly cover the introduction of working groups on a number of the new policies being introduced.

Let us know your thoughts- it is helpful for us to hear from people who are interested for different reasons; so we’d love to hear from:

Has this blog been helpful? What do you think about the proposals which are being outlined? If you’re reading this via a social media post, pop a comment below; or alternatively, drop us an email: info@imagineer.org.uk

You can read some of our other blogs here.

 

Yesterday’s announcement

Yesterday’s announcement (7th September 2021) by Boris Johnson, Rishi Sunak & Sajid Javid demonstrates the lack of recognition of the social care crisis we have been experiencing for so many years. The announcement was to share the proposal for a 1.25% increase on National Insurance Contributions as a levy towards Health and Social Care.

With the social care workforce significantly depleted- workers are leaving care to take higher paid jobs in other sectors, offering more financial security and career stability. Loss of freedom of movement following Brexit has meant loss of many migrant workers who were propping up the social care workforce. A survey of the Directors of Adult Social Services last year found that only 4% were confident that they had the budget to meet their statutory duties. This is extremely concerning, but not at all surprising given the many years of austerity measures.

More to do with the NHS than Social Care?

Initial announcements about the new levy suggested that the funding for social care would ensure fairer rates of pay to providers and support for building and improving the workforce. Within 24 hours, the message had changed significantly to messages about NHS recovery from Covid-19 pandemic and #buildbackbetter. At one point in his announcement, Prime Minster Boris Johnson clearly stated that this reform was about reducing waiting lists for NHS. He used the phrase “Biggest catch-up in the history of the NHS” and talked about the levy going towards more emphasis on NHS treatment delays and improving salaries for NHS key workers which had been affected by the Covid-19 pandemic.

Later in the announcement, Sajid Javid commented that funds from the new levy will initially move into the NHS. He went on to say that this was the beginning of wider reforms- referencing the forthcoming integration white paper to deliver health and care as one.

According to the announcement, £36bn will be put into the NHS over the next 3 years. As a rough calculation, if averaged out across the 106 CCGs in the UK, this would be less than £350,000,000 per CCG over a 3 year period. Once broken down into an annual amount per CCG, it suddenly doesn’t sound a lot.  Not an awful lot of money would be left for social care once the issues relating to shortage of nurses, pay rises for NHS key workers & waiting lists have been addressed.

Is Social Care the poor cousin of the NHS?

The people actually paying for social care currently are those who require social care support- often those on low incomes, with additional household and family pressures to manage. It simply isn’t good enough.

It’s a very generic message which (when you dig a little under the surface) has far more to do with putting a sticking plaster over the NHS and very little to do with social care at all. A little extra funding is not going to make any real impact to the very broken social care system long-term, and it sounds as though social care won’t even see any of the funding initially anyway! We need a radical system change. Could ICS’s (Integrated Care Systems) offer an opportunity to develop a more efficient and cost-effective system with a single point of assessment, planning & resource allocation so that people can Self-Direct their own care & support arrangements? Could it offer the opportunity to strengthen communities and bring power, decision-making and financial resources to local areas where it really makes sense?

A clearer message is needed – what is this funding actually for, how will it be rolled out and what difference will it make? It’s worth pointing out that the decision hasn’t actually been made yet at the time of writing- we are yet to hear the outcome of the proposals.

Share your thoughts with us!

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