Long Read  

Still no end in sight for social care crisis

As well as high costs, there are many other issues facing the social care system: there is a shortage of staff, so providers are finding it difficult to meet demand; there are long waits for local authority assessments; and financial uncertainty among councils mean that home care packages are often commissioned by the minute, so the quality and flexibility of care is variable.

Govt action – or inaction

The magnitude of the social care problem meant that many people were disappointed when the health and social care levy – a means to pay for reforms to the health and social care in England – was scrapped.

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Another complexity to the social care system is that all the four countries of the UK do things differently.

The levy, which was established by the Health and Social Care Act, was first announced by ex-Prime Minister Boris Johnson in September 2021, when the government set out plans to reform adult social care in England. 

It said that £5.4bn would be used to fund the reforms between 2022-23 and 2024-25:

  • £3.6bn would be used to reform how people pay for social care (charging reforms). This included £1.4bn to help local authorities move towards paying a “fair cost of care” to providers.
  • £1.7bn would be used to support wider system reform.

The funding was initially planned to come from the new levy – through an increase in national insurance contributions – but in September 2022 the then Liz Truss government announced the levy would be cancelled. 

The then health secretary, Thérèse Coffey, however, said funding for social care would remain unchanged.

Under the now-delayed charging reforms, the government plans to introduce a new £86,000 cap on the amount anyone in England will have to spend on their personal care over their lifetime. 

The cap will apply irrespective of a person’s age or income. The legislative framework for a cap is already provided by the Care Act 2014, but the relevant provisions are not currently in force.

Alongside the cap were plans to raise the lower means test threshold to £20,000 from £14,250 and the upper to £100,000 from £23,250. 

Curry says: “This would make a tangible difference to more people immediately as more people would qualify for part-funding for care costs as their assets would fall below that threshold.”

While the reforms to health and social care were welcome, they were not without controversy. 

Curry says: “The detail of the cap design means that it would take a long time for people to benefit – around three years for someone in a care home and six-plus years for someone with an average care package at home.

“It also does not include the costs of bed and board in residential care so you would still be liable to pay for 100 per cent of them.”