The Health for Care coalition of 15 national health organisations, led by the NHS Confederation, has set out seven key principles for social care reform as it called on the government to introduce proposals early this year.
The Let's do this: the promise of fixing social care report says the government has to seize the opportunity to ensure social care reform goes from a priority in rhetoric to “a priority in practice, backed up by a long-term and fully funded plan”.
“The core message: if you want a functioning, effective NHS, you need a strong and sustainable social care sector,” said NHS Confederation chief executive Danny Mortimer (pictured).
The seven principles are as follows:
1. Sharing costs: A system providing the care people need should be funded by the introduction of a new financial contribution drawn from across the population. This may require differences in when, how, and how much people pay towards the care system.
2. Fair eligibility: Eligibility should be based on need and must be widened to ensure that those of any age with unmet or under-met need have access to appropriate support. Eligibility must also guarantee parity of esteem across physical, mental and cognitive health.
3. Improving integration: Social care services should work more effectively with other sectors, including with the NHS and the housing sector. Personalisation should be at the heart of greater integration, so that care recipients hold maximum possible control over the support they receive, enabling them to live healthy, independent and meaningful lives.
4. Sustainability: Establishing a sustainable social care system will require closing the existing funding gap in the short-term, as well as establishing a permanent funding settlement that would enable both members of the public and care providers to plan for their long-term future. Levels of funding should also sustain a diverse and stable market of providers.
5. Valuing the workforce: More workers should be recruited to, and retained within, the care sector. Furthermore, those who work within the care sector should be offered sufficient pay, higher quality training (along with the protected time away from work to undertake training), opportunities for career progression, and new career paths.
6. Supporting carers: Unpaid carers should be eligible for increased support from the state. Additionally, offers of care should not be reduced on the basis that someone may be a recipient or possible recipient of informal care.
7. Accessibility: The criteria and assessment process for receiving state-funded care should be simple enough for everyone to understand, with guidance on offers of care to be made widely available. In addition, assessments of individuals’ care needs should be conducted by appropriately-trained assessors.
Mortimer said the report contains three common threads.
“First, that social care funding must urgently be put on a sustainable footing. Underfunding risks the viability of the sector and undermines people’s ability to plan for their future. This situation has been tolerated for too long.
"Second, a sustainable funding model is necessary but not sufficient on its own. The aim of social care should be to help people to live as well as possible, having rich and fulfilling lives despite the challenges they face. Social care should be person-centred, accessible and available to all who need it, without pushing them into financial hardship. As the essays make clear, this is vital to people’s wellbeing, and as a result, to the sustainability of the NHS.
“The third is that a failure to reform social care puts in jeopardy the aims of the NHS Long Term Plan, making any meaningful integration of care impossible. Social care keeps people well and at home, preventing unnecessary hospital admissions and improving wellbeing. If the social care system does not have sufficient capacity, the NHS will experience greater demand for its services. This is not good for people in need of care, their carers and, ultimately, the taxpayer.”
