Commentary: 'What can we do when there are increasing Care needs (UK), but no government long-term thinking and scaled-back social care reform?'

National Audit Office Report and Care England's Response (November 13th 2023)

The National Audit Office (NAO), the UK’s independent public spending watchdog, recently published a report on ‘Reforming adult social care in England’. Care England has expressed concern over the finding. Professor Martin Green OBE, Chief Executive of Care England, said:

“The report unearths an alarming parallel narrative. While the need for care is on the rise, the plans and funding for system reform are being scaled back. This is symptomatic of a broader issue Care England has long since called to be addressed. The solution to the adult social care puzzle is long-term thinking, yet the NAO report finds government over-reliance on short-term policies.”

This is likely to mean that the burden and pressure on Unpaid Carers will continue or worsen, given this lack of system reform. (see Prof. Martin Green's post from Linkedin below or here).

Consider who YOU are caring for today if you/someone you know needs practical help and support because of illness, disability or age, what could this mean for you?

Of course, it’s not just about who we’re caring for today, but also who will care for us if we are diagnosed with a chronic illness, or if we need more help when we get older, in the future.

The irony I’m feeling whilst writing this is that the UK Autumn Statement by the Chancellor is one day before Carers Rights Day, (which also happens to be Thanksgiving in the USA). Imploring support, campaigning and lobbying is important. I’m perhaps cynical as to what will really happen.

Care, be Aware, Prepare & Engage (CAPE) Unpaid Carers are not Superhuman

It would be easy for me to start soapboxing or venting here. For those who know me well, you know I can’t ‘just’ vent, I need to feel like I can pivot and do something.

So let’s ‘TRY, to move from Impotent to I’m Potent’ (sorry, it’s the marketeer in me with tag lines and puns, I’m cringing at myself right now!) BUT still! What can we do, to help ourselves in anticipation of hopefully more support coming in the future? (If some of the organisations and people I know realise their goals then things may certainly shift!)

My recommendation: Prepare ourselves with a support system and information.

Here are a few ideas to get started.

1. Start proactively preparing support for you and your loved ones in terms of community network, and family support system and understanding/defining what is important to you and your loved ones if something happens and you need care-support, or healthcare interventions; their/your wishes. Easy to say, but much harder to do in practice as these discussions are uncomfortable and fraught.

   1. Try to start small with an open question, something like ‘What are their wishes?’ Be gentle and open is my advice, and try not to force things.

   2. Start broaching the topic of official documents like Lasting Powers of Attorney and Wills.

2. ‘Simple’ to-do things:

   1. lists of key contacts (friends - the ones who will be hands on versus updates only, healthcare-related, utilities or house-related support people - electricians, plumbers etc.)

   2. medical history summary, including any recent hospitalisations and if possible the doctors names, current medications summary and highlight recent dose increases or dose decreases or stoppages, highlight allergies and any drug allergies

   3. Have these ready to state: GP practice, NHS number, next of kin or emergency contact, key contact number, address and date of birth

   4. Connect with Carers UK AND mobilise to ensure you’re getting expert advice and support, as well as being part of a Carer-Support network

      1. Carers UK backup contingency planning & tool

In the absence of clarity, it’s possible to create some certainty or at least some ideas to help our path forward. I hope I can offer that through my Carer experience, and this website.

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From Care England

Response to ‘Reforming adult social care in England’

13 November 2023

Care England has today expressed concern over the finding in the National Audit Office’s (NAO) recent report, ‘Reforming adult social care in England’.

In response to the report, Professor Martin Green OBE, Chief Executive of Care England, said:

“The report unearths an alarming parallel narrative. While the need for care is on the rise, the plans and funding for system reform are being scaled back. This is symptomatic of a broader issue Care England has long since called to be addressed. The solution to the adult social care puzzle is long-term thinking, yet the NAO report finds government over-reliance on short-term policies.”

A key finding of the report is that the Department of Health and Social Care (DHSC) has scaled back its short-term plans for system reform and associated funding to £729 million, compared with the £1.74 billion agreed with HM Treasury when DHSC published its white paper in December 2021. This equates to a 58% fall in the budget for system, reform between 2022-23 and 2024-25. Shortfalls such as this present a task to a sector already operating against a backdrop of demographic change, workforce shortages and pressure on local authority finances.

Furthermore, the NAO finds that the DHSC has not established an overarching programme to coordinate its reforms, thereby making it difficult to know if the DHSC is on track to achieve its objectives, and putting additional pressure on local authorities. Implementing policies to make social care an attractive sector to work in, and to ensure providers can continue to deliver fulfilling care to all those who need it is vital for the long-term economic health of the nation. Recent findings from Skills for Care show the adult social care sector adds £55.7 billion per annum to the English economy, making the sector one of the key drivers of the national economy.

Care England’s recent roadmap Care For Our Future, recognises the importance of pragmatic long-term steps to ensure the long-term sustainability of the sector, and recommends that within the first five years of the next Government taking office:

• Consolidate reforms within a fully-funded, long-term adult social care workforce plan

• Deliver a long-term adult social care funding settlement, with a £10bn annual funding boost

• Deliver a fully mapped prevention and integration plan

Care England reiterates the need for future governments to consider the implications of short-term thinking on those who rely on care and support, and those who provide it.

Martin Green continues:

“This report underscores the need for long-term investment into the social care sector with clear measures of success. Care England implores the government to heed this warning ahead of the Autumn Statement this month. With the NAO’s report painting a picture of a broken system, the government must make true on their manifesto promise to fix social care not just for now, but for the long-term.”