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What now for social care?

As the government gets back to something approaching normal following months of turmoil, Care England’s chief executive Professor Martin Green looks at what’s next for social care.

After months of political turmoil, we finally have a government that will offer a bit of stability and clarity about how they will support social care. The government has given clear commitments to austerity, which will mean cuts in public expenditure. It will be challenging for social care to make its case to the Treasury when there are so many other compelling cases that want extra money. I have heard that because Jeremy Hunt is now the chancellor, health and social care will get a more sympathetic hearing. I know that this is true, but we should not delude ourselves into believing that the chancellor can deliver everything, and while his previous roles give him a better understanding of health and social care, he has the difficult job of balancing the budget and ensuring that the enormous debt that was accrued during Covid-19 starts to be repaid. The economy is well positioned to take advantage of growth as the world comes out of this long-expected and deep recession.

For this reason, we must make an extremely strong case to the Treasury, and we need it to be multifaceted. Not only do we need to talk about the impact social care has on people’s lives, but we also need to put it in the context of the NHS and the broader economy. Just telling the world that we do wonderful work will not automatically deliver better funding.

What we need from the government is a clear and long-term funding policy. The local authorities have recently gone through a cost-of-care exercise, and this has clearly shown the enormous gap between the true cost of care and what local authorities are paying. It is disappointing that the DHSC is not putting this data into the public domain because this will need to form the basis of a realistic debate about what it costs to deliver high-quality care and where we are going to get the money required to have a sustainable and long-term future for our sector.

The biggest problem that social care faces is the workforce challenge. Throughout the entire sector, the workforce position is critical, and Skills for Care recently reported that there were 165,000 vacancies. This is leading to huge problems for people who currently receive services and acts as an enormous barrier to the millions of people with unmet needs. I have seen in recent months many care services that have reduced capacity for no other reason than they cannot find the staff to deliver the required care. Unless we get a comprehensive workforce strategy for social care which recognises that we need to move towards professional status and remuneration, we will constantly find ourselves competing with other sectors of the economy and not being able to offer the proper pay to recruit staff.

There are now new structures in

place, and integrated care systems need to engage the care sector early so we can be involved in finding solutions to enormous problems that affect local communities. Currently, most ICSs are dominated by the NHS, but they are tasked with delivering an integrated workforce strategy. This will only be achieved if they ask the social care sector to help craft the solution. The integration

“Not only do we need to talk about the impact social care has on people’s lives, but we also need to put it in the context of the NHS and

the broader economy. Just telling the world that we do wonderful work will not

automatically deliver better funding.” “The biggest problem that social care faces is

the workforce challenge. Throughout the entire sector, the workforce position is critical, and Skills for Care

recently reported that there were 165,000 vacancies”

“The starting point for developing any technology must be that it provides better outcomes for those

who use services. We must

also be clear that it has

to improve efficiency and outcomes.”

Martin Green

“I cannot pretend that the next few years will be easy for social care, but we must

make a compelling case to the government about our essential role as a part of national infrastructure. ”

will require staff to move seamlessly across systems just as citizens do, and we have got to address the disparity in pay between the NHS and social care staff. In reality, much of their work is exactly the same, and they look after people with very complex needs. There is a need to see international recruitment as one part of meeting the workforce challenge, but we also need a much longer-term view on how we encourage people to join our sector. It’s also important that we start to reach out to a range of people with whom we currently haven’t engaged, who will make an excellent contribution to the social care workforce. For example, many former carers have the values and skills to contribute to our workforce, but we are very bad at engaging them.

The workforce challenge must also lead us to think creatively about technology use. Traditionally the social care sector has lagged behind in its use of technology and data. Still, we must recognise the potential of technology to deliver highquality care and to support people with complex needs. The starting point for developing any technology must be that it provides better outcomes for those who use services. We must also be clear that it has to improve efficiency and outcomes.

Social care is also in desperate need of some very robust data sets, because what was apparent during the pandemic was that there are good data sets from the NHS, but social care was lagging. In the future, we must be more data-driven, which will help us direct our resources to those in most need and also deliver preventative and more effective services.

I cannot pretend that the next few years will be easy for social care, but we must make a compelling case to the government about our essential role as a part of national infrastructure. We are part of that infrastructure because we transform people’s lives. Still, we are also part of the national economic infrastructure, and social care is an important part of local economies. It must also be remembered that many people would not be economically active if it were not for social care supporting the people they love.

I know the chancellor is committed to social care and health, and he will do all he can to try and protect services, but he is in a very tough job, and we should not expect to get everything we need immediately.