The Casey Commission, set up by the government to explore social
care reform in England, should consider the benefits of moving to
a national system of assessing people's social care needs, such
as in Australia, Germany and Japan. This is a key recommendation
of a new report from The King's Fund called Fixing social
care: the six key problems and how to tackle them.
In the current system, each local authority in England carries
out its own assessment of people's needs and finances, using
national criteria, and there is wide variation in the number of
people accessing care in different parts of the country.
The report says the Casey Commission should specifically consider
the benefits of moving towards national assessment because it
might provide greater consistency and would limit the risk of
individual authorities ‘rationing' care because of budget
constraints. There may also be the potential for efficiency
gains.
The report also says that more people should be entitled to
publicly funded social care. Making the current means-tested
system more generous, along with introducing a cap on care costs,
is the ‘very minimum' reform needed but alternatives such as free
personal care, as in Scotland, or a ‘social insurance' system
such as Germany, where everyone in need receives support though
may have to contribute towards the cost, are potential
alternatives.
The recommendation is part of an analysis of key problems in
social care: access, quality, workforce pay, market fragility,
disjointed care and the ‘postcode lottery' in access and
performance. It includes an assessment of options for improvement
in all these areas.
Other key recommendations from The King's Fund include:
- The cost of providing care should be more of a partnership
between the individual and the state than it currently is, with
the state bearing most of the cost but the individual
contributing if they can afford it.
- The government's proposed £500 million as part of the Fair
Pay Agreement for the care workforce is a welcome first step on a
long-term solution. However, it will not solve long-standing
issues of recruitment by itself.
- It is not sustainable for social care providers to regularly
face cost rises that are far in advance of the fee increases they
receive from local authorities.
- A review of NHS continuing healthcare, which plays an
overlooked role in social care, is overdue.
Simon Bottery, Senior Fellow, The King's Fund and author
of Fixing social care: the six key problems
and how to tackle them, said:
‘It would be a major change to shift away from the principle that
people's social care needs and finances should be assessed by
local authorities. However, it works well in other countries and
now is the time to explore whether it would be an improvement
here as well.
‘The Casey Commission should consider this and other ideas in
this report. However, there is also much that the government
could do in the meantime ahead of the commission reporting,
including ensuring that local authorities have the finances they
need to run the current system fairly and effectively.'
ENDS
Notes to editors
The report will be available to read online at the following URL
from Wednesday: https://www.kingsfund.org.uk/insight-and-analysis/long-reads/whats-your-problem-social-care.
Please note that the link currently displays older content.
The six key problems and solutions as identified in Fixing
social care: the six key problems and how to tackle them
are:
- Access: means testing, unmet need
and selling homes to pay for care
- Quality of care: 15-minute care
visits and neglect
- Workforce pay and conditions:
underpaid, overworked staff
- Market fragility: care providers
struggling to stay in business
- Disjointed care: delayed transfers
of care and lack of integration with health
- The postcode lottery: unwarranted
variation in access and performance
Paying for it: where should the
money come from?
