Social care reform: running out of time and money?

Social care was conspicuous by its absence in last week’s Budget, despite the troubled sector being just weeks away from having vital financial support removed. With the issue of reform also evaded once more, Nina Hemmings and Camille Oung assess where things stand.

Blog post

Published: 12/03/2021

Sizeable sums were pledged by the Chancellor in this year’s Budget to support the UK’s economic recovery, but there was no mention of social care. That is despite the chronically overlooked sector contributing £46.2 billion a year to the economy and staring this month at crucial financial lifelines being cut off.

It provided no reassurance to those hoping that perennially delayed social care reform was still somewhere near the top of the government’s agenda, nor did it bring short-term financial relief for providers who are possibly just three weeks away from the brink – the impact of which would be devastating for the many people so reliant on them. In this blog, we look at both the immediate funding cliff edge facing the sector during the pandemic, and also the thorny issue of wider social care improvements that have yet again been sidestepped.

Inaction has consequences: the toll of Covid-19 has made that clear

The pandemic has shone a light on the deep-rooted problems of social care. It has been hit particularly hard by the crisis, illustrating the stark human cost of not supporting the sector. Many people receiving social care have sadly fallen victim to Covid-19, and others have seen services break down with severe consequences for their safety and wellbeing. Social care workers, as well as the millions of people who provide informal care, are exhausted and in need of support and better working conditions.

The sector was in a fragile state before the pandemic and has had to rely heavily on short-term emergency support to get it this far. While such measures appear to have been helpful, the lack of clarity on whether this support will be extended is a huge concern. It is difficult to see how providers can put guidance into practice when the funding schemes that support them to do so safely will abruptly come to an end this month. The pandemic will not come to a neat end on the 31st of March. 

Safe visits to care homes have begun this week, requiring every visitor to be tested, but the Rapid Testing Fund which enables that to happen also expires this month. Similarly, the government published guidance last week on restricting staff movement to minimise infection, yet the Infection Control Fund and Workforce Capacity Fund – which enable staff to access regular testing, PPE, and to self-isolate at their normal wages – are also due to end this month. There is no sign as yet of these being extended.

Continued investment in these funding streams is critical to protect those in need of care and the people delivering it. While the vaccination programme will help protect many staff and care users, in the immediate term we will continue to need robust infection control measures in place.

Removing financial support now, rather than extending it, will not only hamper the sector’s recovery but also impact on particularly vulnerable groups disadvantaged throughout the pandemic, especially people with learning disabilities. Support for those returning from hospital is also needed to help ensure people – some of whom will be recovering from treatment for Covid-19 – can return to living independently and safely in their communities.

That Covid-19 has not yet shifted the tendency to provide piecemeal funding in time-limited instalments continues to make it difficult for care providers to plan ahead. Social care users and providers are rightly worried that, in the absence of reassurance in the Budget, their services will be further impacted. 

Pulling away pandemic support funding too early could be fatal, and would be the latest in a long line of mistakes to affect the beleaguered sector.

What next for social care?  

As well as helping the sector to survive the ongoing pandemic, it’s clear that we also need to see action on reform from the politicians who promised to do so. The integration white paper has hinted at some incremental changes, but these fall short of the substantive reform promised by the Prime Minister in the summer of 2019, well before the emergence of Covid-19. He said that the government would not “wait to fix the problems of social care”, before the commitment in last year’s spending review that the government “will bring forward proposals next year”.  

Reform will need to be all-encompassing – a complete upheaval that will provide a step-change in the working conditions of social care staff, much-needed support and recognition of unpaid carers, stability for providers, and, crucially, security and certainty for those in need of care. The multi-year spending review may now be an opportunity to create cooperation for change and to drive through reform. 

The international examples we’ve looked at have shown that social care reform can be achieved even in the most unthinkable political and economic circumstances. Covid-19 has caused more of the public to confront the cold reality of the problems in social care, but at the same time has helped bring the need for clear principles and a vision for a care service fit for the 21st century to the forefront of public and political debate.

Reform is possible if the will exists to achieve it. We need to give social care more than just a lifeline, but a solid ground on which to stand for many years to come.

Suggested citation

Hemmings N and Oung C (2021) “Social care reform: running out of time and money?”, Nuffield Trust comment.