Spending Review leaves social care the poor relation and facing uncertainty

Responding to the Budget and Spending Review, Nuffield Trust Chief Executive Nigel Edwards said:

“While the NHS has received an additional degree of certainty over its funding, social care is once again treated as the poor relation. The budget set out will not be enough to truly overhaul a broken system that leaves hundreds of thousands without the care they should get, and will not address the urgent situation as we head into winter.

On social care:

“Increases of 3% across all local government services are welcome, but they are not enough to address the disastrous situation in social care. The sector will face a stark choice between trying to improve access to care and support for people, or simply trying to stabilise the system in which care providers are on their knees hampered by a devastating shortage of staff.

“The government has handed the sector an increase in funding with one hand but taken it away with the other given competing pressures on these stretched budgets. The increase in the national living wage and national insurance contributions will put extra pressure on providers. The improvement in wages and unemployment is great news for the UK as a country, but it will drive up the costs of expanding the social care workforce still further at a time when vacancies are spiralling. 

“Without transformative funding, we aren’t going to see the real changes required to truly fix social care: widen access, improve working conditions, support carers or improve the way the system works. It is not clear that there is enough funding available to cover the ambition for people who pay for their own care to get a fair price.

“To raise funds, councils will once again be forced to rely on council tax increases, which does not represent a fair or optimal way to increase funds and widens the gap between areas able to raise more funds and those that can’t.

On the NHS:

“Investment in NHS facilities, buildings and equipment has seen a much-needed rise to over £10 billion a year across the next three years. For some time, the NHS has needed to see some longer-term security around these historically raided budgets which will allow the health service to plan and fund these vital upgrades and projects.

“But the ambition of increasing the number of scans, operations and patients that can be seen, on top of upgrading hospitals, increased construction costs and repairing £9.2 billion worth of urgent maintenance after decades of raided capital budgets will place a heavy draw on these funds.

“It is striking that there is a lack of strategic workforce investment alongside this boost in funding for facilities. Staffing is recognised as the number one issue for the sustainability of the health service. Recovery from the pandemic not only rests on investment but on hard-working staff as well.”