Page 17 - Unfair To Care 2024 - Who Cares Wins

These concerns have also been consistently mirrored by care providers. The announcement of the increase to the National Living Wage in 2024, whilst welcomed by the care sector, is an unfunded pressure that both council commissioners of care13 and care providers14 have expressed is financially unsustainable15
without government support to meet the costs.
The gap between the costs of providing care and the fee levels offered by local authorities has also been highlighted by the Government’s Fair Cost of Care16 process and in independent analysis by different segments of the care market such as homecare17 and specialist care providers.
The 2024 Sector Pulse Check report18, delivered by Hft and Care England, reveals that two in five providers of adult social care reported a deficit, 43% closed a part of their organisation or handed back contracts, and almost one in five made staff redundancies and offered care to fewer people in 2023.
It is clear that fair pay for frontline care and support workers will require additional central government funding, as local authorities and providers to state- funded users of social care, do not have the resources to change these conditions directly. This report shows that this support should be seen as an investment that delivers a return in increasing sustainability and a positive impact on the health and social care system.
INTEGRATED CARE SYSTEM FOCUS ON IMMEDIATE HEALTH NEEDS
Integrated Care Systems (ICSs) are dual structure partnership bodies created to break down the silos between health services and social care to improve people’s experience of care and improve the efficiency and effectiveness of the system as a whole.
ICSs have made a good start19 in a challenging environment but the post-Covid legacy of the lengthy backlog of people waiting to be given the health care they need risks pulling system resources and priorities towards clinical, rather than social care, towards hospital-based rather than community- based treatments, and towards cure rather than prevention.
The 2023 independent Hewitt Review20 of ICSs made several recommendations for improving the current system, including that “given the interdependence of health and social care, the Government should produce a complementary strategy for the social care workforce. More should also be done to enable flexibility for health and care staff, both in moving between roles and in the delegation of some healthcare tasks.”
A NATIONAL SOCIAL CARE WORKFORCE PLAN
Released in October 2023, the Skills for Care report on the state of the adult social care workforce in England (referenced earlier in this report) is a comprehensive and thorough analysis of the workforce including its size and structure, employment status, recruitment and retention, demographics, pay, qualifications and training, workforce projections and staff turnover. This has been used to inform several aspects of this report.
Unlike many other public-funded sectors, including the NHS, social care does not have a unified national workforce strategy and pay framework – an issue that is at the core of the disparity between these two interdependent sectors.
The current government has announced their intention to develop a care workforce pathway. However there is, as yet, no government plan to develop a national pay scale for the care workforce, equivalent to the NHS’s Agenda
for Change21 pay framework, nor a long-term workforce development plan equivalent to the NHS Long Term Workforce Plan22. Instead, Skills for Care has now taken the lead in developing a national care workforce strategy without direct government involvement.
SECTION 3: INTRODUCTION
17
13. 14.
15 16 17
’Autumn statement 2023: LGA Submission’, Local Government Association,
October 2023
’Low Pay Commission consultation on national minimum wage rates’, Care England, June 2023
’Local authority fee rate data and interactive maps’, ARC England, November 2022 ’Fair cost of care analysis’, Care England, March 2023
‘The Homecare Deficit 2023’, Homecare Association, October 2023
18
19
20
21 22
‘Sector Pulse Check: A snapshot of finances and the workforce in the adult social care sector in 2023’, Hft and Care England, analysis by CEBR. January 2024
’The state of integrated care systems 2022/23: Riding
the storm’, NHS Confederation, August 2023
‘The Hewitt Review: An independent review of integrated care systems’, Patricia Hewitt, April 2023
’Agenda for Change’, NHS Employers, December 2004
’NHS Long term workforce plan’, NHSE, January 2024
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BETWEEN 2010/11 AND 2020/21 TOTAL GOVERNMENT FUNDING FOR LOCAL AUTHORITIES ACROSS ENGLAND HAS FALLEN
52.3%
(According to the National Audit Office)