The first steps to social care workers getting fair pay and conditions were announced in the King’s Speech on the 17th July. A welcome move for a sector with serious workforce issues, but it’s not the reform that those in the sector want and that has been promised for so long. And there is still the issue of how it will be funded.
The King’s Speech included:
“establishing a Fair Pay Agreement in the adult social care sector and, following review, assess how and to what extent such agreements could benefit other sectors.”
ADASS, the Association of Directors of Adult Social Services, responding on the social media site X said:
“Improved pay & conditions is key to developing a first-class social care workforce, so the fair pay agreement in #KingSpeech is a welcome first step. But given the significant financial challenges facing local councils & care providers, any pay agreement must be funded nationally.”
Vic Raynor, CEO of the National Care Forum, welcomed the Employment Rights Bill and the draft Equality (Race and Disability) Bill, as a move to “enhance the rights of care workers and protect them from exploitative practices.”
But added, that:
“It will be vital that this fledgling legislation is followed up with a clear commitment to properly fund all increases in pay, for a longer-term focus on the broader package of support for the workforce, and to support the infrastructure needed to embed a new approach to pay negotiations that will support the over 1.5 million strong workforce and the establishment of a meaningful and rewarding career pathway.”
As welcome as the fair pay proposal is, those in social care were disappointed that there was so little concerning reform of social care in the speech. Raynes noted:
“the King’s Speech was disappointingly devoid of any detail on how, and equally importantly, when wider reform of adult social care would come forward. The new government must act with urgency and purpose to begin the reform of the social care system now. We are keen to hear more solid plans and timescales around Labour’s development of a National Care Service as part of this reform.”
The King’s speech came just a day after the release of the ADASS Spring survey report, which showed the increasing crisis in adult social services, with over 418,000 people waiting for assessment, dwindling support for unpaid carers, an increasing population with complex and expensive care needs, and councils running out of money and having to dip into financial reserves to cover basic services.
Workforce and pay is an issue, but what ADASS, and others working in the social care sector, want is a commitment to a fully funded long-term plan for social care, as Melanie Williams, President of ADASS noted on the release of the survey report – without long-term investment in social care, spending more on the NHS will be like “pouring water down a sink with no plug in.”
The ADASS report highlights the interdependency between the NHS and adult social care and the impact of recent NHS initiatives on council finances. In particular, the recent push to discharge people from hospitals quickly has led to an increased number of people with very complex needs requiring social care from councils. Such care is expensive and councils on limited budgets are struggling to fund this care and at the same time provide social care for thousands of other vulnerable people.
At the same time, those waiting for NHS treatment, often deteriorate and lose independence, and consequently require more social care support.
ADASS’s spring survey found a 7.5% increase in the number of people requiring multiple visits from two or more care workers, called ‘double handed care’ since the previous year. Plus the average size of care packages for people being discharged from hospital has increased in 76% of council areas over the past 12 months.
Councils are also having to fund an increasing number of people whose care and support had been covered by the NHS (Continuing Healthcare – CHC) or jointly funded, but have now been denied CHC. The NHS is tightening up on who it funds, but the effect is to pass the cost on to councils.
Williams noted:
“Instead of focussing on investment in hospitals and freeing up beds, the new Government must shift to investing in more social care, supporting unpaid carers, and providing healthcare in our local community to prevent people reaching crisis point and ending up in hospital in the first place.”
The increase in complexity of need and its associated higher cost was ranked by Directors of adult social care as the greatest pressure on budgets.
The overspend on budgets is at its highest for a decade, with most councils dipping into financial reserves to cover the basics. For 2023/24 nearly three-quarters (72%) of councils in England overspent on their adult social care budgets, compared to 63% in 2022/23. The overspend nationally for 2023/24 totalled £586mn (based on 145 responses in the survey), up significantly from £74mn in 2022/23.
Worryingly, the survey found only 10% of Directors think their budgets will be enough to meet statutory duties.
ADASS notes that councils, care providers and all involved in providing and receiving social care need the “greater stability and certainty” that multi-year funding settlements bring.
Responding to the ADASS Spring Survey, Dr Rhidian Hughes, Chief Executive of the Voluntary Organisations Disability Group (VODG) said:
‘The latest evidence from the Association of Directors of Adult Social Services demonstrates the urgent need for the new government to prioritise adult social care funding and reform alongside its ambitions for the NHS. While the two are funded and operate separately, we will increasingly see councils failing to meet the needs of those it has a statutory duty to support.”
Dr Hughes called for “radical action” to “reframe relationships and rebalance power” between the different parts of the system, the NHS and social care, to reverse the decline and echoed ADASS’ call for councils to have a multi-year settlement to provide stability to the market and more personalised support for individuals and families in need.”
Cllr David Fothergill, social care spokesperson for the LGA also called for longer-term funding:
“The LGA is calling for immediate investment in adult social care to tackle the urgent issues affecting services and pave the way for a longer-term and sustainable settlement. This needs to be delivered alongside a long-term care workforce plan and a shift to a more preventative model of health and wellbeing.”
Prior to the election Labour had in its manifesto the development of a National Care Service, which was welcomed by social care organisations and unions. Pay reform was part of the NCS, but little detail has emerged on any other aspects.
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