People at the Heart of Care

There is a lot of detail in the Adult Social Care Reform White Paper: People at the Heart of Care published on 1 December. Whether you are in the public or independent sector there are a number of points to note.

Background

The White Paper puts things in perspective when it notes that the scale of social care and support is vast, affecting the lives of over 10 million adults of all ages in England. In 2020-21 local authorities received over 1.9 million new requests for support from 1.3 million new clients. In total 841,000 people were receiving state funded long-term care in 2020-21. It aims to focus on these people and outcomes, not just the systems behind them.

It is laid out to show what the Government wants people to say (those who draw on care and support / those who are unpaid carers) or do (the NHS, Local authorities, care providers, voluntary and community groups and the wider sector).

The Government believes that their vision is ambitious but achievable. They want the proposals to accelerate their reform “journey” over the next three years and move us towards achieving the 10-year vision. They state that this requires change from national government, local government, housing providers, care providers, health and social care professionals, the care workforce and other partners.

The Care Act 2014 is described as the foundation for social care reform and the Government’s long-term vision.  However it is acknowledged that the full spirit of the Care Act is not currently being met. The White Paper clearly states legislation is only part of the solution.

It is said to make a crucial contribution to plans to transform the provision of community mental health support for people living with severe mental illnesses and complex needs. This in turn is stated to be key to realising the ambitions set out in Reforming the Mental Health Act White Paper to deliver a modern mental health service.

The detail

Chapter 3 lists the interdependent issues such as addressing variation in quality and safety of care, supporting the adult social care workforce and accelerating the adoption of technology. 14.3% of providers were rated “requires improvement” and 1.4% were rated “inadequate” as of November 2021.

There are an estimated 1.56 million jobs with adult social care employers and a further 110,000 NHS jobs providing adult social care.

Technology features heavily in the White Paper – see paragraphs 4.28 – 4.42. 

The aim is to provide the right care, in the right place at the right time.  In chapter 4 the White Paper states that the aim is to make every decision about care a decision about housing.

The role of the new Integrated Care Partnerships and Integrated Care Boards is also covered. They are described as having a “critical role” with a need for strategic leadership. For more information on ICPs, ICBs and Integrated Care Systems visit our ICS Hub.

There is to be a new Innovative Models of Care Programme to address key barriers to embedding and mainstreaming innovation in the sector.

Integrated Care Boards and NHS England will have a new obligation to involve carers when commissioning care for the person they care for.

The Care Quality Commission feature in several parts of the White paper. Firstly, the Government are also considering changing CQC Regulations to require CQC registered providers to be more transparent about their fees. Secondly, they refer to the Health and Social Care Bill, which seeks to introduce a duty for CQC to independently review and assess local authority performance in delivery of their adult social care duties under the Care Act 2014.

There are also to be new powers for the Secretary of State for Health and Social Care to intervene in local authorities to secure improvement where there are significant failings in the discharge of their adult social care functions.

With regard to sustainable markets, the White Paper states that in order to achieve this providers must be paid a fare rate. £3.6bn is being made available to reform the social care charging system and enable all local authorities to move towards paying providers a fair rates for care. Further details are to be announced shortly. It goes on to say that, from October 2023 more self-funders will be able to ask their local authority to arrange their care for them.

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