More than £1 billion of the £1.7bn committed to reforming the adult social care system in December 2021 has been diverted to other care priorities, according to a new National Audit Office (NAO) report.
Reforming adult social care in England reveals that only £729 million may now be spent between 2022 and 2025 on reforming the adult social care system, representing a 58 per cent fall in the budget.
Rising inflation has compounded long-standing pressures in adult social care. In addition, concerns about the sector’s contribution to delays to hospital discharge have led the Department for Health and Social Care (DHSC) to reprioritise its reform funding and activity in favour of helping to stabilise the sector.
The NAO also finds local variation in care home funding, and the potential for shortfalls, due to obsolete allocation formulae. DHSC estimates that around a quarter of local authorities may not spend enough to keep up with the cost pressures they face this year, while one in six expects demand for adult social care to exceed capacity this winter.
The NAO report finds that DHSC has much to do if it is to achieve its 10-year ambition for reforming adult social care and must manage significant risks. However, DHSC has not established an overarching programme to coordinate its reforms, or a long-term funded plan. Despite progress in some areas, it is behind schedule even on its revised plans, suggests the NAO.
The NAO recommends that DHSC assesses the impact of its current and planned reform interventions on local authorities and seeks stakeholder views to ensure its plans are manageable. It should also set out a costed plan for implementing charging reform from October 2025, and map the funding required to deliver its planned reform outcomes.
NAO head Gareth Davies said: “To maximise its chances of succeeding, government will need to ensure it understands the impact of its ambitions on local authorities and other stakeholders and establish a costed plan which ensures delivery of its long-term goals.”
Lucinda Allen, senior policy officer at the Health Foundation, added: “The NAO’s report should be a wakeup call to government and political parties ahead of the general election. Successive governments have broken promises to ‘fix’ social care. The current government is no different.”