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Social care reform “not on course”, think tank concludes

Social care reform that gives every person the dignity and security they deserve is not on course to be delivered, the Nuffield Trust has said in a new think-piece.

It says: “The new Prime Minister will start her job with a mountain to climb if she wants to tell voters at the next election that key promises around health and care were delivered. Some already seem impossible, casualties to Covid-19 and the ingrained refusal to prioritise funding for social care or long-term investment.”

This social care reform pledge made by former PM Boris Johnson in 2019 recognised the poor state of social care, when tens of thousands of people needing support received nothing, and staff and companies providing care alike were being pushed out by years of cuts. The manifesto specifically promised an extra £1 billion in funding, and “a guarantee that no one needing care has to sell their home to pay for it”.

Last year’s white paper did lay out some of the right aspirations for an improved system, but a lack of funding and staff threaten progress. A more generous means test and a cap on care costs are scheduled to be introduced, but the cap will be set at £86,000 and will exclude any contributions made by councils. This likely will not prevent some people needing to sell their homes, and will provide limited financial protection generally to those with modest wealth.

While £1 billion extra was delivered, spending per adult remains lower than it was 12 years ago. Reform plans focus on shifting who pays but do little to increase the amount or quality of care. Poor pay and conditions, as well as a migration squeeze after Brexit, saw alarming declines in staffing last year. There is a real risk that far from every person getting the help they deserve, even more people who need care will go without in 2024.

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