Think-tank slams Health and Care Bill integration plans

How can social care cooperate with the NHS to create a better system when it currently lacks the money or staff to provide basic care to people who need it?

That is a key question asked of the Government by think-tank The Nuffield Trust in its analysis of the Health and Care Bill, now going through Parliament.

In its analysis, Nuffield Trust describes the Health and Care Bill as doing very little to address the severe and worsening crisis in social care. It says: “The admirable goal of the NHS working better with social care will not be achieved if the sector is failing to deliver basic support and protection, as is the case today. How can social care cooperate with the NHS to create a better system when it currently lacks the money or staff to provide basic care to people who need it?”

According to the Trust, among important elements for social care missing from the Bill are the following:  

Workforce planning: Clause 33 of the Bill creates a duty for the Secretary of State to report every five years on who is responsible for securing enough NHS staff. This report would simply describe the system that exists. It would do little to improve workforce planning. Along with the King’s Fund and Health Foundation, we have suggested instead a proposal that would introduce independent forecasts of how many staff there will be and how many will be needed, in both health and social care. We believe this would provide accountability and help planning.

Lack of significant reform: The Bill also includes several minor changes around social care, which do not constitute significant reform: a new duty for the Care Quality Commission (CQC) to assess how well councils are fulfilling their social care duties; low fees have pushed many care homes and agencies who send carers out into bankruptcy or refusing council contracts.

The rationale for improvement includes:

Key points include:

  • 163,000 people aged over 65 in England need help with three or more activities of daily living but receive none
  • Those who do access care by paying themselves can run up catastrophic costs with no protection.
  • The social care workforce faces high turnover and vacancy rates, likely due to poor pay, terms, and conditions.

View the passage of the Health and Care Bill online.

View CHM editor’s comment, and analysis of Integrated Care Systems in the July/August issue of CHM available [online] now

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