Select Committee · Housing, Communities and Local Government Committee

Long-term funding of adult social care

Status: Closed Opened: 4 Mar 2021 Closed: 5 Mar 2024 22 recommendations 14 conclusions 1 report

This inquiry will focus on how adult social care should be funded in the long-term. The Committee aims to understand the extent to which the Covid-19 pandemic has changed the landscape for long-term funding reform since we published recommendations on the subject together with the Health and Social Care Committee in 2018. The inquiry will …

Clear

Reports

1 report
Title HC No. Published Items Response
Second Report - Long-term funding of adult social care HC 19 4 Aug 2022 36 Responded

Recommendations & Conclusions

17 items
4 Conclusion Second Report - Long-term funding of ad… Acknowledged

The Rt Hon Boris Johnson MP said as Prime Minister that he would fix the...

The Rt Hon Boris Johnson MP said as Prime Minister that he would fix the crisis in social care once and for all. We commend the Government for attempting to prevent unpredictable and catastrophic care costs for people and introducing reforms to the sector where previous Governments failed to act. …

Government response. The government acknowledged the concerns around the impact of charging reforms and stated they have provided funding for charging reforms, but do not address the concerns that they have underestimated the combined cost of introducing a new cap and more …
Ministry of Housing, Communities and Local Government
6 Conclusion Second Report - Long-term funding of ad… Acknowledged

We do not wish to pit the NHS and adult social care against one another.

We do not wish to pit the NHS and adult social care against one another. The two systems are interdependent and each needs to be adequately funded to reduce pressure on the other. Wherever the money comes from—from allocating a higher proportion of levy proceeds to social care, or from …

Government response. The government recognises the committee’s concerns around the impact of charging reforms on social care assessors and will work with IT suppliers and local authorities, supporting local areas to trial and invest in innovative approaches to reforming operating models and …
Ministry of Housing, Communities and Local Government
7 Conclusion Second Report - Long-term funding of ad… Acknowledged

We do not accept the Government’s position that care providers should not be compensated for...

We do not accept the Government’s position that care providers should not be compensated for employer National Insurance Contributions in relation to the Health and Social Care Levy simply because they are, on the whole, private businesses. We heard again and again that there should be parity of esteem between …

Government response. In light of the new timeline to implement charging reform, the government will be reviewing the delivery plan and considering how to ensure that insights from Trailblazers can be effectively fed back into the development of delivery to refine or …
Ministry of Housing, Communities and Local Government
8 Recommendation Second Report - Long-term funding of ad… Acknowledged

While the Government has provided funding for its charging reforms, we received many concerns that...

While the Government has provided funding for its charging reforms, we received many concerns that it has underestimated the combined cost of introducing a new cap and more generous means test, commencing Section 18(3) of the Care Act 2014 in respect of residential care, and the fair cost of care. …

Government response. The government acknowledges the committee's interest in proposals to improve fee transparency and describes existing initiatives like the Market Sustainability and Fair Cost of Care Fund and the Market Sustainability and Improvement Fund, as well as a commitment to consider …
Ministry of Housing, Communities and Local Government
9 Recommendation Second Report - Long-term funding of ad… Acknowledged

It is nevertheless disappointing that people currently living in and paying for residential care, whose...

It is nevertheless disappointing that people currently living in and paying for residential care, whose payments before October 2023 will not count towards the cap, will now not be able to access local authority rates until 18 months later than they were originally told. The Government should put every effort …

Government response. The government states they agree with the committee’s recommendation for market shaping to include a dedicated focus on outcomes-based commissioning and investing funding to strengthen local authority market-shaping, commissioning, and contract management capability.
Ministry of Housing, Communities and Local Government
11 Recommendation Second Report - Long-term funding of ad… Acknowledged

The Government should publish real-time and regular evaluation, both of the trailblazer scheme and of...

The Government should publish real-time and regular evaluation, both of the trailblazer scheme and of the charging reforms when they are rolled out more widely, so that local authorities can apply insights quickly and so that the Government can provide further funding in a timely manner where necessary should its …

Government response. The government states it understands the benefits for councils of a Local Government Finance Settlement (LGFS) spanning multiple years and will aim to provide a multi-year funding settlement wherever possible in recognition of its importance to councils’ budget setting processes …
Ministry of Housing, Communities and Local Government
12 Recommendation Second Report - Long-term funding of ad… Acknowledged

Given the Government’s investment in the fair cost of care, and our calls for further...

Given the Government’s investment in the fair cost of care, and our calls for further funding and for care providers to be compensated for their employer National Insurance Contributions of the Health and Social Care Levy, it is all the more important that the additional funding reaches the frontline. However …

Government response. The government acknowledges the desire for clarity on distribution reform but states that they will not be proceeding with the Review of Relative Needs and Resources or Business Rates Reset during this Spending Review, focusing instead on stability and clarity.
Ministry of Housing, Communities and Local Government
13 Conclusion Second Report - Long-term funding of ad… Acknowledged

While achieving a fair price of care is vital, price should not be the driving...

While achieving a fair price of care is vital, price should not be the driving factor in commissioning care. Reforms in relation to improvement and market shaping should include a dedicated focus on outcomes-based commissioning, drawing on existing good practice by local authorities. (Paragraph 64) Local government finance

Government response. The government recognizes the concerns of local government and notes the delay to planned adult social care charging reforms. They will comply with the New Burdens Doctrine for relevant aspects of the adult social care reform programme.
Ministry of Housing, Communities and Local Government
14 Recommendation Second Report - Long-term funding of ad… Acknowledged

As well as the desperate human impact on those needing, receiving, and providing care, the...

As well as the desperate human impact on those needing, receiving, and providing care, the underfunding of adult social care has led to many councils having to cut other public services in order to do their best to meet their care duties. The Government should address three core issues to …

Government response. The government restates its commitment to the 10-year vision for adult social care set out in the People at the Heart of Care white paper and highlights actions being taken over the next two years to take the next step …
Ministry of Housing, Communities and Local Government
17 Recommendation Second Report - Long-term funding of ad… Acknowledged

The geographical inequity of relying on council tax to provide the majority of funding for...

The geographical inequity of relying on council tax to provide the majority of funding for adult social care is compounded by an out-of-date adult social care relative needs formula. The Government must update the adult social care relative needs formula by the next financial year. This should be implemented alongside …

Government response. The government states that they remain committed to providing care and support in a person’s own home, but have taken the difficult decision to not progress with the £300 million investment in housing, announced in the white paper, in order …
Ministry of Housing, Communities and Local Government
19 Recommendation Second Report - Long-term funding of ad… Acknowledged

Stakeholders have called for adult social care reform for years, and we commend the Government...

Stakeholders have called for adult social care reform for years, and we commend the Government for introducing many welcome initiatives such as around housing and data that could make a significant difference in the long-term. We are also pleased that many stakeholders welcome the Government’s vision for what good care …

Government response. The government notes that the Older People’s Housing Task Force will provide an opportunity to consider detailed evidence of the operation of the planning system in supporting housing for older people and whether any changes are required, including in respect …
Ministry of Housing, Communities and Local Government
20 Conclusion Second Report - Long-term funding of ad… Acknowledged

The lack of information about how the reforms add up to £5.4 billion, why each...

The lack of information about how the reforms add up to £5.4 billion, why each reform was allocated the amount it was allocated, and how funding will be distributed, does little to instil confidence that the Government has thought through its plans. We have expressed our concerns numerous times about …

Government response. The government emphasizes that local authorities are responsible for ensuring sufficient workforce capacity to meet care needs in their area, and highlights the measures they are taking subject to monitoring and evaluation.
Ministry of Housing, Communities and Local Government
21 Conclusion Second Report - Long-term funding of ad… Acknowledged

Given how fundamentally social care policies made by DHSC affect local authorities’ capacity, budgets, and...

Given how fundamentally social care policies made by DHSC affect local authorities’ capacity, budgets, and residents, it is vital that DHSC and DLUHC work together closely on developing and delivering such policies. We were struck by the discrete division of answers to questions by Ministers, who rarely supplemented one another’s …

Government response. The government acknowledges the importance of health and care staff and integrated care systems working with local authorities, but emphasizes the distinct nature of the social care sector as primarily private.
Ministry of Housing, Communities and Local Government
23 Recommendation Second Report - Long-term funding of ad… Acknowledged

The Government should create a separate taskforce for housing for working age disabled adults alongside...

The Government should create a separate taskforce for housing for working age disabled adults alongside the taskforce for housing for older people. Both taskforces should be accountable to both DLUHC and DHSC and should report to the Senior Responsible Officer for the People at the Heart of Care programme. Their …

Government response. The government points to their 10-year white paper reform vision and states that they will invest up to an additional £25 million for unpaid carers. They are also taking steps towards implementing a new survey of unpaid carers.
Ministry of Housing, Communities and Local Government
29 Conclusion Second Report - Long-term funding of ad… Acknowledged

Our broken care system is held up by unpaid carers doing vital work out of...

Our broken care system is held up by unpaid carers doing vital work out of love and pride. The cost to them can be financial, physical, and emotional. The cost to our economy of carers leaving the workforce is over £3 billion each year—money that could be invested in adult …

Government response. The government recognizes the vital role of unpaid carers and the importance of supporting them and highlights the Care Act 2014 and Better Care Fund (BCF) as ways they are providing support, and will look to improve the clarity and …
Ministry of Housing, Communities and Local Government
32 Conclusion Second Report - Long-term funding of ad… Acknowledged

During this inquiry we heard about a proposal for a national care service, under which...

During this inquiry we heard about a proposal for a national care service, under which health and social care would be delivered by the same organisation. This would be similar to systems in place in Northern Ireland and Wales. This proposal was roundly dismissed by our witnesses. We support the …

Government response. The government recognizes the importance of collaboration between commissioners and providers within integrated care systems (ICS) and will provide further support and advice to help places develop their approaches where needed, including reviewing ICS boundaries in certain areas.
Ministry of Housing, Communities and Local Government
34 Recommendation Second Report - Long-term funding of ad… Acknowledged

Integration strategies should seek to integrate not just health and care but health, care and...

Integration strategies should seek to integrate not just health and care but health, care and housing. Ensuring there is holistic care that fits around a person’s needs includes preventing care needs from arising by having suitable housing, enabling people to live independently in their own homes, and ensuring that people …

Government response. The government agrees that holistic care should include housing and highlights examples of integrated approaches in areas like Greater Manchester and states their Integrated Care Strategy guidance encourages integrated care partnerships to have a joined-up approach to housing.
Ministry of Housing, Communities and Local Government

Oral evidence sessions

5 sessions
Date Witnesses
23 May 2022 Alex Skinner · Department for Levelling Up, Housing and Communities, Gillian Keegan · Department of Health and Social Care, Kemi Badenoch · Department for Levelling Up, Housing and Communities, Michelle Dyson · Department for Education View ↗
25 Apr 2022 Adrian Jenkins · Pixel Financial Management Ltd, Gavin Edwards · UNISON, Sarah Pickup · Local Government Association View ↗
13 Dec 2021 Charles Tallack · Health Foundation, Chris Smith · Thirteen Group, Dr Eleanor Roy · Chartered Institute of Public Finance and Accountancy (CIPFA), Natasha Curry · Nuffield Trust, Paul Teverson · McCarthy Stone, Professor Philip Booth · Institute of Economic Affairs, Sally Warren · Department of Health and Social Care (DHSC), Sue Ramsden · National Housing Federation View ↗
29 Nov 2021 Brian Dow · Rethink Mental Illness, Emily Holzhausen · Care and Support Alliance, Fazilet Hadi · Disability Rights UK, Jackie O'Sullivan · Care and Support Alliance, James White · Alzheimer’s Society, Ruthe Isden · Age UK View ↗
25 Oct 2021 Cllr Tim Oliver · County Councils Network, Dr Jane Townson · Homecare Association, Jane Ashcroft CBE · Anchor Hanover, Stephen Chandler · Association of Directors of Adult Social Services, Steve Scown · Dimensions UK View ↗

Correspondence

13 letters
DateDirectionTitle
12 Sep 2023 To cttee Letter from the Minister of State for Social Care, Department for Health and So…
15 Jun 2023 To cttee Letter from the Chair to the Minister for Social Care DHSC dated 12 June 2023 c…
8 Mar 2023 To cttee Letter from the Minister of State for Social Care to the Chair dated 7 March 20…
7 Mar 2023 To cttee Letter from the Parliamentary Under Secretary of State for Local Government and…
21 Feb 2023 To cttee Letter from the Chair to the Secretary of State dated 20 February 2023 concerni…
12 Jul 2022 To cttee Letter from the Minister for Housing to the Chair dated 5 July 2022 concerning …
28 Jun 2022 To cttee Letter from the Minister of State for Equalities, Local Government, Faith and C…
14 Jun 2022 To cttee Letter from the Minister for Care and Mental Health to the Chair dated 7 June 2…
24 May 2022 To cttee Letter from Care England to the Chair dated 20 May 2022 concerning the long-ter…
17 May 2022 To cttee Letter from the Local Government Association to the Chair dated 6 May 2022 conc…
18 Jan 2022 To cttee Letter from the Chartered Institute of Public Finance and Accountancy to the Ch…
18 Jan 2022 To cttee Letter from McCarthy Stone to the Chair dated 16 December 2021 concerning long-…
20 Apr 2021 To cttee Letter from the Minister for Health and Social Services for Wales to the Chair …