Recommendation 3

HM Government Accepted

The proposed Health and Social Care Levy has been repealed since the publication of the Committee’s report. Instead, the government is making available more funding for adult social care through general taxation and increased Council Tax flexibilities. As set out in response to Conclusion 3, the Autumn Statement made available up to £7.5 billion of additional funding over two years to support adult social care and discharge - with up to £2.8 billion available in 2023–24 and up to £4.7 billion in 2024–25. This historic funding boost is on top of the funding originally announced at Spending Review 2021 Government response 9 and will put the adult social care system on a stronger financial footing for the long-term, helping local authorities to address waiting lists, low fee rates, and workforce pressures in the sector. This includes £1 billion of new grant funding in 2023–24 and £1.7 billion in 2024–25 and further flexibility for local authorities on Council Tax. This includes £600 million in 2023–24 and £1 billion in 2024–25 to support discharge from hospital into adult social care, including fast access to domiciliary care and home-based reablement. Reducing delayed discharges frees up hospital capacity and ensures patients can be discharged home or to other appropriate settings, with the right care and support to help their recovery. Addressing this issue requires a coordinated approach across health and social care systems locally. Funding will be split between local authorities and NHS integrated care boards (ICBs) and pooled through the Better Care Fund (BCF) to deliver an integrated plan to reducing delayed discharges and improving collaboration and information sharing across health and social care services. The government is also taking specific action to improve access to adult social care by expanding capacity in the care sector through increased funding, workforce recruitment assistance and support for volunteers. The new grant funding announced at the Autumn Statement also includes the creation of the Market Sustainability and Improvement Fund (MSIF), where an additional £400 million of ringfenced funding for adult social care will be made available to local authorities in 2023–24, and £683m in 2024–25. This will be combined with £162 million of Fair Cost of Care funding in both years, to total £1.4 billion (£562 million in 2023–24 and £845m in 2024–25). Local authorities will have flexibility to use this funding to drive tangible improvements to adult social care across several areas; to address discharge delays, social care waiting times, low fee rates, workforce pressures, and to promote technological innovation in the sector. We published more detail on the purpose and high-level grant conditions for MSIF in an explanatory note1 alongside the final local government finance settlement (LGFS) on 6 February 2023. The Delivery Plan for Recovering Urgent and Emergency Services, published in January 2023, set out further detail on how local government, the NHS and the social care sector will work together to improve access to short-term packages of health and social care to support timely hospital discharge. Six new ‘national discharge frontrunners’ have been announced, of which three will focus on intermediate care. NHS England is developing a new planning framework and national standard for rapid discharge into intermediate care, building on the learning from the frontrunner sites. The Autumn Statement also announced the delay to charging reforms. All savings from this delay, £1.3 billion in 2023–24 and £1.9 billion in 2024–25, are being retained in local authority budgets and paid through the Social Care Grant to help them meet current pressures in social care, which we hope will improve access for care. Increased funding for local authorities must come with genuine, long-term reform of the adult social care system, which is why we are committing over to £2 billion over the next two years to supporting and improving adult social care and discharge in England. Our Next Steps to Put People at the Heart of Care plan sets out how we plan to spend £700m of funding to support our key system reform activities. This includes workforce 1 Social care resources explanatory note - GOV.UK (www.gov.uk) 10 Government response recognition and career development, supporting people to remain independent at home, new local authority oversight and data collections, joining up services around people, and supporting unpaid carers. Conclusion 7 – compensation to private care providers for employer NICs Conclusion 7 - 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 the NHS and social care. Compensating the “health” component of the “Health and Social Care Levy”