Recommendations & Conclusions
16 items
2
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
We remain unconvinced as to whether the Department knows if it is achieving value for money from the additional funding going to adult social care. Recent funding for adult social care includes short-term, top-up pots of money in response to crises. In response to emerging pressures in 2022, government awarded …
Government response. The government agrees and states it is undertaking significant assurance of new grant funding by requiring local authorities to report on performance and submit detailed spending plans. It cites increases in fee rates and supported discharges, and ongoing engagement with …
HM Treasury
4
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
Notwithstanding its recent efforts to make adult social care a more attractive career, the Department has still not produced a convincing plan to address the chronic staff shortages in the long-term. Workforce vacancies in adult social remain worryingly high with some places, such as rural areas, particularly affected. In 2022–23, …
Government response. The government agrees but states it has already published its workforce strategy in 2021 and an updated plan in 2023. It reports a decrease in vacancy rates and highlights existing investments in recruitment, retention, workforce training, and support for ethical …
HM Treasury
5
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
Long-awaited workforce reforms are way behind schedule and too dependent on a ‘novel’ payment system. We welcome the Department’s launch of the care workforce pathway, which aims to provide consistent career progression for those working in the sector, but we are concerned at the lack of progress on other workforce …
Government response. The government agrees and confirms the payment system is on track to start making payments from the end of June 2024 with a phased approach. It will enable claims for qualifications and training from June and commits to update the …
HM Treasury
1
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department) and from the Department for Levelling Up, Housing and Communities (DLUHC) about progress in reforming adult social care in England.1
Government response. The government agrees and details ongoing work, including new Care Quality Commission assurance of Integrated Care Systems and local authorities, and efforts to improve adult social care data quality, timeliness, and availability through a new data strategy and collection methods.
HM Treasury
8
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
We asked the Department about how it was measuring the effectiveness of joint working between health and social care in delivering better outcomes for the people they served. We heard that CQC inspections, which were now measuring systems as well as institutions, and a “colossal improvement” in data gave the …
Government response. The government accepts the recommendation, stating CQC assessments of ICSs and local authorities will be published by Summer 2024 to enable public understanding and comparison of outcomes. They are also improving adult social care data through a new strategy, including …
HM Treasury
9
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
In recent years, there have been multiple short-term, top-up funding announcements for adult social care in response to crises. In response to emerging pressures in 2022, in the November 2022 Autumn Statement government announced funding of up to £7.5 billion over two years (up to £2.8 billion in 2023–24 and …
Government response. The government agrees and states the recommendation has been implemented, detailing the up to £8.6 billion in additional funding made available over two financial years and its impact. It also describes ongoing assurance and scrutiny of new grant funding to …
HM Treasury
10
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
When we asked what the Autumn Statement funding had delivered, the Department told us it had achieved “an awful lot” but acknowledged this was not as much as it had wanted and there was more to come. The Department did not quantify how much the MSIF funding had contributed to …
Government response. The government states the recommendation is implemented, providing figures for £8.6 billion in additional funding that supported an 8.9% average increase in provider fee rates and a 10% increase in supported discharges. They are undertaking significant assurance of grant funding, …
HM Treasury
11
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
We asked about the risk of profiteering and how the Department was ensuring that the money it was putting into the system was going to the right places. The Department explained that was mainly down to the quality of commissioning and that, as CQC was now inspecting local authority commissioning, …
Government response. The government states the recommendation is implemented, referring to £8.6 billion in funding and describing ongoing measures to ensure money goes to the right places and prevent profiteering. These include significant assurance processes for new grant funding, requiring detailed spending …
HM Treasury
12
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
With regard to additional funding for hospital discharge—£600 million in 2023– 24 and £1 billion in 2024–25—the Department told us that delayed discharges had been consistently lower over the last 6 months than the previous year despite an increase in emergency admissions. The Department said that the best measure of …
Government response. The government states the recommendation is implemented, highlighting £8.6 billion in additional funding for adult social care and discharge over 2023-25, which has supported increased provider fee rates and supported discharges. They are also implementing significant assurance processes for new …
HM Treasury
18
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
We have repeatedly raised concerns about care workforce shortages. When we reported in 2018, vacancy rates for 2016–17 were 6.6%.38 The vacancy rate has increased since then and, as the NAO reported, in 2022–23 vacancies were 152,000, a rate of 9.9%, despite the recruitment of 70,000 staff from overseas. We …
Government response. The government agrees and states the recommendation has been implemented, referring to its 2021 workforce strategy and 2023 plan. It highlights ongoing investment in recruitment and retention reforms, including workforce training, pay, and a £15 million investment in 2023-24 for …
HM Treasury
19
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
In its 2021 white paper, the Department said it expected the number of jobs in adult social care to increase by almost one-third by 2035.42 Given its reliance on overseas workers to date, we asked what percentage of the workforce it expected to come from overseas in future. The Department …
Government response. The government agrees and states the recommendation has been implemented, referring to its 2021 workforce strategy and 2023 plan. It details investments in recruitment, retention, and international recruitment, including £15 million in 2023-24 for local initiatives, alongside adherence to ethical …
HM Treasury
20
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
Given the significant workforce challenges facing the sector, we asked the Department why it had not produced a workforce strategy, despite repeated calls from the sector and our previous recommendations.46 It told us that it considered the workforce chapter of its 38 Committee of Public Accounts, The adult social care …
Government response. The government states the recommendation is implemented, asserting that its 2021 white paper and 2023 'Next Steps' plan serve as its workforce strategy. They highlight ongoing investments in recruitment, retention, professionalisation, workforce training, pay, and international recruitment initiatives, citing a …
HM Treasury
21
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
Care England said there was a widespread sense within the sector that careers in adult social care did not enjoy parity of esteem with the NHS and care workers were not afforded the same level of respect from the Government or across wider society.52 Pay for equivalent roles in adult …
Government response. The government agrees and states the recommendation is implemented, outlining existing and ongoing actions such as published workforce strategies, investment in recruitment/retention reforms, workforce training, the Market Sustainability and Improvement Fund (focused on pay), and £15 million for international recruitment …
HM Treasury
22
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
We welcomed the Department’s introduction of a new framework aimed at providing consistent career progression for the social care workforce (the Care Workforce Pathway) in January this year.54 However, we challenged the Department on why it had made so little progress overall on its workforce reforms which, even after scaling …
Government response. The government accepts the recommendation and expects the new payments system to begin making payments from the end of June 2024, enabling employers to claim funding for training courses and the new Level 2 Adult Social Care Certificate qualification. The …
HM Treasury
23
Recommendation
Twenty-Second Report - Reforming adult …
Accepted
The Department explained that it had chosen a new payments system because it would be making payments on a scale not dealt with before and had wanted a proper way 47 Q 47 48 Department Health and Social Care, People at the Heart of Care: Adult Social Care Reform White …
Government response. The government accepts the recommendation, stating the new payments system is on track to start making payments from the end of June 2024 for training courses and the Level 2 Adult Social Care Certificate. The department will provide updates on …
HM Treasury
24
Conclusion
Twenty-Second Report - Reforming adult …
Accepted
When asked when the payments system would be ready, the Department told us that it was aiming for summer 2024 but that delivery was “at risk”. The Department described the system as “difficult”, “complex” and “novel” which, we noted, sent “chills down our spine”.61 The Department has since confirmed that …
Government response. The government agrees and confirms the payments system is on track to begin making payments from the end of June 2024, with a phased approach for specific funds and qualifications. It commits to updating the Committee on fund take-up before …
HM Treasury