Recommendation 2

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 £1.6 billion to help speed up hospital discharge through the Better Care Fund and £1.1 billion new grant funding to local authorities through the Market Sustainability and Improvement Fund (MSIF). It is troubling that, though MSIF funding is intended to support “tangible improvements” in adult social care, the Department did not quantify by how much the funding has contributed to its three objectives of increased staff pay, increased fee rates paid to providers or reduced waiting times. It remains to be seen whether the new CQC inspection regime, and promised improvements in local commissioning, can provide better assurance that top-up funding is not simply going into provider profits. We are concerned that the Department’s grasp of what it is getting for the £1.6 billion funding to support hospital discharge, is similarly vague. Although ‘supported discharges’ (the number of people being discharged from hospital with a package of care) may well have increased as a result of this funding, it is far from clear whether this represented good value compared with other interventions. Recommendation 2: The Department should write to the Committee alongside its Treasury Minute response to set out how it is assuring itself that each additional fund aimed at supporting adult social care is achieving value for money, including on benefits in relation to costs, for example: 6 Reforming adult social care in England • how much additional capacity it has bought with the discharge funding through the Better Care Fund. • how it will ascertain whether funding for market sustainability and improvement has not just ended up increasing provider profit margins.