Source · Select Committees · Public Accounts Committee
Recommendation 9
9
Accepted
Adult social care funding relies heavily on multiple short-term, top-up announcements.
Conclusion
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 up to £4.7 billion in 2024–25) to help stabilise the care sector. This included £2.7 billion of new grant funding: £1.6 billion through the existing Better Care Fund to support hospital discharge and £1.1 billion to local authorities through a new Market Sustainability and Improvement Fund (MSIF) for local authorities to support “tangible improvements” in adult social care.17 Further top-up funding during 2023 included £570 million for the Market Sustainability and Improvement Workforce Fund, and £30 million for urgent and emergency care, announced in July, with a further £10 million top-up for urgent and emergency care announced in September.18
Government Response Summary
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 local authorities.
Government Response
Accepted
HM Government
Accepted
2.1 The government agrees with the Committee’s recommendation. Recommendation implemented 2.2 Since Spending Review 2021, the government has made available up to £8.6 billion in additional funding over 2023-24 and 2024-25 for adult social care and discharge. This funding has directly supported an 8.9% average increase in fee rates paid to providers in 2023-24 (which is greater than inflationary pressures), and a 10% increase in the number of supported discharges for patients assessed as no longer meeting the criteria to reside from February 2023 to February 2024. As the most recent State of Care Report shows, data from the CQC Market Oversight scheme indicates that provider profit margins are generally low on average, and we continue to engage CQC to understand whether funding uplifts result in any change in margins. 2.3 The department is undertaking significant assurance of new grant funding, requiring local authorities to report on performance against priorities, and requiring local authorities and ICBs to submit detailed spending plans for their discharge funding for 2023-24 and 2024-25. 2.4 The department works alongside the Department for Levelling Up, Housing and Communities to provide scrutiny and assurance of funding, as well as ensuring transparency to support local accountability. This includes the recent introduction of the Office for Local Government, assurance by the CQC, and reforms to the collection and availability of data on social care activity.