Source · Select Committees · Public Accounts Committee
Recommendation 10
10
Accepted
Autumn Statement funding impact on adult social care remains unquantified and unclear.
Recommendation
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 its three objectives of increased staff pay, increased fee rates paid to providers, or reduced waiting times.19 The Department told us that 85% of local authorities had said they planned to use the money on fee rates and that “a lot” of local authorities had said that average fee rates had gone up by 8.9%, noting that this was 13 Qq 22, 23 14 Qq 25–27 15 Qq 29–31 16 Letter from DHSC to Committee, 1 February 2024 17 Q 10; C&AG’s Report, para 2.7 18 C&AG’s Report, para 2.18 19 C&AG’s Report, para 2.7 12 Reforming adult social care in England above inflation. We heard that, as 70% of care provider spending goes on the workforce, this was a way of putting money into the workforce.20 Yet some care providers were more sceptical about the effectiveness of this top-up funding especially with further increases in the national living wage to come. For example, Care England reported that 84% of care providers said that government funding measures such as MSIF had had ‘no impact’ on their financial sustainability in 2023.21 Bupa Global & UK said that when engaging with local authorities it had become apparent that much of the Market Sustainability and Improvement Workforce Fund, which has similar requirements to MSIF, had been absorbed into central local authority costs, rather than being passed on to providers.22 The Local Government Association noted that much of the additional funding would go on meeting pay and inflationary pressures due to the sector’s higher exposure to costs associated with pay, energy, food and fuel prices.23
Government Response Summary
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, requiring reporting on performance and spending plans, and engaging CQC to monitor profit margins.
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.