Source · National Audit Office

The adult social care market in England

This report examines the current care market and the Department of Health & Social Care’s role in overseeing it.

Published: 25 Mar 2021 Recommendations: 7 Type: Value for Money NAO confirmed: 4 Department: Department of Health and Social Care

Dept: Department of Health and Social CareMinistry of Housing, Communities and Local Government Topics: Commercial and financial managementCommissioning servicesCorporate financeHealth and social careLocal governmentLocal service deliveryLocal services and housingSocial care nao.org.uk →

Recommendations

7 items

5 accepted 1 partially accepted 1 rejected 5 implemented 1 in progress

Recommendation 1

Addressee: Department of Health and Social Care · Source location: Page 12, paragraph 28, point a

The Department should:
a) as a priority, set out a cross-government, long-term, funded vision for care. It should collaborate with the Ministry and local government in particular; factoring in sector and user perspectives, such as people with lived experience;

Response position: Accepted

Delivery: Implemented · 12/2021

Recommendation 2

Addressee: Department of Health and Social Care · Source location: Page 12, paragraph 28, point b

b) develop a workforce strategy, in line with its previous commitments, to recruit, retain and develop staff, aligned with the NHS People plan where appropriate;

Response position: Accepted

Delivery: Implemented · 12/2021

Recommendation 3

Addressee: Department of Health and Social Care · Source location: Page 12, paragraph 28, point c

c) in conjunction with the Ministry, Department for Work & Pensions and local government, develop a cross-government strategy for the range of accommodation and housing needed for people with care needs, and how to fund it;

Response position: Rejected

Delivery: No implementation status recorded · Confirmed by NAO

Recommendation 4

Addressee: Department of Health and Social Care · Source location: Page 12, paragraph 28, point d

d) assess the performance and cost data it needs to gain assurance over the system’s performance as a whole and the potential costs to the sector of
providing these data, bearing in mind its current proposals for enhanced accountability and oversight;

Response position: Partially accepted

Delivery: Implemented · Q1 2023/24 · Confirmed by NAO

Recommendation 5

Addressee: Department of Health and Social Care · Source location: Page 13, paragraph 28, point e

e) address significant gaps in the performance and cost data it collects on care, particularly on self-funders and unmet need. In doing so, it should be mindful of, and assess, the potential burden on local authorities and care providers;

Response position: Accepted

Delivery: In progress · Q3 2026/27 · Confirmed by NAO

Recommendation 6

Addressee: Department of Health and Social Care · Source location: Page 13, paragraph 28, point f

f) consult on options for enhancing support for local commissioners which promotes an integrated approach and incentivises commissioning for outcomes; and

Response position: Accepted

Delivery: Implemented · Q4 2025/26 · Confirmed by NAO

Recommendation 7

Addressee: Department of Health and Social Care · Source location: Page 13, paragraph 28, point g

g) explore with CQC how best to increase visibility of and transparency over providers’ financial sustainability and costs, bearing in mind operational and legal practicalities.

Response position: Accepted

Delivery: Implemented · Q1 2022/23