The Department for Health and Social Care’s practice of issuing emergency cash injections to head off social care funding crises is counterproductive in the long-term and should be ended, the Institute for Government has warned.
Health secretary Matt Hancock this week announced the government would provide councils with a £240m funding tranche to deal with the phenomenon of bed-blocking this winter by providing additional support for patients to return home from hospital more quickly.
Council lobby group the Local Government Association said the funding was “desperately needed”, but also that it was no substitute for a sustainable funding settlement that allowed non-NHS services to plan for having the right staffing and resources in place.
Institute for Government researcher Graham Atkins said councils needed confidence about future funding to invest prudently, but that cash injections were stop-gap solutions that made it hard to invest to fix problems like rising staff turnover and the financial sustainability of care homes.
He said that social care staff turnover rates had increased to 37.5% in 2017-18, up from 28.4% the year before, while the Competition and Markets Authority had found that funding pressures had led councils to push down the rates they paid for care home places to 10% below the cost of provision.
Atkins said that with Brexit consuming the government's time and political capital, a cross-party inquiry was the government’s best hope to reform social care funding and provide councils with the financial certainty they needed. That move meant that care home providers were no longer interested in investing in new facilities for anyone other than those who paid for their own care, he added.
“The amount of money is not the only problem,” Atkins said in a blog post. “The way the government has given money to social care since 2015 – injecting emergency cash in the face of political or operational crises – is just as big a problem.
“The government has now given social care one-off cash top-ups each year for the last four years. This is ineffective. It makes it hard for councils to address underlying problems because they cannot be sure how much money will be available for them to spend on adult social care next year.”
Atkins said a cross-party commission would allow the government to build the political and parliamentary support it needed for a sea-change in social care funding.
“Reformed funding would give councils, and the providers they purchase services from, the financial certainty they need to plan ahead and address underlying problems,” he said.
“To his credit, Matt Hancock recognised that £240m wouldn’t be enough, and promised the forthcoming social care green paper will tackle these problems. But the green paper has already been delayed three times.”
Hancock acknowledged that the latest funding package was designed to “help the NHS through this winter”, by paying for home care packages, so-called “reablement” packages or home adaptations.
“We will use this money to get people who don’t need to be in hospital, but do need care, back home, back into their communities, so we can free up those vital hospital beds, and help people who really need it, get the hospital care they need,” he said.
The Local Government Association – which represents the majority of England's councils with social-care responsibilities – said adult social care services still faced a £3.5bn funding gap by 2025 just to maintain existing standards of care.