Why the future of social care is at a tipping point

29 Apr 19

NHS Providers’ Miriam Deakin explains why 15 health organisations came together last month to write to the prime minister to call for action to create a sustainable social care system.


For the first time, fifteen health organisations have come together to call on the government to urgently address the growing crisis in social care. This is a significant moment and a tipping point in the continuing but crucial debate about how we develop a sustainable and fair social care system for generations to come.

But why is the health sector, which has recently received its own funding settlement from the government, offering a combined voice in support of the social care sector?

Most importantly - it is the right thing to do. Health organisations care about patients and people, so we care about an overall health and care system that makes sure every person receives the right care in the right place at the right time and regardless of ability to pay.

It is the right thing to do for the millions of people and their families who need social care to live as they choose and stay well, and for the millions more of us who will use social care services in the future.

Every year that we delay action has a profound impact on the public, with social care services, including care homes, in some parts of the country, close to collapse.

The need for action is now more pressing than ever.

In terms of funding for the sector, we know that adult social care services face a funding gap of £3.6bn by 2025. This is not sustainable. Even providing that level of funding would only keep the sector's head above water. It would just keep on delivering existing services at current levels and would not meet the cost of changing the current model of provision or include the funding needed to meet the growing need for services in the future. We need radical thinking.

As for the NHS, the current state of the workforce in social care is also troubling. The challenge of recruiting and keeping the right level and mix of staffing to keep services running for local populations is the number one concern across health and care. There is a growing workforce gap due to low pay, working conditions and lack of job security.  A study by the IPPR think tank found that half the social care workforce was paid below the real living wage.

The continuing uncertainty over Brexit has also had an impact. European nationals make up a significant proportion of the social care workforce. Many have chosen to leave as questions over their status after Brexit remain unanswered.

The IPPR found that if the situation remains unchanged, there will be a shortage of 350,000 social care workers by 2028 – this would rise to 400,000 if freedom of movement ends.

'The government will have to make careful considerations about what a future immigration system will look like. High skilled does not equal highly paid. We must ensure that it does not exclude the talented and vital workforce that both health and social care services require.'

The government will have to make careful considerations about what a future immigration system will look like. High skilled does not equal highly paid. We must ensure that it does not exclude the talented and vital workforce that both health and social care services require.

The NHS and social care are two sides of the same coin. Without addressing the social care challenge, we risk devaluing every pound of the funding settlement for the NHS and undermining the ability of health services to meet the ambitions of the NHS long term plan.

Yes, much-needed investment in additional social care packages and support for social care staff and carers would be welcomed. But we need long term solutions as well.

We need a strong social care system – alongside greater investment in preventative healthcare services and other community services. This would help people to live well and independently within their community among family and friends, preventing the need to contact emergency services because insufficient access to social care has led their health to deteriorate, or because they have nowhere else to turn.  Colleagues in health and care need to work together to ensure patients can be discharged from hospital swiftly once they are medically fit.

It is clear to us that an effective, functional and sustainable social care system is essential to supporting a healthy NHS and providing the high-quality health and wellbeing services that people rightly expect.

NHS Providers is pleased to add the voice of trusts, alongside our colleagues in other healthcare organisations to call for urgent action and a long term sustainable solution for social care.  

The Health for Care coalition, led by the NHS Confederation, will be setting out what we need to see from the long-awaited social green paper and calls for the government to use the upcoming spending review to invest in the sector urgently. We have also set out a set of principles for a new system which is sustainable and fair for future generations.

This coalition shows that there is a broad consensus around increasing the funding for social care, but the method for delivering this is a political decision for the government to make. We need to see bold and decisive action.

If we miss this opportunity to make meaningful change we only risk storing up further problems for both health and care services in the future.

This blog was first published on the NHS Providers’ website

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