Why do we need a national care service and what form could it take?

The social care system in England does not meet the needs of the current population, and going forward it will not meet the needs of the country’s ageing population and the increasing numbers of younger people and working-age adults with life-long care needs.

A savage squeeze on funding for over a decade has meant the quality and quantity of support and care available has fallen. Those who work in the current care system have been trying to patch it up and keep it working for decades, but it is widely acknowledged that the system is now at a crisis point.

Long waits for care or even no care at all

The most obvious problem is that too many people are going without the care they need. There were an estimated 430,000 people waiting for assessment, reviews, care and support and direct payments to begin in August 2022. The time people are having to wait for an assessment has increased, with a third of people having to wait over 6 months. And even when people do get support, this support is often inadequate and their needs are not fully met.

The lack of social care capacity is causing significant and growing problems for the NHS; people admitted to hospital can not leave as they are waiting for social care support, either a place in a care home, for rehabilitation, or a home care package. This delayed discharge is reducing NHS capacity and having an adverse effect on patient outcomes.

An increasing number of requests for social care support result in no care being provided at all (27% in 2021/22 compared to 23% in 2017/18). As council funding has been cut, so they have had to ration care, by tightening the rules around who receives care, leaving many more people having to fund care themselves. Often though, despite people being eligible for care, workforce issues mean none can be provided.

It was estimated by ADASS (the Association of Directors of Adult Social Services) that between April and June 2022, 1.1 million home care hours were not delivered due to insufficient staffing capacity. There are also reports of some local authorities reducing the number of time allocated to recipients of home care services, resulting in rushed or poor care.

Full story in The Lowdown, 5 July 2023