The pandemic has seen social care brought to the forefront of public attention like never before and “reform” of the sector has been long-awaited. The announcements (7 Sept) are a step forward but not what we had hoped, and we are concerned that the plans outlined may not solve the social care crisis as is required. The publication of Building Back Better does, however, bring some optimism as we see this as a sign of social care being firmly placed on the Government’s agenda but now we must ensure future actions respond to the needs of the sector.
The social care sector needs urgent short-term fixes including ring-fenced funding and focus on the workforce, but it also requires long-term support and solutions to help it grow and make it sustainable. Crucially, we need to shift the longstanding belief that social care is just about older people and care homes – it’s not – it’s also about children, working age adults, and families receiving a range of care and support services.
Funding for the whole health and social care system is essential and whilst £5,4bn over three years for social care is a welcome start, it is unlikely to deliver the change or reform that is urgently needed, with almost half the amount covering the care cap recommended in the Dilnot report and falling short of the £7bn requirement as outlined by the Health and Care Select Committee. Furthermore, an increase in National Insurance payments will place pressure on those already on low incomes and deprived communities, who will be simultaneously affected by the impending cut to Universal Credit payments. This will have a detrimental impact on the mental health and wellbeing of people with pre-existing conditions, as well as lead to presentations of new cases.
However, as always, conversations on adult social care continue to omit its importance to mental health and wellbeing. Across mental health, there needs to be greater government understanding of the value of social care and its role in healthier communities as well as the essential role of the workforce in achieving this, taking into consideration their extensive knowledge, skills, and experience. Local authorities, through their duties for adult social care under the Care Act 2014, are currently the major commissioners of The Association’s members, the voluntary and community mental health provider sector, who offer an essential range of services – from prevention and crisis intervention to community support – for people who experience poor mental health or severe mental illness.
The Association’s report to the DHSC Social Care Task Force as co-chair of the DHSC Mental Health and Wellbeing Advisory Group last year, estimated that an additional £1.1 billion per annum is required to restore mental health related adult social care budgets to 2010/11 levels by 2030. This would maintain effective provision and enable the VCSE mental health sector to play the role envisaged of it in NHS England’s plans for the transformation and modernisation of community mental health services. Unfortunately, beyond the £500m commitment to help the social care workforce with much needed mental health support, these announcements do not address this deficit appropriately nor do they furnish the detail around greater equity in the accessibility and provision of services needed in any package of reform for social care.
Social care plays a crucial role in helping people to live fulfilling lives and must be recognised as an equal partner to the NHS in supporting people in communities, and the acknowledgement of the interconnectedness between health and social care is welcomed. Alignment (if not integration) across health and social care of mental health services will be vital for the sector and there must be strong engagement of local government, VCSE and people with lived experience in all aspects of planning with a deliberate and assured process in place to support delivery of support services. There is an urgent need to enable a truly connected system that will improve outcomes for people with mental health needs and their families and carers. This health and social care system must be capable of reducing the inequalities that have been developed by austerity and further exposed and exacerbated through the pandemic.
Whilst we are disappointed that there is no signal of an immediate injection of resources required to both stabilise and help maintain the social care sector, we will continue to work with the Government on co-producing the upcoming White Paper and call for further investment at the Spending Review. We will continue to collaborate with all key stakeholders to ensure a greater understanding of the vital contribution of the VCSE sector and that the people who need to draw on services have the support they require as laid out in the Care Act to ensure we can transform and improve the health and wellbeing of the nation.
1. Association of Mental Health Providers is the only representative organisation for voluntary, community, and social enterprise (VCSE) sector mental health service providers, with a membership of over 250 organisations.
2. The Association’s Report to Department of Health and Social Care’s Social Care Taskforce as co-chair of the Mental Health and Wellbeing Advisory Group. The Association has continued to co-chair the reconstituted Mental Health and Wellbeing Policy and Oversight Group, which has supported the work of the DHSC Social Care Stakeholders Group since Summer 2020.
3. For more information, please contact Dania Hanif, Head of Policy and Programmes.