Association of Mental Health Providers

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Silver Lining in the Social Care Cloud – Reflecting on the Next Steps to Put People at the Heart of Care

Almost 18 months since the publication of the People at the Heart of Care: Adult Social Care Reform White Paper, the Government, on 4 April, published the next steps policy paper as part of its reform process.

However, with the reform having stalled since the initial series of announcements and abovementioned White Paper, we thought we’d ponder over this social care paper, and consider what the silver lining in this particular cloud might be.

So was it all that we’d hoped it would be? Unfortunately, no. Was it worth the wait? Unfortunately, no.

For us, this seems all too familiar. Time has passed but rather than moving forward, sadly, we have taken several steps back and are no closer to creating an effective social care system that meets the needs of people with poor mental health and illness.

Ironically named The Next Steps to Put People at the Heart of Care, the paper suggests the foundations for person-centred, personalised care and support have been laid. A plan that has not been coproduced and consists of broken promises leads us to once again question, can this vision truly become a reality?

Since its publication, there has been confusion over the funding – is it new money? is it old money? is it already-promised money redressed as more money? –  so some number crunching has happened this week but the pot just isn’t adding up. And with the significant 50 percent cut, from £500m to £250m, in social care workforce funding that was promised initially being just one of the areas that has had a slash, we’re struggling to see a sliver of silver.

Following the publication of the White Paper in 2021, we said the measures didn’t go far enough and the funding (£1.72bn committed then) was not enough to solve the demand and cost crisis facing the sector – the pressures have only just worsened during this time, with even fewer solutions offered and existing measures and funding either reduced or abandoned entirely. Mental health social care, at that time, achieved a tokenistic acknowledgment, and 16 months later, it is all but forgotten.

Our 300+ members of mental health charities providing services across the country consistently report the many challenges they face, including with its workforce, whether it be their recruitment or retention, and we know this highly skilled and competent workforce working with people with multiple, complex needs, is now finding better opportunities in other sectors. Skills for Care data states that there were 50,000 fewer people in the social care workforce and 165,000 vacancies in 2021/22– an all-time high when really, we need more people to continue delivering care and support services safely.

Halving funding for the social care workforce on the same day Rt Hon. Patricia Hewitt recommends in her Review of Integrated Care Systems that the government produce a long-term social care workforce plan to support better integration is not a positive step forward at all. The Review itself, on the other hand, was more promising: acknowledging more money is needed in social care; highlighting importance of tackling inequalities through outcomes as well as preventative support; recognising the role of the VCSE and social care sectors in integrated care; and the need to strengthen collaboration.

And with the publication of these two key papers, we reflect on our own Mental Health Social Care: What it is, why and how it matters for Integrated Care briefing (June 2022), which we can truly say does advocate for keeping people at the heart of social care; emphasising the importance of person-centred, personalised care and support for people with poor mental health and illness. We’re pleased that the Hewitt Review has considered and supported the recommendations we made around prevention, parity of esteem, preservation of the Mental Health Investment Standard, and support for the workforce – all essential in creating an effective and accessible social care and support system.

“We will fix the crisis in social care once and for all with a clear plan we have prepared”, stated Boris Johnson on the steps of Downing Street in his first speech as Prime Minister in July 2019.  “We need a long-term solution for social care”, stated the Conservative manifesto later in 2019. As we get closer to the end of this government’s term in office, we wonder whether a solution will be found and whether the crisis will be fixed but again, we say that our “resolve remains steadfast”, and we will continue to make mental health social care a priority