Social care reforms could make care markets ‘unsustainable’ report warns


The government’s reforms will protect more people from large care costs, but they will not improve access for the hundreds of thousands ineligible for services and make care markets “unsustainable”, a new report warns.

The State of Care in Counties, released by the County Councils Network (CCN) and the Rural Services Network (RSN), analyses the impact of the government’s social care reforms – announced last week – for councils.

It warned that while councils support a cap on care costs as this will ensure more people do not pay for catastrophic care costs, the proposals announced earlier this month will not improve eligibility for the thousands currently below the criteria to access care services.

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The study found that 58% (545,000) of people who made a request to their local county authority were told they were ineligible for care, as councils have tightened their eligibility over the years owning to financial pressures. This figure has remained stagnant since 2017.

CCN and RSN also warned that the reforms will make local care markets potentially unsustainable by allowing private fee payers access to council-arranged care and the fee levels they pay providers.

Self-funders cross subsidise the market by paying 40% on average more than councils for care, creating a £761m fee gap.

Councils are concerned that the government has underestimated the costs of equalising fees paid by councils and private payers, and are uncertain whether the £5.4bn committed for all the reforms and to move towards paying ‘a fairer price for care’ will be enough. 

They say the new health and social care levy could raise £12bn a year, but outside of 20% of this fund set aside for social care reform, there is no commitments on how these resources will be distributed between the two health systems. 

Therefore, in the future, the government should enshrine in law that beyond 2025, most of this income is earmarked for social care, the report said.

Cllr Martin Tett, County Councils Network Adult Social Care Spokesperson, said: “Unlike successive governments, this administration has grasped the nettle and set out the first attempts at reforming the adult social care system in a generation.

“However, these reforms, and the sums committed, fall short of truly addressing all the issues within the social care system and could have unintended consequences, including destabilising county care markets. They will not address existing challenges, not least in improving eligibility for the hundreds of thousands unable to access to services.

“Because no short-term funding is available for current pressures, things are likely to get worse before they get better. Councils are likely to reduce services rather than enhance them – unless the Spending Review provides more resource. We cannot rely on council tax alone to fund rising demographic and inflationary pressures.”

Tags : County Councils Networkreformsocial care reform
Sarah Clarke

The author Sarah Clarke