Dr Ed Rosen, Lambeth GP Food Co-op – helping the medical community to grow food
- March 2022
With Christmas around the corner, many authorities will be waiting in eager anticipation for the long-awaited green paper on Adult Social Care; originally promised in 2017 we now hope it will be published 18 months later in early 2019. With the budget setting in full flow, the anticipation of options for a long-term sustainable adult social care funding model is at the back of minds when faced with the challenges we find ourselves in. Recent financial settlements by the treasury have included minor increases in the Social Care budget for England. My own authority in Staffordshire has seen a £6.1 million one-off ‘gift’, barely enough to plug our own existing budgetary gap.
The financial pressures on Adult Social Care make for quite solemn reading. Our adult care workforce, once the pride of our local authority services has been reduced to commissioned provision through a challenging marketplace. At any given time, there are around 90,000 social care vacancies across England, representing around 8% of the total workforce. Each year roughly 27% of care workers leave the profession, leading to significant ‘churn’ in the workforce and loss of experience skill sets. Around 8% of the workforce are EU nationals, facing significant uncertainty of their future status to remain in the UK post-Brexit. One in ten care workers are on temporary employment contracts, and around 25% of the workforce are on dreaded ‘zero-hours’ contracts.
Many providers have blamed the rise in ‘National Living Wage’ as the precursor to their financial issues. The minimum wage for over 25’s has risen from £6.70 to £7.50 in 2017, costing the sector an extra £600 million, and due to rise again to £8.75 by 2020. It is impossible to refute the financial pressures placed on providers by the increased staffing salary costs. But, we must also agree that the care worker sector has long deserved a pay rise, given the vital role they play in providing dignity and care to our older residents. The financial pressures we face, as authorities commissioning social care provision, are entirely due to the method by which we are able to fund such care. Notably, without some very clear financial intervention, the social care funding gap is projected to reach £2.1 billion by the end of the 2019-20 budget year.
It has been speculated, that when the Adult Social Care green paper is finally published, we will be faced with a range of models for how we tackle the under-funding of social care in both the short- and long-term. Quite simply, the current model for funding social care, being based entirely on council tax receipts and a minor ring-fenced precept, is not fit for the medium or long-term. It is entirely conceivable that residents below the age of 50, will be presented with more direct methods of funding their future social care, either through designated national insurance additions, or ‘pension-like’ contributions. Though with all like interventions, the time frame for financial sustainability of these initiatives is very much long-term. For those of us in local government, staring down the quite daunting February local budget deadline, we need answers to these funding questions now.
Though, within this troubled sector, there are pockets of providers based on co-operative models of operation that have bucked the trend. A review by Pat Conaty of Co-operatives UK has highlighted this excellent provision and should be essential reading for all us involved in social care provision within our authorities. Notably, these ‘Social Co-operatives’ display greater financial sustainability, quite envious staff retention rates, and find it much easier to recruit in the tricky recruitment market. When the green paper is published, hopefully in early 2019, we must take every opportunity to lobby our parliamentarians to ensure that ‘Social Co-operatives’ are recognised and supported.
As we battle against a tough financial climate, a fractured sector, and ever-increasing demand, we must be reminded of the critical role social care plays in our own community provision. Social care is one of the prime examples of a service provided to our residents where the council is seen as responsible for that provision. We must not forget that for many of our vulnerable residents, this provision is essential to their quality of life. We must remember that the provision of this service enables us to make a positive impact on the lives of many of our residents, and by inference, their families. If we can work to ensure that our social care provision is truly excellent, we will make a significant positive impact on many of our residents.
Cllr Dave Jones
Labour & Co-operative Member of Staffordshire County Council
Shadow Lead for Health, Wellbeing and Adult Social Care
Associate Member of the CCIN