On The Pulse | 3rd January 2025

Your weekly round up of the major social care news stories from PLMR's expert Health and Social Care Team. Nathan Hollow | Lucy Taylor | Jessica Peddie | Michela Bandilla

Hitting the snooze button on care reform??

Today, the Government shared a major announcement on social care, following several months of intense calls for clarity on the future of the sector following October’s Budget. ?

The announcement centres on the launch of an independent commission, reporting to the Prime Minister, that will make clear recommendations for how to rebuild the adult social care system, meet the current and future care needs of the population, and deliver Labour’s election manifesto commitment of a ‘National Care Service’. Opposition Parties, as well as those receiving and providing care, will be invited to participate in the process.?

As part of announcing the Commission, Health and Social Care Secretary, Wes Streeting, also penned an article for The Guardian highlighting some of the key challenges facing the Government and the current system – particularly how the cost of the current system to taxpayers is expected to double by 2038.?

So, what will the Commission look like and what will it mean for social care in the immediate, short, and long term??

The Commission?

The Commission will be chaired by Baroness Louise Casey who has had a long career in the civil service and third sector and has previously led?high-profile government reviews for four former Prime Ministers, including most recently into the culture and performance of the Metropolitan Police following the murder of Sarah Everard.?

The Commission will report in two stages – the first in mid-2026, identifying the “critical issues” facing adult social care and recommendations for “pragmatic reform in the medium term”. These recommendations will need to align with the Government’s spending plans, created in this spring’s Spending Review process. This rather creates a ‘cart before horse’ situation of the recommendations and budget being created drawn up separately and out of order and risks further disappointment next year. ?

The second phase, reporting by 2028, will make longer-term recommendations for the transformation of adult social care, looking at the model of care needed to address the ageing population, how services should be organised to deliver this, and how to best create a fair and affordable adult social care system for all.??

The Commision and its reports come as just one part of what has been a long line of social care reports and National Care Service plans over the years - including last year’s Labour-commissioned Fabian Society report, which was created alongside people working in and drawing on care services. ?

The proposed timescales of the Commission suggest tangible reform for social care is unlikely to be seen until 2028 – or later, since this would be perilously close to the next General Election. Although Streeting was quick to defend the government’s plans on BBC Radio 4 this morning, insisting that this work will lay the foundations for the creation of a National Care Service, the three-year timeline has raised concerns that social care may once again be kicked into the political long grass. ?

Melanie Williams , President of ADASS, has suggested the timelines are “too long”, warning that “continuing to tread water until an independent commission concludes will be at the detriment of people’s health and wellbeing.” Similarly, Vic Rayner, Chief Executive of the National Care Forum, has urged Baroness Casey to “bring forward the work so these much needed changes can be seen within two years.”? ?

Wider Changes?

Alongside the commission, the Government is also announcing a further ￡86 million boost to the Disabled Facilities Grant for this financial year – this is in addition to the ￡86 million announced for next financial year at October’s Budget. This funding injection is intended to increase the money available to elderly and disabled people for home improvements, ensuring they are better able to live safely at home, aligning with the Government’s long-term aim of reducing hospital admissions. ?

They have also announced reform of the Better Care Fund to ensure its spending contributes to wider efforts to reduce emergency admissions, delayed discharges and care home admissions.?

There was also?a commitment to develop a “shared digital platform to allow up-to-date medical information to be shared between the NHS and care staff, including when someone last took their medication”. This will coincide with new national standards for “the best technology in care”, so providers know which systems to invest in.? ??

Care workers are to be “better supported” to take on further duties to deliver health interventions, such as blood pressure checks, meaning people can receive more routine checks and care at home without needing to travel to healthcare settings. There is currently no detail on how exactly this “support” will be provided, and whether there will be funding for any extra training that is required.?

Additionally, the Government has pledged to expand the ‘national career structure’ for social care. While little detail has been provided on how this expansion will be seen in practice, it may well be a continuation of the work started by the last Government, alongside Skills for Care, which reported in Spring 2024.?

While these smaller announcements should help create a more integrated health and care system, that they are being set out pre-Commission, in isolation, and without meaningful funding makes it difficult to see them as more a than a quick-fix attempt to hit NHS waiting time targets in line with the Prime Minister’s ‘Plan for Change’ milestone.? ?

What now??

It remains unclear whether a new Commission is necessary or simply another reinvention of the wheel that can be used as a ‘stone wall’ defence the Government can point to in any media or parliamentary questions about social care reform for the next 18-months or more.?

However, what is clear is that the perilous state of some parts of the social care system will struggle to wait three years for this Commission to do its work. Moreover, there has already been plenty of excellent work on what a National Care Services could be or do – the problem, as with so many things the Government is grappling with, is money. ?

With the cost to the taxpayer of the current care system expected to double within 12 years – yet, with provision already exceptionally restricted – it is hard to see this fiscal situation as anything other than completely unsustainable. ?

As such, on the one hand the public rightly wants to be protected from potentially catastrophic care costs, and doesn’t understand the distinction between a free-at-the-point-of-use health system but largely self-funded older person social care system, whilst the Government (and taxpayers) are concerned about how to sustainably fund the limited state provision that already exists, let alone what should exist in a more generous system.

Through this lens, the Commission should really be seen as about creating the political conditions required to fundamentally change either the tax system, to be better able to fund the country’s long-term care needs, or the expectations of the public on what elements of care the state will fund.?

Arguably, this is a debate that should have been had ten or more years ago, and while there is generally broad agreement over what a well-designed social care system could or should do, there has so far been very little unanimity over how the costs of long term care should be met.

That is the true question, and challenge, Baroness Casey must address.?

New Year, New Me?

We would like to congratulate everyone connected to the sector who was recognised in the New Year’s Honours list. ?To name a few:

Former Health Secretary Patricia Hewitt was made a Dame, and a CB was awarded to Michelle Dyson , Director General, Adult Social Care, Department of Adult Social Care. ?

CBEs were awarded to Christopher Badger, Executive Director of Adult Social Care Services, Hertfordshire County Council, and Joe Harrison , Chief Executive, Milton Keynes University Hospital NHS Foundation Trust, while Kathryn Smith OBE , Chief Executive, Social Care Institute for Excellence, received an OBE. ? ?

MBEs were awarded to Elaine James, Head of Service, Learning Disabilities and Preparation for Adulthood, Bradford Metropolitan District Council; Erica Lockhart MBE , Chair, South East Social Care Alliance; Paul Newman MBE , Chief Executive, Greensleeves Care; Harvey Rosenblatt, President, Nightingale Hammerson; Karen Rogers MBE , Chief Executive, Herefordshire Care Homes Group, and Keely Siddiqui Charlick MBE , Chief Executive Officer, Sunnyside Rural Trust, Hertfordshire. ?

Here’s what else we’re reading this week?

Sky News: AI tool detects heart condition before people have symptoms?

A new AI tool developed by the University of Leeds and Leeds Teaching Hospitals NHS Trust can identify individuals at risk of atrial fibrillation (AF) before symptoms arise, potentially preventing thousands of strokes annually in the UK. Using anonymised health records from over 12 million people, the algorithm detects "red flags" in patient data and recommends at-risk individuals use portable ECG devices to confirm AF diagnosis, enabling early treatment.?

The Times: How board games can help health and care workers cope with a crisis

Interactive board games are being used across industries and universities to improve collaboration, problem-solving, and professional development. These games provide immersive, hands-on learning experiences to address complex issues, such as planning for ageing populations or palliative care, by fostering teamwork and breaking down silos in a safe, engaging environment. Their success has demonstrated that gamified approaches can effectively promote understanding and communication in contexts ranging from healthcare to social services and corporate training.?

The Independent: Ambulance, GP and emergency care waits among biggest NHS concerns – poll?

A new survey has revealed widespread concern among Britons about long waits for A&E, GP appointments, ambulances, and planned hospital care, with 83% expressing worries about the NHS and over half doubting the government’s plans for improvement. Key issues include staff workload, quality of care, recruitment challenges, and health worker wellbeing, while only a quarter are aware of Labour’s pledge to reduce waiting times.?

Daily Mail: ?Care workers are set to be trained to carry out NHS health checks?

Care workers will be trained to perform routine health checks, such as measuring blood pressure and administering insulin, to reduce NHS waiting lists and ease pressure on doctors. This initiative is part of broader reforms to integrate adult social care with the NHS, including a new ‘digital platform’ to share patient data across care, GP, and hospital services, aiming for full digitisation by 2029. ?

Daily Mail: Revealed: The shocking scale of bed-blocking in NHS hospitals - and it is costing the NHS billions?

The latest figures show ‘bed-blocking’ is costing the NHS over ￡2 billion annually, with more than 12,000 hospital beds (equivalent to 26 hospitals) occupied each day by patients fit for discharge – an increase of 59% since 2021. Delays, which are blamed on a?lack of care home placements and home care packages, exacerbate ambulance delays, cancel operations, and prolong NHS waiting lists, affecting over 7.5 million patients. This highlights the scale of challenge facing the Government and the importance of the new Commission on forming a National Care Service. ?

Health Service Journal: Hospital group takes over ￡450m trust after years of talks?

The Royal Free London Foundation Trust has officially taken over the North Middlesex University Hospital Trust, creating a ￡2 billion organisation aimed at improving healthcare in North London. The merger, discussed since 2017 and initially resisted due to concerns about local accountability, is expected to enhance services in oncology, colorectal surgery, medical trials, and surgical hubs. While no immediate significant changes are planned for patients or staff, leaders from both trusts emphasised the potential for faster service improvements and better health outcomes for local communities.?

Thank you for reading! Happy New Year and we hope 2025 is filled with good health and exciting opportunities for you.

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