Mark Topps Care Column on Record Keeping
Mark Topps
September 16, 2021

Mark Topps

Those of us working in social care have long awaited reform, especially over the last 19 months as the pandemic has highlighted just how fragile and vulnerable the sector is. In recent weeks, we’ve been reminded of this even more so with the current recruitment crisis. With the Government now beginning to roll out the Health and Social Care tax increase, many have shared their opinion on the matter. I personally think that, while this is a start, it doesn’t go any where near as far as it should for the sector to get the support that it truly deserves.

What do we know?

  • The Government is issuing a 1.25% increase in National Insurance from April 2022. This will be paid by both the employer and employee – it will then become a separate form of tax in 2023 and will appear on people’s payslips. 
  • The objective is for social care to receive £5.4bn over the next three years. 
  • Care costs will be capped at £86,000 (with some exclusions) over someone’s lifetime in England from October 2023.
  • The government is estimated to raise £36bn from this initiative going forward.

In theory, everything listed above sounds great. More money will be driven into the sector and the responsibility is divided between employers and employee to create a sense of fairness. But, when you look at the bigger picture, it doesnt provide the social care sector, thats currently on its knees, with anywhere near enough support. To solve the problems that the sector currently faces, there needs to be a more thoughtful and strategic approach to the way that this money is fed into the system and the speed at which is coming. The social care workforce deserves to be recognised otherwise there could be new issues for those receiving care and support now (or in the future). 

For me, there are some key factors that really need to be addressed by the government, including:

The Levy vs Social Care Allocation

Increasing the National Insurance contributions by 1.25% will raise £36 billion over the next three years. £30.6 billion of this will go to the NHS, leaving £5.4 billion for social care, with only £2.5 billion being available for the wider reform. A white paper on social care has been promised for Autumn this year but for now, the levy and investment going towards social care is far too low. I fully appreciate that the NHS is in need of priority however, so is social care and the government must stop pushing the sector behind in their list of priorities.

People who use Services

There is often a large emphasis on social care being about care homes and elderly and in fact there are so many other services providing care as well as thousands of working age adults who receive support with their care needs. The government has again failed to recognise those living with learning disabilities. Research conducted by the National Autistic Society suggests that 2 in 3 autistic adults do not get the support they need, leading to isolation, increased mental health problems and people facing crisis before receiving the support and care they need. The government needs to wake up to this aspect of support that the care industry needs. 

The new levy will not come quick enough for thousands of people who are unable to source care due to the shortage of providers and/or staff. According to ADASS, there is an estimated 300,00 people on waiting lists for adult social care services. 

Whilst the cap on care costs were announced at £86k, the government have since confirmed that this will only be for the support people require for daily tasks such as washing, dressing and eating and does not take into account the cost of the accommodation. Therefore, people may still be at risk of paying large monthly bills. It is also worrying to hear that the in order to be eligible for the cap in care costs, the person requiring care and support is reliant on the local authority stating they meet the criteria for care (and these days this threshold is getting harder and harder to meet). Any privately arranged care over a figure that the local authority deems as needed will still be chargeable.

I personally welcomed the announcement that legislation will allow those paying privately for their care to ask their local councils to arrange the care at the rate that the local authority charges. Of course, this is not good news for providers who are heavily reliant on the subsidy of private payers to keep them afloat. The government must act and ensure that local authorities are commissioning care at rates that help providers to break even. If not, when this change is in place, providers relying on the private market run the risk of going under. 

The Workforce and Recruitment

The social care sector is in the midst of a recruitment crisis leading to many home care providers turning customers and visits away. Some care home providers are looking for opportunities to sell their business and many more are struggling to ensure safe levels of staff are available for care that needs to be delivered. This is further being impacted with the mandating of the COVID vaccine for care home staff. With this in mind, it’s clear that the new levy fails to support providers with recruitment and doesn’t address the fact that frontline care and support workers should receive a pay rise as they’re at high risk of leaving due to all of the above. 

I worry that many care and support workers will face an increase in the amount of tax they pay due to the new levy, but many wont receive a sustainable pay rise and therefore thousands of front line care staff could be financially worse off.

The Prime Minister praised staff working in the NHS but failed to do the same to those working within social care and it is another slap in the face of all of those who have worked tirelessly throughout the pandemic (and beforehand) to ensure the best possible care for those that they support. I feel that a thank you and/or recognition wouldnt have gone amiss. 

Looking at others who have commented, I fully agree with Mike Padgham, Chairman of the Independent Care Group, who said it was a “huge opportunity missed for radical, once-in-a-generation reform of the social care system”.

Final Thoughts

It has been well documented that the reform has been put off by government officials for decades and ministers may be able to claim that they have not dodged the issue. However, the sector cannot afford to wait for another three years!s The government have stated that they have a clear commitment to the vision of social care and what comes next and if they carry through with their commitment to involving people who draw on care services and engage with providers, then we must remain optimistic that we can really improve what comes next.