Richard Humphries, Senior Fellow at the King’s Fund, to give a presentation on the current issues facing care and health, how they might be impacted by the forthcoming General Election, and what opportunities and risks this period presents for the sector. Richard will then engage in a discussion with the Board.
Minutes:
The Chairman welcomed and introduced Richard Humphries, Senior Fellow of the King’s Fund, to give a presentation on the current issues facing care and health, how they might be impacted by the forthcoming General Election, and what opportunities and risks this period presents for the sector. The Chairman also expressed the gratitude of the Board to Richard for having agreed to give his presentation at such short notice.
Richard gave an overview of the King’s Fundand the key challenges to adult social care in coming years. In particular he identified funding, and workforce pressures, and the need for service transformation and better public awareness and engagement on social care. Regarding workforce issues he highlighted a concern that, for the most part, working in adult social care is not seen as high status work. He also emphasised the importance of making the best use of technology and developing the right kind of integrated care.
As a part of his presentation he detailed the previous efforts over the last two decades of governments to tackle the question of adult social care sustainability for the long-term. He also raised the options for sustainable funding, breaking these down broadly to ‘public’ (taxation and/or redirection of existing spending on older and disable people) and ‘private’ (charges, insurance, means testing and equity release). Richard emphasised that there are no examples abroad where social care has relied on one sole source of funding. He explained that public opinion is very divided on how social care should be paid for.
Richard highlighted opportunities for future work on the adult social care agenda including; the potential for social care to be a key campaign issue, to promote public awareness on social care and to explore different funding options. He emphasised the importance of maintaining momentum on the agenda as there will likely be strong media interest given political parties’ different approaches to adult social care.
Richard also highlighted risks to the adult social care agenda, in particular; he raised a concern that the political focus on Brexit could force out key domestic issues, the momentum behind reform and the green paper could slow, and heightened political fault lines post-Election could damage cross-party consensus for change.
Richard explained to the Board that the fundamental challenges facing adult social care will not have changed following the general election. He identified post-election issues in the effect on key policies and of NHS pressures, STPs and the emergence of accountable care systems on the future of adult social care. He also expressed concern as to the uncertainty around the implications of Brexit on the social care workforce, effect on economy and public finances as well as in distracting from domestic issues.
In the discussion which followed Members raised the following points;
· A Member raised a query as to what the role of local authorities in STPs would be going forward.
· A concern was also raised regarding the challenge faced by local authorities in creating a sustainable workforce and sustainable social care.
· A view was expressed that local authorities required greater flexibility to try something different to meet these challenges, and raised whether devolution would assist.
· A Member raised a query as to the correct balance on how the additional money for adult social care should be spent.
· Richard explained that local government needs to be centrally involved in STPs, and that the Scottish example of the changes they have made without looking to taxation to fund social care.
· Richard also stated that evidence is suggesting a reduced use of residential care is worth looking into.
· Regarding the £2 billion in additional funding Richard advised that local judgement should be paramount in influencing how this is spent.
· A concern was raised about NHSE’s willingness to engage with local government.
· Richard expressed a view that NHSE should want to work far closer with local government to reduce the need for social care.
· Regarding a concern raised as to how local authorities can change the culture around adult social care Richard explained that there are deeply entrenched cultural ideas and that we should expect it to be a difficult challenge to change this.
Decision
The Board noted the presentation.