Is Government still set on social care reform by October 2023?

Difficult policy decisions indicate that this Government is still set on social care reform by October 2023. Will that hold true for the next?

Amid the political turmoil of the last week, only the keenest Government observers will have noticed that the Department for Health and Social Care announced a significant update to means test reform policy. Last Thursday, the Department confirmed that people in residential care on 1 October 2023 will not be able to ask local authorities to commission their care on their behalf for 18 months, in essence meaning that they cannot access likely lower local authority fee rates for their care. This is a technical issue but has significant operational, financial and political implications for reform.

From an operational perspective the decision has advantages. For care providers it provides certainty that their existing clients won’t suddenly start to pay less for the same services. For local authorities it removes the need to recommission existing care packages, and in theory extends the time period to make needs and financial assessments for existing care home users. From a financial perspective it should protect provider revenues in the short-to-medium-term, though for local authorities any financial benefits are harder to quantify.

This updated policy by no means addresses all of means test reform implementation’s challenges and a challenging timetable remains. However, its publication indicates that the Government are serious about the timeline – to announce a difficult policy amid unprecedented political turbulence can be read in many ways (some less charitable than others), but it does demonstrate a determination to get on with reforms.

This, of course, comes with an enormous caveat. All the contenders for the Conservative leadership have focussed on tax reduction, and charging reform is inextricably linked to the Health and Social Care Levy announced last year. While some have been clear on the future of the levy, no candidate has given the same clarity on the future of adult social care reform, though some have made hints.

The frontrunner Rishi Sunak has indicated his tax-and-spend approach is more likely to be “steady as she goes” than his leadership rivals. He has however previously sought to indicate that social care reforms were the outgoing Prime Minister’s priority rather than his, dedicating just 14 words to this £5.4bn investment in his last Budget. Sajid Javid, who signed off on the reforms as Health Secretary, has committed to scrap the levy, indicating that he would have paid for the reforms through “headroom”. Whether that headroom is still there now is unclear. Jeremy Hunt, a keen advocate of social care in the last few years, would keep the National Insurance increase as “the NHS needs the money”. On adult social care, he has indicated he would introduce a mechanism to encourage people to save more for care, without saying whether this adds to, or replaces, existing reform plans.

A change of administration makes it harder to be certain that the Government won’t get cold feet in the longer term, but for now the timelines remain. For local leaders already facing huge pressures, the macro-political uncertainty on these major reforms is immensely unhelpful. But Directors of Adult Social Services simply can’t afford to wait, either in getting the nuts and bolts of reform ready or in planning to maximise the wider opportunities that it could bring, as the state starts to take a role in the provision of everyone’s care and not just those below an arbitrary wealth threshold.

At IMPOWER we are keen to help Directors of Adult Social Services and others to navigate these complex changes and their implications, working through the political uncertainty in a way that best prepares their care services for the future, whatever it may hold. To that end we will be holding a series of roundtables in the coming weeks and months and if you are interested in attending, please get in touch.