£3bn boost fails to address challenges facing health and social care

Industry experts respond to Chancellor's Comprehensive Spending Review with fears social care services will crumble

The Chancellor, Rishi Sunak, announced the Comprehensive Spending Review on Thursday

The extra £3billion promised by the Chancellor last week to help the NHS deal with the backlog caused by the Coronavirus pandemic does not go far enough to address with the problems facing the health service, experts have warned.

Rishi Sunak’s Comprehensive Spending Review (CSR) announcement on Thursday, while welcomed, has been widely criticised for failing to properly deal with the pressures facing the NHS and social care services.

The planned investment in health and social care is welcome given the wider financial situation. However, it is unlikely to be enough to address the pressures faced by services across the country

In the announcement, the Government changed its pre-COVID plan to provide a long-term funding package for public services, instead opting for a one-year settlement because of the scale of the Coronavirus pandemic and its unknown impact on future public finances.

For the health sector, that means:

Chancellor, Rishi Sunak

  • A total of £18billion for COVID testing, PPE, and vaccines over then next year
  • The health budget in England to rise by £6billion, including an extra £3billion for the NHS to cope with COVID pressures
  • £1billion to tackle treatment backlogs and enable delayed operations to go ahead
  • £500m for mental health services in England
  • £325m to replace ageing diagnostic equipment like MRI and CT scanners
  • £300m extra grant funding for councils for social care
  • A pay rise for NHS staff based on advice from the national pay review bodies

Commenting on the news, Sally Warren, director of policy at The King’s Fund health think tank, said: “This Spending Review is an understandable attempt to balance the need to invest in health and care services as they emerge from the pandemic with the stark economic reality we find ourselves in.

“The planned investment in health and social care is welcome given the wider financial situation. However, it is unlikely to be enough to address the pressures faced by services across the country, which are likely to require more emergency funding next year.

“Funding for social care, in particular, falls a long way short of what is needed to meet the needs of service users, their families, and carers, let alone reform the system.

If we don’t start now in bringing together the departments of housing, health and social care to address the issues, rather than funding the cracks; those cracks will become a chasm that we can’t easily close

“Leaders across health and social care will need support from national government as they face some very-tough choices in the year ahead.

“The lack of funding for a multi-year health and care workforce strategy is also disappointing and will make it difficult for the Government to fulfil its manifesto commitments, such as the promised 50,000 extra nurses.

“This will only add to the uncertainty and pressure faced by health and care services.”

As part of the settlement, local authorities’ core spending power on social care will increase by 4.5%, giving access to £1billion more to fund social care on top of the extra £1billion social care grant announced earlier this year.

Councils will also be able to levy an additional adult social care charge on council tax bills of up to 3%, specifically for the care of older and disabled people.

But the approach has drawn heavy criticism, with The Association of Directors of Adult Social Services describing it as ‘fragmented’ and ‘short-term’.

And Nick Sanderson, chief executive of care provider, Audley Group, warned that ‘cracks will become a chasm we can’t easily close’.

He told BBH “The Chancellor announces a holistic approach to local community projects, but neglects to do the same for social care, which gets the smallest of mentions in the Spending Review.

“And this is despite the clear lens that’s been shone on the problems in the social care system in 2020.

“If we don’t start now in bringing together the departments of housing, health and social care to address the issues, rather than funding the cracks; those cracks will become a chasm that we can’t easily close.

“We need to take the burden off hospitals and care homes and find new models to support older people before they need to use these overstretched facilities.

We need to take the burden off hospitals and care homes and find new models to support older people before they need to use these overstretched facilities

“Without this, the ‘extra flexibility’ the Chancellor promises local authorities to raise money for social care will be a drop in the ocean.”

Victoria Hemmingway, public affairs and policy manager at national learning disability charity, Hft, said a more-long-term view was needed.

She added: “After a year when the adult social care sector has been firmly on the frontline of the COVID-19 pandemic, the announcements made in the Comprehensive Spending Review are deeply disappointing.

“While access to an additional £1billion for local councils to fund social care is a welcome step; it is yet another stopgap solution, falling dramatically short of what is required to place the sector on a sustainable financial footing.

“Even before the COVID-19 pandemic, the adult social care sector was stretched beyond its limits.”

There has been widespread criticism over the lack of a long-term settlement for social care services

Hft’s Sector Pulse report for 2018-19, which provides an annual snapshot of the financial health of the social care sector; revealed earlier this year that 52% of care providers would need to close services in the near future due to financial pressures.

Hemmingway said: “Coupled with the unexpected additional costs of COVID-19, this places adult social care providers under undue strain, during a time when the service they provide is needed more than ever by some of the most-vulnerable adults in society.

“The CSR includes a commitment to bring forward proposals on a funding solution for the social care sector next year.

“It is vital that the Government does not fall short on this promise yet again and ensures that the long-term future of social care is secured at the earliest-possible opportunity.”

And Councillor Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “The Coronavirus crisis has demonstrated the crucial value of councils’ adult social care and public health services.

After a year when the adult social care sector has been firmly on the frontline of the COVID-19 pandemic, the announcements made in the Comprehensive Spending Review are deeply disappointing

“Extra funding for children’s and adult social care will help address some short-term pressures, but we need a clear plan on the future of care and support and how we pay for it, which recognises low pay in the adult social care workforce and finally delivers parity of esteem with the NHS.

“No new public health funding, despite this incredibly-challenging period, also runs contrary to addressing the stark health inequalities exposed by COVID-19 and levelling up our communities.

“Keeping people healthy and well throughout their lives reduces pressure on the NHS and social care.”

The key role played by GPs was also overlooked, according to Jonathan Murphy of Assura Group, who said the Government needs to invest in primary care, as well as hospitals, to truly address challenges faced by the NHS moving forward.

He added: “With the NHS Long Term Plan, and experiences of the pandemic to guide us; the common denominator is flexible modern capacity in primary care.

We all hope we’ll never experience a situation like this again – but there is so much we can learn from it to create the health spaces of the future, and in using place to help address the health inequalities which the pandemic has laid bare

“Hospital upgrades are desperately needed, but as the NHS attempts to address care backlogs, and as GPs look ahead to a future where clicks and consultations combine; the most-transformative infrastructure investment would be in creating the right space for consultation, both digital and traditional, diagnostics, and treatment close to home.

“Clearly, we all hope we’ll never experience a situation like this again – but there is so much we can learn from it to create the health spaces of the future, and in using place to help address the health inequalities which the pandemic has laid bare.”

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