Social care cap a bold step forward but funding won't ‘fix’ social care or tackle the NHS backlog

Responding to today’s announcement on the NHS and adult social care, Anita Charlesworth, Health Foundation Director of Research and the REAL Centre, said:

‘The introduction of a cap on social care costs is, at long last, a positive and bold step forward. It will provide people with greater certainty about the future costs they need to plan for and help reduce the care cost lottery. But the funding announced today falls well short of what is needed to stabilise the current system and deliver the comprehensive reform that is so desperately needed. The proposals are less generous than those legislated for in the 2014 Care Act.

‘With the cap set at £86k, most people will be protected from catastrophic care costs,* but those with modest assets and high care needs will still risk losing a high proportion of their wealth in future. For example, an individual whose house is valued at £125k still risks losing almost half of their housing wealth whereas a cap set at £50k would have enabled them to retain two thirds. By comparison, a person with a house valued at £500k risks losing less than a fifth of their housing wealth. 

‘And a cap alone will not be enough to deliver the prime minister’s promise to “fix social care once and for all”. Today’s announcement does little to help the third of care users aged under 65 who rely on the quality of the publicly funded system. The government has parked decisions on wider funding and reform – much now rests on the forthcoming autumn spending review. In addition to the cost of the cap, further funding increases, rising to an extra £9.3bn in 2024/25**, will be needed to support the growing number of people going without the care they need, raise care quality, stabilise the provider market and improve the pay and conditions of those working in the sector. Without this, social care will continue to fail people who need it.

‘The government has announced significant new funding for the NHS, including £10bn specifically to tackle the elective care backlog. While this is a huge amount, the scale of the care backlog means that even with this funding, the waiting list will almost certainly be longer at the end of this parliament than it is now. To meet the 18-week standard by 2024/25 would have required closer to £17bn over this parliament. But money is far from the only challenge. The extra staff, beds and equipment needed to treat so many more patients in the coming years are likely to be the biggest hurdles to recovery. Given the lead times for training staff, targeted investment in the workforce is needed now. Otherwise, waiting lists are likely to remain very high for many years to come.

‘Overall, the funding announced for the NHS is not sufficient for an ambitious recovery programme. If COVID-19 continues to require enhanced infection control beyond this year, there is a real risk that the NHS will be forced to make very hard trade-offs between tackling the elective care backlog and delivering on the planned investment to improve primary, community and mental health services, while delivering services that are safe for patients and staff.’

Notes to editors

*See here our analysis which explores what different levels of social care cap would mean for people with different levels of wealth

**See here (see slide 23) we have calculated the funding that would be needed (in addition to funding announced for a cap on care costs) to expand access to social care, pay more for care to sustain the provider sector and pay higher wages to staff.

Media contact

Simon Perry
Simon.Perry@health.org.uk
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