The social care funding gap: Implications for local health care reform

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Key points

  • The visible squeeze on NHS funding has added a powerful urgency to local plans to reform health and care services, known as STPs.
  • The 44 STPs across England bring together a coalition of local hospital, primary care and social care bodies to think collectively about how to respond to the challenges of a growing and ageing population. The plans contain ambitious proposals to close the gap between demand and available funding by improving the prevention of ill health; making more efficient use of hospital and specialist care; and by delivering care, when possible, closer to people’s homes. 
  • Successful implementation of these plans will require a robust social care sector. Six years of real terms reductions in social care budgets have left 400,000 fewer people receiving essential help, as well as destabilising the providers of care, leading to some going out of business. Social care is essential for people to lead as independent a life as possible, and to ensure they can be moved out of hospital safely and quickly. 
  • Our analysis of STPs suggests that the funding gap for adult social care is at least £2bn in 2017/18. This figure is in line with other estimates.
  • Many of the STPs include proposals to improve the care of older people, often requiring effective and accessible social care. 
  • We interviewed local STP leaders and found that the size of the social care funding gap identified in the STPs may be an underestimate. They also reported that, while health and social care were working well together in some areas, in others the social care funding situation was creating strain in the relationships between sectors.
  • So far, the government has allowed local authorities to raise additional funding through a new council tax precept and committed an additional £1.5bn of central funding for social care by 2019/20. However, this is insufficient to meet the rising needs on the social care system, and the benefits will not be fully realised until the end of the parliament. 
  • The 2017 budgets need to provide significant additional funding for social care to ensure proper support for those people and their families who are struggling to manage, and to protect the NHS from inefficiency.

This briefing offers an analysis of the size of the gap in adult social care funding in England – at least £2bn in 2017/18.

This estimate is based on information provided on the position of social care funding in 25 of the 44 Sustainability and Transformation Plans (STPs).

The briefing draws on interviews with a range of STP leaders and argues that the social care funding gap has significant implications for STPs. Insufficient funding risks their ability to improve care and put services on a more sustainable footing.

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