“The Government is failing to fix the crisis in adult social care as was promised”

This is the conclusion reached by the Public Accounts Committee (PCA) in its report of 20 March 2024.

The care sector has and continues to face many challenges from an aging and more demanding population contributed to by the cost of living crisis and increased pressure on mental health services.  A lack of public funding, high turnover of staff, Brexit, poor terms and conditions, and historically low pay compounded by the pandemic continue to strain the sector.

Summary of the PAC’s report

With more than 1 million adults with care needs at a cost of £23.7 billion and 152,000 vacancies (10%) in the sector, there is surprisingly no roadmap for achieving any targets or milestones beyond 2025 and nothing meaningful in place to demonstrate progress. The PAC concludes:

• Integrated Care Systems are not making an obvious demonstrable difference to delivery;
• It is unclear whether the Department of Health and Social Care knows if it is achieving value for money from the additional funding provided to adult social care;
• Local authorities are planning and commissioning social care services against a background of fragmented and uncertain funding;
• There is still no convincing plan to address chronic staff shortages; and
• Workforce reforms are still way behind schedule.

The Chair of the Committee noted that whilst increased funding is welcome, the fear is that it will do little to address the key challenges faced by the sector in the absence of a well-funded multi-year strategy.

Workforce implications

Issues of low pay, perceived low skill and challenging conditions, including a heavy reliance on zero hours contracts and agency staff mean that the sector has a history of difficulties both in terms of recruitment and retention of staff. As the PAC identifies, the absence of a clear and comprehensive plan to tackle these issues is a concern, and with a reported over 152,000 vacancies in the adult social care sector in March 2023, the issue is clearly not going away.

However, whilst there is a call for improved pay and terms and conditions more generally for the social care workface, which will undoubtedly be welcomed by those working in the sector, there also needs to be a clear, economic growth strategy. It is also important to remember that this is unlikely to just be about pay. In order to attract and keep talent in the adult social care sector long term, there need to also be clear career pathways and progression opportunities. 

Impact on claims

A lack of financial and staffing resources is not usually a defence to a claim because providers have a statutory obligation to provide an adequate service. If the care sector is not adequately resourced, sadly things will go wrong for service users who will not receive the care they need. This can often have significant if not catastrophic consequences. Care providers, local authorities and their insurers will continue to face claims for compensation which are likely to increase in number if sufficient measures are not put into place.