Thread by @blimeysimon

Though it has some good measures, the govt’s white paper is lightweight and underfunded to deliver real reform of adult #socialcare. A rapidly written thread on how the WP sits alongside the Health and Care Bill, Build Back Better and the spending review. gov.uk/government/pub…

First, a reminder of key stuff already announced:
- @CareQualityComm to oversee council delivery of #socialcare
- more generous means test
- £86k cap
- £500m for workforce wellbeing
- a promise of a ‘fair price of care’ to ensure selffunders pay same as publicly funded clients

The white paper tries to provide a vision that wraps these reforms together and it’s not bad: choice, control and independent lives; outstanding quality; fairness and accessibility. The problem comes when it tries to back this up with action and money.

Basically, after the cap/means test has been paid for, @DHSCgovuk only has up to £1.7bn left from the £5.4bn raised by the Health and Care Levy. As a % of GDP, this is loose change down the back of the sofa. And that has to be split over 150 councils. Over three years.

It tried hard on housing, with £300m to increase the range of supported housing options, a new practical support (handyperson) service for minor repairs and more money for Disabled Facilities Grants. These are all good, if hardly earth-shattering, moves.

It’s also very strong on improving data across the sector. Again this is important and necessary. Though it probably won’t excite too many people, it might just be the measure in the WP that turns out to have had most impact when we look back in 10 years.

There’s also £150m to improve adoption of technology and small pots of cash for carers, innovation and planning. It’s a telling sign, though, that the document has to resort to putting ‘a new national website’ among the key policies in the executive summary.

On the critical issue of workforce, the white paper has some decent measures to spend the £500m. There’s emphasis on skills, with a ‘digital hub’ for staff and a ‘skills passport’. But the claim that these measures ‘will attract new staff’ rings hollow. This won’t fix the crisis.

Oddly, given the vision, the white paper is also weak on extending personalisation. There’s nice words but I can’t see anything new or robust here. Perhaps the plan is to do this via the new CQC oversight function of councils but it’s not obviously a priority in the document.

Another big omission is detail of the ‘fair price for care’ policy, funded from the Levy and intended to ensure self funders pay the same as state funded users for care. Providers fear it may destabilise the sector but there’s nothing in the WP to explain how it will work.

There is some hope in a promise that #socialcare will get a bigger share of the Health and Care Levy after three years. But no one will be investing in services, recruiting new staff or feeling confident about their support in old age/disability on the basis of that.

And the promise does nothing, of course, to tackle the sector’s immediate problems around workforce and funding. When they’ve paid for the cap etc, the spending review gives local authorities just 1.8% increased spending power to respond to costs that are rising much faster.

So, even with the measures already announced, the WP is far more ‘whimper’ than ‘bang’. It doesn’t tackle the immediate problems and the measures announced aren’t enough to bring real change. It’s a missed opportunity to put in place a solid foundation for reform of #socialcare.