Simon Bottery Profile picture
Sep 22 8 tweets 4 min read
The plan announced today by @theresecoffey to support #socialcare falls far short of the measures needed to ensure people get the support they need this winter and beyond. It was also, alarmingly, saw social care entirely through an NHS| lens. A thread. gov.uk/government/pub…
There were 3 measures announced, of which only one has real resources - a £500m fund to support hospital discharge. Details are scarce but it looks like targeted reinstatement of parts of the hospital discharge fund and recruitment/retention fund, both scrapped earlier this year.
The money is of course welcome and necessary but its short term nature and limited focus on discharge means it offers no more than a couple of stitches to the gaping wound that is the state of #socialcare at the moment.
The second measure involves a new national recruitment campaign for #socialcare and a tiny pot of money to boost international recruitment. Again, there is nothing wrong with either measure just that they are nowhere near the scale of the response that is required on workforce.
The third measure is the most imprecise: providers will be 'supported' to digitise. Again, that's fine but it's absurd to suggest that this is going to have any real immediate impact on the sector's capacity to support more people.
One sentence offers hope but also rings alarm bells: the promise of 'further action from next year to rebalance funding across health and care'. If that means more money for #socialcare, great. But not at the expense of vital NHS spending on e.g. the backlog. More detail needed.
That sentence is also at odds with the strong NHS focus of the statement, from the initial 'patients are my top priority' to the key measure being on hospital discharge. It's good that @theresecoffey is at least talking #socialcare, but this is a terribly narrow perspective on it
All in all, this is another of those health and social care statements that does little to offer hope that a government has the will to tackle - of perhaps even see - the deep-rooted issues facing #socialcare.

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More from @blimeysimon

Sep 22
We’re expecting a statement from @theresecoffey on hospital discharge today. It certainly needs urgent action but a thorough plan will require more than just short term £££ and a focus on more than just #socialcare. A quick thread with some stats.
Historically, delayed discharges have not been mainly been due to #socialcare. Before COVID-19, it was responsible for only a THIRD of delays (the biggest issue: home care packages). The rest were due to NHS issues. There are no recent stats on this NHS/socialcare split though.
Have things got worse for #socialcare since then? Yes - there are fewer staff. The vacancy rate rose to 10.7% in 2021/22 (and may now be even worse). The biggest problem is home care, with a 13.2% vacancy rate. All this might well well be pushing up #socialcare delays.
Read 10 tweets
Aug 4
Another damning report on #socialcare today, this time from @CommonsLUHC: “The Government currently has nothing more than a vision [for social care], with no roadmap, no timetable, no milestones, and no measures of success.”
A thread on some key points…
committees.parliament.uk/committee/17/l…
The MPs commend the Government for “introducing reforms to the sector where previous Governments failed to act”. But they say it has “not come close to rescuing #socialcare, and needs to be open with the public that there is a long way to go.” So, a long way from being ‘fixed’.
It also urges the govt not to ignore the immediate crisis in the sector: “The Government is focused on long-term reform of adult social care, but in order to get to the future it needs to save the sector from the brink of collapse.”
Read 12 tweets
Jul 19
Top line on today’s @1adass survey of #socialcare directors? Funding isn’t sufficient to meet increased DEMAND and increased COSTS. But if that sounds familiar, this year there are a few important, COVID-related twists. A thread. adass.org.uk/adass-spring-b…
Let’s look at DEMAND first. Partly, this is demographics - it’s a familiar story that there are more older people, living longer; more working age people with disability, including LD; and more mental health issues. Directors think these will add 4% to budgets this year.
Added to this, the report now suggests demand arising from problems in the HEALTH system. As the NHS struggles, directors are seeing more people needing #socialcare due to early discharge from hospital, lack of community support or failure to admit people to hospital at all.
Read 14 tweets
Jun 13
I spent two days last week with social services professionals from 40+ countries at the @ESNsocial conference in Hamburg. A quick thread here on some key #socialcare themes. Very impressionistic and not always evidenced so take with large pinch of ‘salz’. essc-eu.org/about-essc-202…
Increasing demand for services seemed a consistent issue, forcing at least some countries to evaluate what they do and how. One Icelandic delegate said its country’s approach was ‘moving from a right to have services to a need to have services’.
That demand was mainly driven by long term factors, particularly ageing populations. But inevitably it was exacerbated by COVID-19, which exposed underlying structural problems. ‘We were unprepared as a sector’ said @ThomasBignal. Sound familiar? kingsfund.org.uk/publications/c…
Read 10 tweets
Mar 30
Lots of interest today in @TheKingsFund @NuffieldTrust findings about public satisfaction with the NHS. But the findings about #socialcare are no less remarkable. Only 15% say they are satisfied - the lowest of all services asked about. 50% are dissatisfied. A short thread…
This year, the survey asked WHY people are satisfied (or not). The main reasons are staff pay, unmet need, unaffordability of #socialcare and lack of support for unpaid carers. Lack of integration between health and care also gets a look in. These are familiar problems…
…and all grounded in fact: the number of people able to access long-term care has been falling since 2015/16, workforce pay has failed to keep pace with other sectors and 1 in 7 people are now estimated to face lifetime care costs of over £100,000. kingsfund.org.uk/publications/s…
Read 7 tweets
Mar 18
This is an important analysis on the implications of @DHSCgovuk 'fair cost of care' reform, which has received less attention than the 'cap' but involves an unprecedented, potentially risky intervention by govt in the #socialcare market. Quick thread:
countycouncilsnetwork.org.uk/new-analysis-w…
'Fair cost of care' basically involved the government funding local authorities to pay more for the care home places/homecare they commission. Why is government bothered about that? Two, related reasons...
1. Most councils, because they're short of cash, 'underpay' for publicly-funded care home places/homecare. To compensate, providers 'overcharge' people who self-fund their own care. This 'self-funder subsidy' is obviously unfair. However, it's not why govt is acting now...
Read 10 tweets

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