Time to end the social care doom loop
Research Assistant
Another year, another social care-less budget.
English adult social care faced November 26th in an already frail state. Last year's hikes to National Insurance Contributions and National Minimum Wage were beginning to really bite social care providers. Along with rising demand, static funding, and chronic labour shortages, the sector has little wriggle room to absorb changing cost pressures. Against this background, the Government's decision to raise the minimum wage again, whilst neglecting any mention of social care support, will likely redouble the challenges facing the sector.
Public support for increasing pay for social care workers is high, reflecting consensus that the work is demanding and underpaid. Less commonly appreciated are the possible unintended consequences: without additional funding to enable local authorities to meet increased staffing costs, wage rises could further destabilise the sector. Providers operate on thin margins, and unfunded cost pressures push them to reduce workers' hours, cut recruitment, or exit the market entirely.
As things stand, social care can expect to see further workforce losses in the years to come. Providers are likely to cut their services or negotiate their costs up. Local authorities will reduce the volume of people they support on their packages, whilst self-funding becomes less feasible. All in all, fewer people will likely be able to access quality social care.
Serious reform is the only escape from this doom loop. The Casey Commission has been tasked with scoping out a new 'National Care Service', which – whatever we think of the brand – is a welcome signal that the need for deeper change has been recognised. That being said, given the earliest the Casey Commission is expected to lay out a plan is 2028, there is still high risk that it could come as too little and too late.
By 2028, the population will have aged further and would be living with more complex health and social care needs. With a stopper in international recruitment, there will be even fewer carers. The social care supply-and-demand mismatch will by then be unmanageable, with spillover effects on the NHS and wider economy as more informal carers are pulled out of the labour market.
A crisis this impending shouldn't continue to be kicked down the road on the basis of being politically unsexy. If the Government view the Casey Commission as its holding piece for the social care crisis, then it must fund local authorities adequately to prevent a complete market failure in the meantime. Otherwise, it must begin implementing structural reform without further delay.
One area particularly ripe for reform is the workforce. The current deal offered to social care workers does not reflect the demanding nature of the job, and incremental changes like raising minimum wage are unlikely to address workforce shortages. Rather than solely focusing on pay, rethinking the “package” of a career in social care could enable easier recruitment and retention of care workers.
Finding ways to professionalise the workforce, for example, could instate the recognition, support, and structured skillset development needed by the sector. In turn, this could make a long-term career in social work far more appealing, helping to cultivate the higher career loyalty enjoyed by countries like Germany and Japan. At the same time, restructuring the funding flows and incentive landscape could encourage providers to invest in technologies, so that tools like homecare monitoring systems can help alleviate the pressure on the workforce.
Without decisive action to remake social care, the crisis will only deepen – it is time to break the doom loop.
Watch this space for a series of papers from Re:State looking at the future of social care.