A quarter of the £2bn NHS funding boost announced this week should be allocated to social care or home care services will fall into crisis, former care minister Paul Burstow has warned.
Burstow was speaking ahead of the launch today of his Commission on the Future of the Home Care Workforce, which made extensive recommendations to boost investment in care workers’ wages, training and development.
Health secretary Jeremy Hunt today confirmed that an extra £1.7bn would be invested in the NHS in 2015-16 – recycled from other government department and Department of Health coffers – and a further £1bn generated from banking fines would be spent on health over the next four years.
Burstow said it would be a mistake for the extra funding to go solely to health services. He warned: “If all of the money just finds its way into the NHS and not social care, and in particular home care, then clearly implementing our recommendations will be difficult. We will end up with fewer people having access to home care and the support they need and instead finding themselves in crisis.”
Instead, the former care minister suggested that half a billion of the approximately £2bn announced for 2015-16 be earmarked for social care. This could be transferred through the Better Care Fund, the £3.8bn-a-year pooled budget for integrating health and social care services that commences in 2015-16.
Hunt said the £1bn from banking fines would be invested in new primary and community health care facilities. He said £1.5bn of the £1.7bn would go on NHS frontline services, including mental health, while the remaining £200m would be invested in new models of care set out in NHS England’s Five Year Forward View, published in October. This may include social care spending as NHS England said that new models could include GP services expanding into “multispeciality community providers” that may take on responsibility for social care, and enhanced healthcare services in care homes.
When challenged in Parliament by Burstow on the potential for the new funding to support social care, Hunt said yesterday: “Home care is going to become an increasingly important part of what the NHS and social care systems deliver. I want them to deliver it in an integrated, joined-up way and £200 million of the £1.7 billion going on to the NHS front line is to help develop new models of care. I think that improved home care could be a very real way we do that.”
Home care crisis
The Burstow commission’s report, published today, warned that the home care sector was heading into crisis. The combination of dwindling council resources and poor employment practices had led to the exploitation of care workers, with 60% now on zero hours contracts and up to 220,000 being paid less than the minimum wage.
The report, which was supported by think-tank the Local Government Information Unit (LGiU) and home care provider Mears, made 11 recommendations for improving terms and conditions for workers, including the introduction of minimum payments for contact hours.
This would ensure that councils were paying a sufficient rate to providers for the time workers spend with clients, ensuring that all staff can be paid at least the minimum wage.
Other recommendations include:
- Immediate key worker status for care workers employed directly by the public sector and an investigation into how this can be offered to other workers.
- Councils being more proactive in ensuring that their use of framework contracts are not contributing to bad practice, such as 15-minute care slots.
- All care workers should receive the living wage.
- A training and career pathway should be set up for care workers to ensure minimum standards of training and an opportunity to specialise.
Although implementing its recommendations would come with a price, the commission said the cost of ‘doing nothing’ would be greater.
Social care leaders said that addressing both the problems raised by the Burstow commission and the pressures on the NHS required significant investment in social care.
Janet Morrison, chief executive of charity Independent Age, said: “We welcome the recommendations, particularly those that focus on better pay for care workers. Putting this right, however, requires fundamental reform, as the root cause of low pay and zero-hours contracts of care workers, is a care system impacted by years of underfunding.”
David Pearson, president of the Association of Directors of Adult Services, added: “Simon Stevens [NHS England’s chief executive] said in his five year forward view that the NHS needs a sustainable social care system so there should a similar level of resources going into social care. It may be a proportion of the £2bn that has been announced by the NHS or it may be another proportion of money.
“Either way, we need investment to reflect the increased demand and need in social care and the vital role social services play in supporting people at home and reducing the pressures on hospitals.”