‘Care funding cap risks overwhelming councils and undermining NHS integration’

The government’s plan to ‘cap’ individuals’ social care costs risks overwhelming councils and undermining integration with health, warns a report published today.

Councils will have to provide several hundred thousand additional assessments from April 2016 as this will be the route by which self-funders would be able to benefit from the £72,000 limit on their reasonable care costs. The change will come amid deepening pressures on funding and the introduction, in 2015, of other significant reforms under the Care Bill.

A report today from think-tank the Strategic Society Centre warned that this could overwhelm councils’ organisational capacity and budgets, risking increased waiting lists for assessments and cuts in funding for service users and care providers.

Undermining integration

The report also raised concerns about how the policy fits with the government’s efforts to integrate health and social care. People will only qualify for the cap if they have eligible unmet needs for care. However, the report said government plans to integrate health and social care in order to reduce pressures on acute hospitals pointed to more people receiving preventive support at home before they have eligible needs. It said the planned cap placed social care “in isolation from the rest of the care pathway” and could thereby make integration more difficult.

 “With less than three years until implementation, the government must face up to and deal with the fact that the ‘capped cost’ reforms will not achieve any of their objectives,” said James Lloyd, director of the Strategic Society Centre.
 
The report said the government should consider introducing the changes over a longer period of time to reduce the pressure on councils. This could be done by either rolling out the cap nationally over a three-year period or by letting councils decide when to implement the various aspects of the cap in their own area.
 
While it conceded that a longer national rollout risked confusing people, while allowing councils to set the pace of its introduction itself could result in a ‘postcode lottery’, it said these options would reduce the potential for adverse consequences from the reforms.
 
The think-tank also said the reforms should be revised to promote health and social care integration. One option it puts forward is to introduce separate systems for residential and home care. A cap similar to the government’s proposals would apply to residential care costs, while a separate charging system could be introduced for integrated health and social care at home, with a cap on the weekly costs faced by individuals.

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