'Time bomb' warning after report slams Department of Health

According to a new report from the National Audit Office (NAO), the cost of adult social networking is set to double from £ 26bn to £ 56bn a year over the next 20 years.

The report also criticizes the government for short-term investments and the lack of long-term vision and accountability.

Jeremy Hunt, former health minister and current chairman of the Commons Health and Social Care Committee, described the situation as a “time bomb” and the amounts involved as a “feast for the eyes”.

“Doing nothing is just not an option,” Hunt said on Twitter.

“The NAO Social Welfare Report released today should hold us back.

“Over the next two decades, taxpayer-funded care costs for the elderly will increase by 106% and the total cost of social care for the taxpayer will increase from £ 28 billion to £ 56 billion.

“These are staggering sums that mean doing nothing is simply not an option. We have known for years that the demographic time bomb is on the way. There is no more time for can-kicking or endless consultations.

“Ensuring the dignity and safety of our elderly population should be vital to conservative government. If we don’t do this after the welfare horrors this year, I fear we never will.”

“I am delighted that yesterday the Prime Minister committed himself to a ten-year plan for social care for this year, and indicated that we will see something about it in the Queen’s speech. We are eagerly awaiting the details and we will get them involved hold tight.”

The NAO report, which examines the current care market and the role of the Department of Health and Social Welfare in overseeing the market now and in the future, says the “lack of long-term vision” has hampered – and is coming – the efforts of local authorities concluded that “current accountability and oversight regimes are not working”.

It should be noted that local authorities spent £ 16.5 billion net on care over the 2019-20 period.

A NAO spokesman said: “Short-term funding and a lack of long-term vision have hampered planning, innovation and investment in adult social care. Current accountability and oversight regimes are ineffective for monitoring the care market, according to a report by the National Audit Office.

“The Department of Health & Social Care (the Department) is responsible for setting national guidelines for adult social care and for the overall performance of the care system. The Care Act 2014 imposes a number of obligations on local authorities. The authorities are responsible for responsible for hiring adult social welfare to around 14,800 registered providers, most of which are independent.

“In 2019-20, local authorities spent £ 16.5 billion net on care. The Department of Housing, Municipalities and Local Government oversees the distribution of funds to local government and the financial framework within which local authorities operate The Care Quality Commission (CQC) regulates the quality of service providers and monitors the financial resilience of the largest and possibly the most difficult-to-replace service providers.

“The current rules on accountability and supervision of adult social care are ineffective. Although the CQC rates most care services as good, the ministry is unaware of how effectively local authorities provide care and what results are being achieved. There are no legal issues Powers to intervene or individual authorities to hold account.

“This limits the ministry’s ability to assess how well money is being spent or what additional resources are needed to support those in need. The ministry has increased its focus on adult social care in response to Covid-19 and taken steps to to raise the money. ” Capacity and address data gaps and published a white paper in February 2021 with proposals to improve the data collected and the monitoring of social service delivery by local authorities.

“The department has failed to meet its previous commitments to address the recruitment and retention issues for the 1.5 million people who work in nursing. It has not created a workforce strategy since 2009, although it committed to it in 2018. The department split the NAO that it is a workforce. ” The strategy would depend on the next spending review and the broader reforms set out in the recent White Paper.

“The department does not have a clear strategy for developing homes for adults in need of care and does not monitor the condition of the current homes themselves. Uncertainty about future funding and care policies makes providers reluctant to invest in housing. Funding is for new investments ad hoc with no coordinated, long-term vision across government on how to develop new accommodation or adapt existing accommodation to care needs.

“Short term funding agreements have hampered long-term planning of adult social welfare. The NAO previously stressed the importance of clarity about funding beyond the end of a spending review. Uncertainty has made it difficult for local authorities to face significant financial pressure. to plan how much care they could buy beyond the current fiscal year, which limits much-needed innovation and investment. For the 2019-20 period, the ministry assessed that most local authorities pay care providers under a sustainable care rate.

“Stakeholders lack visibility of provider finances across the care market. Before Covid-19, many care providers were financially unsustainable and the impact of Covid-19 could have other ramifications. Given the responsibilities of local authorities for care and market oversight for CQC In this role, the department does not collect additional information about the finances of the provider.

“CQC’s analysis of the major providers shows that government support has helped stabilize the market. The decline in occupancy from around 90% before the pandemic to 80% in February 2021 raises concerns that continued support may be required.

“In 2019-20, 839,000 adults gained access to long-term support from local authorities. Before Covid-19, Carers UK estimated that there were around 7.3 million unpaid carers in England. Around 24% of adults 65 and over have an unmet need for care.

“Future demand for care is expected to increase sharply, which will lead to rising costs. The department estimates that in 2038, compared to 2018, around 29% more adults between the ages of 18 and 64 years and 57% more adults During this period, the total cost of care for adults aged 18 to 64 is expected to increase by 90% and for adults aged 65 and over by 106%. These projections are highly uncertain and depend on changes in the population Manner of care delivered that the department has not yet assessed.

“Despite long-standing government papers, consultations and reviews, the ministry has not come up with a long-term plan for care. The pandemic has delayed promised reforms as the government prioritizes the response to Covid-19.

“The ministry will lead reform plans and is committed to putting forward proposals in 2021. Reforming the sector will be a significant challenge and will require an overall system and an intergovernmental approach.”

Gareth Davies, director of the NAO, said, “The lack of a long-term vision for adult social care coupled with ineffective monitoring of the system means people may not receive the care that best supports them.

“The Department of Health and Social Affairs has increased its focus on adult social care in response to the Covid-19 pandemic. It needs to build on this to ensure that its long-awaited reforms provide affordable, high-quality and sustainable social care for adults enable the future. “

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