The Department of Health and Social Care (DHSC) recently announced reforms and an independent commission to help improve adult social care.
As part of the plans to “transform” adult social care, the UK Government unveiled a new £86 million funding boost to the Disabled Facilities Grant (DFG) this financial year. This is in addition to the £86 million announced for the next financial year at the Autumn Budget 2024, taking the annual total for DFGs to £711 million.
As part of long-term reform of the adult social care system, the government wants to create a national care service underpinned by national standards.
As a first step, the government will launch an independent commission into adult social care, to be chaired by The Baroness Casey of Blackstock DBE CB, to inform the work needed to deliver this.
The commission, reporting to the Prime Minister, will make clear recommendations for how to rebuild the adult social care system to meet the current and future needs of the population.
Split over two phases, the commission will set out a vision for adult social care, with recommended measures and a roadmap for delivery.
The first phase, reporting in 2026, will identify the critical issues facing adult social care and set out recommendations for reform and improvement in the medium term.
It will recommend tangible, pragmatic solutions that can be implemented in a phased way to lay the foundations for a national care service. The recommendations of this phase will be aligned with the government’s spending plans, which will be set out at the Spending Review in spring.
The second phase, reporting by 2028, will make longer-term recommendations for the transformation of adult social care. It will build on the commission’s first phase to look at the model of care needed to address the UK’s ageing population, how services should be organised to deliver this, and how to best create a fair and affordable adult social care system for all.
Reacting to the plans for social care reform, David Stockdale, Chief Executive of the British Healthcare Trades Association (BHTA), commented: “The BHTA overall welcomes the government’s recent proposals for social care reform.
“The £86 million funding for DFGs is encouraging. Many of our members provide assistive products that facilitate life-changing home adaptations, so this additional funding means that more people can have access to these crucial pieces of equipment.
“However, the BHTA has previously expressed concern about the consequences of the increases in employer National Insurance Contributions and the National Living Wage on businesses.
“We again encourage the government to rethink the impact of these additional costs for businesses – which the government will rely on to deliver this additional activity within the DFG – so that wider health and social care services aren’t negatively impacted as a result.
“As for the independent commission, the government shouldn’t overlook the importance of healthcare and assistive technology products in helping people to remain independent and healthy. The right products provided in a timely manner can help avoid unnecessary hospital admissions, enable people to stay in their own homes for longer, and ease pressure off an overworked and under-resourced care sector.
“Our members provide the local expertise, products, and services required to help the government achieve its vision of a national care service that meets the needs of older and disabled people.
“However, the timeline for the commission is a major concern. There is worry about what the impact of ‘kicking the can down the road’ will be for businesses supporting social care and what the landscape will look like if no action is taken until the commission’s final publication date of 2028.
“We invite the government to engage with the BHTA and assistive technology community to see what transformational actions can be implemented now.”
Last month, the British Healthcare Trades Association (BHTA) invited members and non-members to its spring conference to discover how current policy decisions are shaping the future of health and social care, impacting UK patients, and what this change means for businesses.
The sell-out conference, ‘UK Health and Social Care Landscape: How will UK policy decisions impact patient experience?’, took place on 11 May 2023 at the Manor Hotel in Meriden, Solihull.
Sponsored by Verlingue, the conference saw an impressive roster of senior government and sector leaders present engaging sessions throughout the day to suppliers about future policy directions, new UK Government priorities, and how collaboration and innovation will ultimately improve the patient experience.
Attendees gained invaluable insights into the changing health and social care landscape, asked questions to the high-profile roster of speakers, and networked with key stakeholders and peers.
Below are the highlights from the other two morning sessions from Simon Williams, Local Government Association Director of Social Care Improvement, and Alan Wain, COO at EPSCOT.
Topics covered by these two presentations included social care reform, how better use of technology could improve the lives of millions of social care users, and how social value in public procurement impacts suppliers.
The first set of BHTA morning presentations from David Stockdale, BHTA CEO; Steven Ferguson, Head of Market Access at IQVIA; and Paul Gaffney, Director of Tendo Consulting, can be found here. These sessions explored how the BHTA is successfully lobbying on behalf of its members, how tackling NHS waiting lists with innovative technology is a priority, and how the changing political landscape is impacting healthcare policy.
The remaining afternoon presentations from the conference will be shared on the BHTA website and social media over the coming days.
Simon Williams, Local Government Association (LGA) Director of Social Care Improvement, gave an overview of the LGA’s perspective on social care.
He underlined that there are millions of social care users whose lives could be improved by better usage of technology. It has a huge role to play in tackling social care challenges and realising the sector’s vision.
He advised that technology needs to be accessible to staff without going through formal assessments and that it should help properly reduce the need for intensive staffing or deploy staff more efficiently.
“Social care is a priority for government and the NHS because the NHS is saying it is not going to be able to find the capacity to get on top of its waiting lists unless there is investment in social care,” Simon noted.
People are unnecessarily admitted into hospital, as there are not reliable alternatives. People stay in hospital for too long as the right solutions are not in place in their homes. Often, people are admitted into care homes instead of going home because the right solutions are not in place, he added.
818,000 people receive adult social care through local authorities. Most spending on social care is made via tax. With all this pressure within the social care sector, especially post-COVID, councils are looking for ways to make savings and meet user needs.
Simon continued: “There has actually been a decline in the number of people who receive long-term care through local authorities, and that particularly affects older people. That’s despite our ageing population.”
LGA estimates that £13 billion is needed to get social care on a sustainable, long-term footing.
Workforce pressures were also highlighted in Simon’s presentation, as he stated that there are currently 165,000 vacancies in the social care sector. Social care is now on the shortage occupations list for immigration.
“Vacancy levels are a massive constraint on meeting demand at the moment, particularly care,” he said.
Simon then moved on to a discussion around social care reform.
As part of this, since April 2023, councils are subject to CQC assessments for their adult social care function for the first time since 2010. That has been brought in primarily because the government says it is going to be delving more into care and there needs to be more transparency around outcomes.
Importantly, Simon explained that the upcoming social care charging reform – which has been pushed back from October 2023 to 2024 at the earliest – would have major consequences for how the care market operates.
“There will be a cap on how much anyone is expected to contribute to their own care,” he said. “Councils have changed the thresholds in which charging applies, so there will be more generous thresholds before people are asked to contribute to their own care or pay for all of it.
“Then there’s the duty on councils to assess self-funders, who ask councils to assess for their care. One of the key issues on that last point is that will potentially erode the differential between providers. Typically, providers will charge more to their self-pay market than to their local authorities. As this duty comes in, you can see that differential being eroded.
“Either providers are going to be squeezed, and I don’t think there’s a lot of profit in many providers to be able to support the loss of that differential. Or local authorities are going to have to find the money to put into that. Then the question is who’s going to pay for that?”
Alan Wain, COO at EPSCOT, presented next at the BHTA spring conference 2023. His session was all about the importance of social value in public procurement.
All public NHS tenders must now have a minimum of 10 percent of the total award scoring to social value, he outlined. This is a significant step change from the traditional price and quality criteria.
“Now that social value has come into it, price and the social value will be taken into account in the evaluations,” Alan explained. “Social value encompasses a lot of initiatives that are going on in society at the moment, such as sustainability, corporate social responsibility, ESG, wellbeing, carbon reduction planning, and so on.”
“The implementation of social value is really about generating additional value in UK plc,” he added. “It’s not about generating additional value in the organisations themselves, it’s about UK plc.
“When social value is being measured, there are two things people are looking at. One is what I call the ‘rear-view mirror’, which asks companies: What are you already doing around social value? And then comes the forward-looking bit: What are you prepared to commit to if you get this contract that’s being awarded?
“The backwards bit is looking for evidence that you’re already doing it and really that supports the credibility of the forward-looking bit.”
Alan said it is important for firms to look at what contracting authorities want when tendering so their proposition is relevant.
He continued: “For you, as an organisation, when you look at what social value touches on, it touches on all parts of your organisation. It goes across all the functions of your organisation. Whereas, when you were looking at price, it may not have quite gone across all the same functions.
“It also goes outside of your organisation. Social value guidance talks about collaboration, using SMEs, and using innovation to make your own products and processes better.”
Large organisations will need to provide data about how many SMEs they work with and what percentage this accounts for in terms of total cost. This data needs to be collected, so organisations can answer these questions sensibly.
In operations where manufacturing occurs in the UK, Alan noted that a lot of manufacturing operations are not doing a lot in their local communities, or it is not recorded anywhere. This data is also important for tenders.
Looking outside of the organisations, NHSE’s net zero targets are very significant in public procurement, including reducing emissions within the supply chain and not just within the organisation.
He underlined that NHS net zero guidance states that the carbon footprint of third parties needs to be removed by 16.5 million tonnes CO2e from supply chain. Scope 1 emissions are direct emissions, scope 2 emissions are indirect emissions, and scope 3 emissions are supply chain emissions.
“Current carbon reduction planning only asks you account for 5 out of 15 scope 3 emissions,” he commented. “Where are the other 10 going to come from? The other 10 get more challenging.”
When EPSCOT did the calculations for tender evaluations, if companies are not accounting for the minimum 10 percent social value, the product’s price must be significantly lower to get the same evaluation score, which would significantly impact suppliers’ gross margins.
Alan added that implementing social value is about improving UK plc. He said social return on investment (SROI) tells a story of how change is being created by measuring social, economic, and environmental outcomes. However, he nodded to the fact that the UK Government’s social value guidance is complex and open to interpretation.
To help with social value, EPSCOT has an affordable social value tool available, which makes it easier for suppliers to quantify the impact of their social initiatives and insights for improving future strategies.