Any future plan for social care must address massive unmet and under-met needs across the country by widening eligibility, writes Nick Ville, director of policy and membership at the NHS Confederation, which is a leading the Health for Care coalition.
At least 1.4 million people in England are not getting the care they need to live safe, dignified, independent lives.
That is vast numbers of people who, among other things, may need help with essentials like washing, getting dressed and getting in and out of bed.
The reasons for this are well worn: local authorities’ budgets have been cut to the bone, meaning that expenditure on social care dropped in real terms by more than a fifth from 2005/06 to 2014/15, from £8.1 billion to £6.3 billion.
As a result, councils have had to tighten eligibility criteria and reduce the numbers of people receiving care and support. At the same time an ever-greater proportion of local authorities’ dwindling budgets is used to protect those with greatest level of needs, including growing numbers of younger people.
Demand for care is only going one way: up. Estimates suggest there will be 4.4 million more people in the UK aged 65 and over in the next 15 years, with the number over 85 likely to rise by more than 1.3 million. There were over 1.8 million new requests to local councils for adult social care in 2015/16, of which just over a quarter were from adults aged 18 to 64.
Combined with the fact we are seeing more people with complex and multiple conditions, it is not unreasonable to conclude we are only seeing the beginnings of a dramatic increase in the people who will need some kind of social care support.
So unless we act quickly to secure a sustainable long-term settlement and plan for the social care sector, we will see more people missing out on essential care services. And we will see more families having to pick up the pieces – the number of family and friends providing unpaid care in England increased from 4.9 million in 2001 to 5.4 million in 2011.
Health for Care, the coalition of 15 heath sector organisations joined together to support a long-term settlement for social care, believes that a fundamental principle of any plan for the system must be that eligibility is based on need and must be widened to make sure that those with unmet or under-met need have access to appropriate care and support.
The NHS was set up to make sure that everyone had access to good healthcare, regardless of their wealth. We believe that this should be no different for those needing social care. Whatever proposals are included in the upcoming green paper, they must address the central issue of widening eligibility.
With governments from all parties failing to tackle the thorny issue of social care over many, many years it is clear the scale of the task is enormous: quite simply, it is among the greatest challenges our country faces.
And while the government was able to commit to a long-term funding deal and a long-term plan to secure the NHS, it is only half of the picture. Social care and health care go hand-in-hand, and one sector cannot succeed unless the other does too. An effective and functional adult social care system is vital for the health, wellbeing and independence of so many and it is essential for our NHS to thrive and survive.
Yet asking the taxpayer to pay more – which any extra investment will almost certainly mean – is rarely an easy task for politicians. The public ultimately has a choice as to what kind of health and care system they are willing to pay for.
Nick Ville is director of policy and membership at the NHS Confederation. Follow the Confederation on Twitter @nhsconfed, and support @HealthForCareENG
This blog is part of a series focussing on Health for Care and its campaign for a sustainable, long-term solution for social care. Read the rest in the series here.