Health for Care

Making the case for a sustainable social care system, backed up by a long-term funding settlement.
A healthcare worker pushing a wheelchair up a ramp and into a car.

The NHS Confederation leads Health for Care, a coalition of 15 national health organisations who have joined forces to make the case for a sustainable social care system, backed up by a long-term funding settlement.

Finding a long-term, sustainable solution to how we pay for and provide care and support to people in England is among the greatest challenges our country faces. The impact on the public has been profound, with record numbers of people now left to struggle each day without the care and support they need. We believe it is the time to put this right.

  • The Health for Care coalition has adopted seven key principles upon which a new social care system in England should be based.

    Health for Care’s seven key principles:

    1. Sharing costs: A system providing the care people need – free at the point of use – should be funded by universal and compulsory financial contributions. This may require differences in when, how, and how much people pay towards the care system.
    2. Fair eligibility: Eligibility should be based on need and must be widened to ensure that those of any age with unmet or under-met need have access to appropriate support. Eligibility must also guarantee parity of esteem across physical, mental and cognitive health.
    3. Improving integration: Health and care services should be designed to work more effectively together, with personalised care and prevention at the heart of both services. Health and care services should deliver treatment and care at the right time and place and guarantee maximum personal control to the recipients of care.
    4. Sustainability: Establishing a sustainable social care system will require closing the existing funding gap in the short-term, as well as establishing a permanent funding settlement that would enable both members of the public and care providers to plan for their long-term future. Levels of funding should also sustain a diverse and stable market of providers.
    5. Valuing the workforce: More workers should be recruited to, and retained within, the care sector. Furthermore, those who work within the care sector should be offered sufficient pay, higher quality training (along with the protected time away from work to undertake training), opportunities for career progression, and new career paths.
    6. Supporting carers: Unpaid carers should be eligible for increased support from the state. Additionally, offers of care should not be reduced on the basis that someone may be a recipient or possible recipient of informal care.
    7. Accessibility: The criteria and assessment process for receiving state-funded care should be simple enough for everyone to understand, with guidance on offers of care to be made widely available. In addition, assessments of individuals’ care needs should be conducted by appropriately-trained assessors.
  • Our Health for Care coalition has developed a set of principles upon which we believe a sustainable social care system should be based. We hope they will be a useful contribution to the debate ahead of the publication of the adult social care Green Paper. Alongside the principles, we have three recommendations that we believe are critical to achieving a long-term settlement for social care:

    • Eligibility should be 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.  Around 2.1 million people in the UK were estimated to have received some level of informal care in 2014, but the number of family and friends providing unpaid care in England increased from 4.9 million in 2001 to 5.4 million in 2011. Moreover, Age UK have identified that at least 1.4million people have unmet or under met need.
    • Any new settlement should provide secure, long-term, funding at a level to enable the social care system to operate effectively and deliver the outcomes that people want and need. The settlement needs to address immediate needs from April 2020, as well as putting the social care sector on to a sustainable path for the longer term. That will require the right funding, workforce and a diverse and stable market of providers. This will need to be supported by good quality, trusted information and advice to help people navigate the care system effectively. The Spending Review presents an essential opportunity to invest in social care at the same scale as the Government is now investing in the NHS.
    • A recent report commissioned by the NHS Confederation, and undertaken by the Institute for Fiscal Studies and the Health Foundation, calculated that social care funding would need to increase by 3.9% a year to meet the needs of an ageing population and an increasing number of younger adults living with disabilities. We recognise that any significant additional funds must be accompanied by reform and improved service delivery. Social care services and the NHS are working together to transform and integrate local care services, but they can only go so far when services are being placed under so much strain.