Long-term funding of adult social care
Housing, Communities and Local Government Committee
Closed
Inquiry
This inquiry will focus on how adult social care should be funded in the long-term. The Committee aims to understand the extent to which the Covid-19 pandemic has changed the landscape for long-term funding reform since we published recommendations on the subject together with the Health and Social Care Committee …
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22
Recommendations
14
Conclusions
1
Report
5
Oral sessions
13
Letters
5
Events
Activity timeline 25 events
12 Sep
2023
2023
15 Jun
2023
2023
15 Jun
2023
2023
8 Mar
2023
2023
7 Mar
2023
2023
21 Feb
2023
2023
4 Aug
2022
2022
Report published
12 Jul
2022
2022
28 Jun
2022
2022
14 Jun
2022
2022
24 May
2022
2022
23 May
2022
2022
Oral evidence
Oral evidence sessions 5 sessions
23 May 2022
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Oral Evidence
Alex Skinner · Department for Levelling Up, Housing and Communities
Gillian Keegan · Department of Health and Social Care
Kemi Badenoch · Department for Levelling Up, Housing and Communities
Michelle Dyson · Department for Education
25 Apr 2022
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Oral Evidence
Adrian Jenkins · Pixel Financial Management Ltd
Gavin Edwards · UNISON
Sarah Pickup · Local Government Association
13 Dec 2021
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Oral Evidence
Charles Tallack · Health Foundation
Chris Smith · Thirteen Group
Dr Eleanor Roy · Chartered Institute of Public Finance and Accountancy (CIPFA)
Natasha Curry · Nuffield Trust
Paul Teverson · McCarthy Stone
Professor Philip Booth · Institute of Economic Affairs
Sally Warren · Department of Health and Social Care (DHSC)
Sue Ramsden · National Housing Federation
29 Nov 2021
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Oral Evidence
Brian Dow · Rethink Mental Illness
Emily Holzhausen · Care and Support Alliance
Fazilet Hadi · Disability Rights UK
Jackie O'Sullivan · Care and Support Alliance
James White · Alzheimer’s Society
Ruthe Isden · Age UK
25 Oct 2021
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Oral Evidence
Cllr Tim Oliver · County Councils Network
Dr Jane Townson · Homecare Association
Jane Ashcroft CBE · Anchor Hanover
Stephen Chandler · Association of Directors of Adult Social Services
Steve Scown · Dimensions UK
Reports 1 report · click to expand
| Title | HC No. | Published | Items | Response |
|---|---|---|---|---|
| Second Report - Long-term funding of adult social care | HC 19 | 4 Aug 2022 | 36 | Responded |
Recommendations & Conclusions
36 results
1
Conclusion
Accepted
Second Report - Long-term funding …
The covid-19 pandemic has had a severe impact on adult social care.
The covid-19 pandemic has had a severe impact on adult social care. People have received less care and often care workers have been compelled to deliver only the basics. More people are going without care and many people’s needs are …
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Government Response
The government states that throughout the pandemic they made available over £2.9 billion in specific COVID-19 funding to support the adult social care sector.
Ministry of Housing, Communities and Local Government
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2
Recommendation
Accepted
Second Report - Long-term funding …
The Government provided vital additional funding to the adult social care sector during the pandemic,...
The Government provided vital additional funding to the adult social care sector during the pandemic, and we appreciate that the additional covid-19 funding cannot continue indefinitely. However, the Government’s own guidance that care workers should self-isolate if they test positive …
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Government Response
The government states that at the Autumn Statement 2022 it made up to £7.5 billion of additional funding available over two years to support adult social care and discharge.
Ministry of Housing, Communities and Local Government
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3
Recommendation
Accepted
Second Report - Long-term funding …
The Government is focused on long-term reform of adult social care, but in order to...
The Government is focused on long-term reform of adult social care, but in order to get to the future it needs to save the sector from the brink of collapse. Covid-19 has highlighted the underlying structural challenges of rising demand, …
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Government Response
The government is making available more funding for adult social care through general taxation and increased Council Tax flexibilities, with up to £7.5 billion of additional funding over two years to support adult social care and discharge.
Ministry of Housing, Communities and Local Government
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4
Conclusion
Acknowledged
Second Report - Long-term funding …
The Rt Hon Boris Johnson MP said as Prime Minister that he would fix the...
The Rt Hon Boris Johnson MP said as Prime Minister that he would fix the crisis in social care once and for all. We commend the Government for attempting to prevent unpredictable and catastrophic care costs for people and introducing …
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Government Response
The government acknowledged the concerns around the impact of charging reforms and stated they have provided funding for charging reforms, but do not address the concerns that they have underestimated the combined cost of introducing a new cap and more generous means test, commencing Section 18(3) of the Care Act 2014 in respect of residential care, and the fair cost of care.
Ministry of Housing, Communities and Local Government
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5
Conclusion
Accepted
Second Report - Long-term funding …
The covid-19 pandemic had the effect of raising public awareness of adult social care.
The covid-19 pandemic had the effect of raising public awareness of adult social care. It also achieved general support for a tax increase specifically to plug the long- standing funding gap. However, the Government has missed this opportunity. It has …
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Government Response
The government states that the savings from delaying the implementation of charging reform are being retained in local authority budgets to help them meet the current pressures in social care, with additional funding being provided.
Ministry of Housing, Communities and Local Government
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6
Conclusion
Acknowledged
Second Report - Long-term funding …
We do not wish to pit the NHS and adult social care against one another.
We do not wish to pit the NHS and adult social care against one another. The two systems are interdependent and each needs to be adequately funded to reduce pressure on the other. Wherever the money comes from—from allocating a …
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Government Response
The government recognises the committee’s concerns around the impact of charging reforms on social care assessors and will work with IT suppliers and local authorities, supporting local areas to trial and invest in innovative approaches to reforming operating models and to improving the recruitment and training of the adult social care workforce.
Ministry of Housing, Communities and Local Government
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7
Conclusion
Acknowledged
Second Report - Long-term funding …
We do not accept the Government’s position that care providers should not be compensated for...
We do not accept the Government’s position that care providers should not be compensated for employer National Insurance Contributions in relation to the Health and Social Care Levy simply because they are, on the whole, private businesses. We heard again …
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Government Response
In light of the new timeline to implement charging reform, the government will be reviewing the delivery plan and considering how to ensure that insights from Trailblazers can be effectively fed back into the development of delivery to refine or adapt our approach to implementation.
Ministry of Housing, Communities and Local Government
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8
Recommendation
Acknowledged
Second Report - Long-term funding …
While the Government has provided funding for its charging reforms, we received many concerns that...
While the Government has provided funding for its charging reforms, we received many concerns that it has underestimated the combined cost of introducing a new cap and more generous means test, commencing Section 18(3) of the Care Act 2014 in …
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Government Response
The government acknowledges the committee's interest in proposals to improve fee transparency and describes existing initiatives like the Market Sustainability and Fair Cost of Care Fund and the Market Sustainability and Improvement Fund, as well as a commitment to consider changing the CQC registration regulations to require greater fee transparency.
Ministry of Housing, Communities and Local Government
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9
Recommendation
Acknowledged
Second Report - Long-term funding …
It is nevertheless disappointing that people currently living in and paying for residential care, whose...
It is nevertheless disappointing that people currently living in and paying for residential care, whose payments before October 2023 will not count towards the cap, will now not be able to access local authority rates until 18 months later than …
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Government Response
The government states they agree with the committee’s recommendation for market shaping to include a dedicated focus on outcomes-based commissioning and investing funding to strengthen local authority market-shaping, commissioning, and contract management capability.
Ministry of Housing, Communities and Local Government
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10
Conclusion
Accepted
Second Report - Long-term funding …
While the changed timetable for rolling out Section 18(3) will help to stagger the additional...
While the changed timetable for rolling out Section 18(3) will help to stagger the additional assessments local authorities will need to conduct, we are nevertheless concerned about local authorities’ capacity to conduct tens of thousands of additional assessments, particularly given …
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Government Response
The government states it is committed to addressing the pressures facing social care and continues to provide significant additional grant funding to councils.
Ministry of Housing, Communities and Local Government
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11
Recommendation
Acknowledged
Second Report - Long-term funding …
The Government should publish real-time and regular evaluation, both of the trailblazer scheme and of...
The Government should publish real-time and regular evaluation, both of the trailblazer scheme and of the charging reforms when they are rolled out more widely, so that local authorities can apply insights quickly and so that the Government can provide …
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Government Response
The government states it understands the benefits for councils of a Local Government Finance Settlement (LGFS) spanning multiple years and will aim to provide a multi-year funding settlement wherever possible in recognition of its importance to councils’ budget setting processes and to delivering excellent public services.
Ministry of Housing, Communities and Local Government
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12
Recommendation
Acknowledged
Second Report - Long-term funding …
Given the Government’s investment in the fair cost of care, and our calls for further...
Given the Government’s investment in the fair cost of care, and our calls for further funding and for care providers to be compensated for their employer National Insurance Contributions of the Health and Social Care Levy, it is all the …
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Government Response
The government acknowledges the desire for clarity on distribution reform but states that they will not be proceeding with the Review of Relative Needs and Resources or Business Rates Reset during this Spending Review, focusing instead on stability and clarity.
Ministry of Housing, Communities and Local Government
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13
Conclusion
Acknowledged
Second Report - Long-term funding …
While achieving a fair price of care is vital, price should not be the driving...
While achieving a fair price of care is vital, price should not be the driving factor in commissioning care. Reforms in relation to improvement and market shaping should include a dedicated focus on outcomes-based commissioning, drawing on existing good practice …
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Government Response
The government recognizes the concerns of local government and notes the delay to planned adult social care charging reforms. They will comply with the New Burdens Doctrine for relevant aspects of the adult social care reform programme.
Ministry of Housing, Communities and Local Government
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14
Recommendation
Acknowledged
Second Report - Long-term funding …
As well as the desperate human impact on those needing, receiving, and providing care, the...
As well as the desperate human impact on those needing, receiving, and providing care, the underfunding of adult social care has led to many councils having to cut other public services in order to do their best to meet their …
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Government Response
The government restates its commitment to the 10-year vision for adult social care set out in the People at the Heart of Care white paper and highlights actions being taken over the next two years to take the next step toward person-centred care.
Ministry of Housing, Communities and Local Government
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15
Recommendation
Accepted
Second Report - Long-term funding …
We recognise the benefits of raising a proportion of funding for adult social care locally.
We recognise the benefits of raising a proportion of funding for adult social care locally. As we have argued in previous reports, we support greater fiscal devolution. In finding the right balance of funding sources for adult social care, however, …
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Government Response
The government states that overall funding for health and social care will be maintained at the same level as if the Levy was in place, and that savings from delaying implementation of charging reform will be distributed via the existing Social Care Grant that supports local authorities to meet the current pressures in social care.
Ministry of Housing, Communities and Local Government
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16
Recommendation
Accepted
Second Report - Long-term funding …
One-year funding settlements and short-term grants are hampering local authorities’ ability to plan and to...
One-year funding settlements and short-term grants are hampering local authorities’ ability to plan and to deliver value for money, which in turn affects local care markets as it makes it more difficult for local authorities to enter longer term contracts …
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Government Response
The government states that in developing the People at the Heart of Care white paper, it engaged extensively with other government departments, and has worked closely with colleagues across government since the white paper publication to produce the recently published Next Steps to Put People at the Heart of Care plan.
Ministry of Housing, Communities and Local Government
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17
Recommendation
Acknowledged
Second Report - Long-term funding …
The geographical inequity of relying on council tax to provide the majority of funding for...
The geographical inequity of relying on council tax to provide the majority of funding for adult social care is compounded by an out-of-date adult social care relative needs formula. The Government must update the adult social care relative needs formula …
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Government Response
The government states that they remain committed to providing care and support in a person’s own home, but have taken the difficult decision to not progress with the £300 million investment in housing, announced in the white paper, in order to prioritize spending on the reforms we believe are most needed.
Ministry of Housing, Communities and Local Government
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18
Recommendation
Accepted
Second Report - Long-term funding …
The Department for Health and Social Care is drip-feeding numerous policy changes in adult social...
The Department for Health and Social Care is drip-feeding numerous policy changes in adult social care, many of which are welcome, but many of which will have a significant impact on local authorities in terms of their spending and capacity. …
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Government Response
The government states that National Planning Policy already makes clear that local authorities must plan for a range of housing needs, including the needs of older and disabled people, and that they do not intend to introduce statutory requirements at this time.
Ministry of Housing, Communities and Local Government
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19
Recommendation
Acknowledged
Second Report - Long-term funding …
Stakeholders have called for adult social care reform for years, and we commend the Government...
Stakeholders have called for adult social care reform for years, and we commend the Government for introducing many welcome initiatives such as around housing and data that could make a significant difference in the long-term. We are also pleased that …
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Government Response
The government notes that the Older People’s Housing Task Force will provide an opportunity to consider detailed evidence of the operation of the planning system in supporting housing for older people and whether any changes are required, including in respect of use classes, but makes no firm commitments.
Ministry of Housing, Communities and Local Government
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20
Conclusion
Acknowledged
Second Report - Long-term funding …
The lack of information about how the reforms add up to £5.4 billion, why each...
The lack of information about how the reforms add up to £5.4 billion, why each reform was allocated the amount it was allocated, and how funding will be distributed, does little to instil confidence that the Government has thought through …
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Government Response
The government emphasizes that local authorities are responsible for ensuring sufficient workforce capacity to meet care needs in their area, and highlights the measures they are taking subject to monitoring and evaluation.
Ministry of Housing, Communities and Local Government
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21
Conclusion
Acknowledged
Second Report - Long-term funding …
Given how fundamentally social care policies made by DHSC affect local authorities’ capacity, budgets, and...
Given how fundamentally social care policies made by DHSC affect local authorities’ capacity, budgets, and residents, it is vital that DHSC and DLUHC work together closely on developing and delivering such policies. We were struck by the discrete division of …
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Government Response
The government acknowledges the importance of health and care staff and integrated care systems working with local authorities, but emphasizes the distinct nature of the social care sector as primarily private.
Ministry of Housing, Communities and Local Government
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22
Conclusion
Deferred
Second Report - Long-term funding …
We welcome the Government’s commitment to “making every decision about care is a decision about...
We welcome the Government’s commitment to “making every decision about care is a decision about housing”, but we are concerned that currently the Government is not putting this into practice. The detail on the housing policies in the People at …
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Government Response
The government has noted the Migration Advisory Committee’s (MAC) recommendation that care workers’ inclusion on the shortage occupation list should not automatically expire after 12 months and commissioned the MAC to review the SOL.
Ministry of Housing, Communities and Local Government
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23
Recommendation
Acknowledged
Second Report - Long-term funding …
The Government should create a separate taskforce for housing for working age disabled adults alongside...
The Government should create a separate taskforce for housing for working age disabled adults alongside the taskforce for housing for older people. Both taskforces should be accountable to both DLUHC and DHSC and should report to the Senior Responsible Officer …
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Government Response
The government points to their 10-year white paper reform vision and states that they will invest up to an additional £25 million for unpaid carers. They are also taking steps towards implementing a new survey of unpaid carers.
Ministry of Housing, Communities and Local Government
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24
Recommendation
Deferred
Second Report - Long-term funding …
Despite guidance from the Government on planning for housing for older and disabled people, not...
Despite guidance from the Government on planning for housing for older and disabled people, not enough councils are producing plans or conducting sufficiently robust housing needs assessments. The Government should consider introducing statutory requirements for local authorities to produce plans …
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Government Response
The government states it has no plans to carry out a review into carer’s assessments, stating that CQC assessment of local authorities’ delivery of their Care Act responsibilities will show how effectively local authorities are supporting unpaid carers.
Ministry of Housing, Communities and Local Government
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25
Recommendation
Not Addressed
Second Report - Long-term funding …
The Government should consult on whether one or more Use Classes or sub-classes should be...
The Government should consult on whether one or more Use Classes or sub-classes should be introduced in order to unlock more development of different types of accommodation that is suitable for older and disabled people, and meets the demand within …
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Government Response
The government's response discusses integrated care systems and budget arrangements, but does not address the recommendation to consult on Use Classes or sub-classes for accommodation suitable for older and disabled people.
Ministry of Housing, Communities and Local Government
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26
Recommendation
Accepted
Second Report - Long-term funding …
The Minister for Care and Mental Health asserted that the chapter on the workforce in...
The Minister for Care and Mental Health asserted that the chapter on the workforce in the People at the Heart of Care White Paper is the Government’s social care workforce strategy, but the number of further calls for a social …
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Government Response
The government agrees that ensuring there is holistic care that fits around people’s needs includes ensuring that people receive the right care and support, and can maintain healthy independent living, beginning with where they live, and the people they live with.
Ministry of Housing, Communities and Local Government
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27
Conclusion
Accepted
Second Report - Long-term funding …
We heard repeatedly that an absolutely critical lever for stabilising the adult social care market...
We heard repeatedly that an absolutely critical lever for stabilising the adult social care market was tackling staff shortages and low retention. This would widen access to care and help to give unpaid carers a much-needed break. There is also …
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Government Response
The government welcomes the committee’s interest in shared care records and notes its Digital Health and Care Plan sets out that health and care professionals will have access to a comprehensive view of a person’s health record by April 2025.
Ministry of Housing, Communities and Local Government
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28
Recommendation
Accepted
Second Report - Long-term funding …
We welcome the addition of care workers, care assistants and domiciliary care workers to the...
We welcome the addition of care workers, care assistants and domiciliary care workers to the Shortage Occupation List, acknowledging that these roles are in short supply within the UK resident labour market. The Government should monitor the impact of adding …
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Government Response
The government outlines existing funding allocated to support timely and safe discharge from hospitals through social care and reablement services, and integrated care boards commissioning step-down bed-based capacity.
Ministry of Housing, Communities and Local Government
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29
Conclusion
Acknowledged
Second Report - Long-term funding …
Our broken care system is held up by unpaid carers doing vital work out of...
Our broken care system is held up by unpaid carers doing vital work out of love and pride. The cost to them can be financial, physical, and emotional. The cost to our economy of carers leaving the workforce is over …
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Government Response
The government recognizes the vital role of unpaid carers and the importance of supporting them and highlights the Care Act 2014 and Better Care Fund (BCF) as ways they are providing support, and will look to improve the clarity and transparency of spend on unpaid carers through BCF reporting requirements and activity data.
Ministry of Housing, Communities and Local Government
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30
Recommendation
Accepted
Second Report - Long-term funding …
The Government claims “the money is there” to support carers’ breaks, but the evidence we...
The Government claims “the money is there” to support carers’ breaks, but the evidence we received is that not enough carers are getting a break. There are many carers who have not had a break since the start of the …
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Government Response
The government claims to already support carers through the Care Act 2014, the Better Care Fund, and an investment of up to £25 million for unpaid carers, stating the 2023-25 BCF framework will improve spend clarity.
Ministry of Housing, Communities and Local Government
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31
Recommendation
Accepted in Part
Second Report - Long-term funding …
We recognise that it is not always easy to engage with people who do not...
We recognise that it is not always easy to engage with people who do not identify as “carers”, but more must be done to ensure that carers receive the support to which they are entitled, and that the support they …
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Government Response
While recognizing the importance of supporting unpaid carers, the government does not plan to carry out a review of carer’s assessments, but will be implementing a new survey of unpaid carers and will use CQC assessments to show how effectively local authorities are supporting unpaid carers.
Ministry of Housing, Communities and Local Government
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32
Conclusion
Acknowledged
Second Report - Long-term funding …
During this inquiry we heard about a proposal for a national care service, under which...
During this inquiry we heard about a proposal for a national care service, under which health and social care would be delivered by the same organisation. This would be similar to systems in place in Northern Ireland and Wales. This …
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Government Response
The government recognizes the importance of collaboration between commissioners and providers within integrated care systems (ICS) and will provide further support and advice to help places develop their approaches where needed, including reviewing ICS boundaries in certain areas.
Ministry of Housing, Communities and Local Government
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33
Recommendation
Accepted
Second Report - Long-term funding …
We welcome the Joining up Care for People, Places and Populations White Paper and commend...
We welcome the Joining up Care for People, Places and Populations White Paper and commend the Government for making the integration of health and social care a policy priority. We particularly welcome the Government’s ambitions around shared outcomes, workforce integration, …
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Government Response
The government states that much of the activity to integrate care should be driven by collaboration between commissioners and providers within integrated care systems (ICS) and will continue to work with place-based partnerships as they develop collaborative arrangements, including reviewing ICS boundaries in certain areas.
Ministry of Housing, Communities and Local Government
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34
Recommendation
Acknowledged
Second Report - Long-term funding …
Integration strategies should seek to integrate not just health and care but health, care and...
Integration strategies should seek to integrate not just health and care but health, care and housing. Ensuring there is holistic care that fits around a person’s needs includes preventing care needs from arising by having suitable housing, enabling people to …
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Government Response
The government agrees that holistic care should include housing and highlights examples of integrated approaches in areas like Greater Manchester and states their Integrated Care Strategy guidance encourages integrated care partnerships to have a joined-up approach to housing.
Ministry of Housing, Communities and Local Government
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35
Recommendation
Accepted
Second Report - Long-term funding …
Barriers to data-sharing between health and social care have been a long-standing challenge, so we...
Barriers to data-sharing between health and social care have been a long-standing challenge, so we particularly welcome the Government’s ambition to have shared care records for all citizens by 2024. It is vital that this ambition becomes a reality. 80 …
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Government Response
The government claims to be addressing this already through the Digital Health and Care Plan, funding for integrated care systems to acquire shared record systems, and supporting local systems to develop care planning systems, including patient and carer input.
Ministry of Housing, Communities and Local Government
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36
Conclusion
Accepted
Second Report - Long-term funding …
We are not reassured by the Director General for Adult Social Care’s comments that some...
We are not reassured by the Director General for Adult Social Care’s comments that some places have found ways to continue discharge to assess funding from their own funding streams, not least by her admission that these workarounds are only …
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Government Response
The government acknowledges the positive impact of Discharge to Assess funding, stating they allocated £500 million in 2022-23 and provided £200 million to integrated care boards, and are providing £1.6 billion over 2023-24 and 2024-25.
Ministry of Housing, Communities and Local Government
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Government Response AI assessment · 36 of 22 classified
Accepted
15
Acknowledged
17
Deferred
2
Total
22 recs + 14 conclusions
Correspondence 13 letters
12 Sep 2023
To committee
Letter from the Minister of State for Social Care, Department for Health and Social Care to the Chair dated 28 July 2023 concerning the long term funding of adult social care
Parliament page
15 Jun 2023
To committee
Letter from the Chair to the Minister for Social Care DHSC dated 12 June 2023 concerning the Government response to the report on the Long-term funding of Adult Social Care
Parliament page
8 Mar 2023
To committee
Letter from the Minister of State for Social Care to the Chair dated 7 March 2023 concerning the Committee's report on the Long-term funding of Adult Social Care
Parliament page
7 Mar 2023
To committee
Letter from the Parliamentary Under Secretary of State for Local Government and Building Safety to the Chair dated 6 March 2023 concerning the Long-term funding of Adult Social Care
Parliament page
21 Feb 2023
To committee
Letter from the Chair to the Secretary of State dated 20 February 2023 concerning the Government's response to the Committee's report on the Long-Term Funding of Adult Social Care
Parliament page
12 Jul 2022
To committee
Letter from the Minister for Housing to the Chair dated 5 July 2022 concerning the long-term funding of adult social care
Parliament page
28 Jun 2022
To committee
Letter from the Minister of State for Equalities, Local Government, Faith and Communities dated 17 June 2022 concerning long-term funding of adult social care
Parliament page
14 Jun 2022
To committee
Letter from the Minister for Care and Mental Health to the Chair dated 7 June 2022 following up her appearance before the Committee on 23 May concerning the funding of adult social care
Parliament page
24 May 2022
To committee
Letter from Care England to the Chair dated 20 May 2022 concerning the long-term funding of adult social care
Parliament page
17 May 2022
To committee
Letter from the Local Government Association to the Chair dated 6 May 2022 concerning long-term funding of adult social care
Parliament page
18 Jan 2022
To committee
Letter from McCarthy Stone to the Chair dated 16 December 2021 concerning long-term funding of adult social care
Parliament page
18 Jan 2022
To committee
Letter from the Chartered Institute of Public Finance and Accountancy to the Chair dated 16 December 2021 concerning long-term funding of adult social care
Parliament page
20 Apr 2021
To committee
Letter from the Minister for Health and Social Services for Wales to the Chair dated 24 March 2021 regarding adult social services
Parliament page