UK Inquiry Tracker

Reforming adult social care in England

Public Accounts Committee Closed Inquiry

Opened: 13 Dec 2023 Closed: 28 May 2024 Parliament page

The Government promised to “fix the crisis in social care” in 2019. In June 2021, the Committee’s ‘Adult social care markets’ report found that the Department for Health and Social Care (DHSC) had poor oversight of the system, and seemed complacent about the risk of market failure. The report called … Read more

12 Recommendations

15 Conclusions

1 Report

1 Oral session

2 Letters

1 Event

Activity timeline 5 events

28 May
2024

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Twenty-second report from Session 2023-24

20 Mar
2024

Report published

Twenty-Second Report - Reforming adult social care in England

19 Feb
2024

Correspondence

Correspondence from Shona Dunn, Second Permanent Secretary, Department of Health and Social Care, re Public Accounts Committee Hearing – 24…

6 Feb
2024

Correspondence

Public Accounts Committee hearing: Reforming Adult Social Care in England, 24 January 2024

24 Jan
2024

Oral evidence

Reforming adult social care in England

Oral evidence sessions 1 session

24 Jan 2024

View on parliament.uk

Reforming adult social care in England

Catherine Frances · Department for Levelling Up, Housing and Communities Michelle Dyson · Department for Education Sir Chris Wormald · Department of Health and Social Care

Reports 1 report · click to expand

Title	HC No.	Published	Items	Response
Twenty-Second Report - Reforming adult social care in England	HC 427	20 Mar 2024	27	Response document linked

Recommendations & Conclusions

27 results

2 Conclusion

Twenty-Second Report - Reforming a…

Explain how additional adult social care funds achieve value for money and improved capacity.

We remain unconvinced as to whether the Department knows if it is achieving value for money from the additional funding going to adult social care. Recent funding for adult social care includes short-term, top-up pots of money in response to … Read more We remain unconvinced as to whether the Department knows if it is achieving value for money from the additional funding going to adult social care. Recent funding for adult social care includes short-term, top-up pots of money in response to crises. In response to emerging pressures in 2022, government awarded £1.6 billion to help speed up hospital discharge through the Better Care Fund and £1.1 billion new grant funding to local authorities through the Market Sustainability and Improvement Fund (MSIF). It is troubling that, though MSIF funding is intended to support “tangible improvements” in adult social care, the Department did not quantify by how much the funding has contributed to its three objectives of increased staff pay, increased fee rates paid to providers or reduced waiting times. It remains to be seen whether the new CQC inspection regime, and promised improvements in local commissioning, can provide better assurance that top-up funding is not simply going into provider profits. We are concerned that the Department’s grasp of what it is getting for the £1.6 billion funding to support hospital discharge, is similarly vague. Although ‘supported discharges’ (the number of people being discharged from hospital with a package of care) may well have increased as a result of this funding, it is far from clear whether this represented good value compared with other interventions. Recommendation 2: The Department should write to the Committee alongside its Treasury Minute response to set out how it is assuring itself that each additional fund aimed at supporting adult social care is achieving value for money, including on benefits in relation to costs, for example: 6 Reforming adult social care in England • how much additional capacity it has bought with the discharge funding through the Better Care Fund. • how it will ascertain whether funding for market sustainability and improvement has not just ended up increasing provider profit margins. Show less

HM Treasury

Reforming adult social care in England

Activity timeline 5 events

Oral evidence sessions 1 session

Reports 1 report · click to expand

Recommendations & Conclusions

Explain how additional adult social care funds achieve value for money and improved capacity.

Set out spending review preparations and long-term funding certainty for local authorities.

Set out plan to lead sector in addressing chronic adult social care workforce challenges.

Confirm workforce projects reliant on payments system and update progress on system and initiatives.

Set out and publish a roadmap with KPIs for delivering the adult social care vision.

Committee took evidence on progress in reforming adult social care in England.

Adult social care lacks sufficient weighting and understanding within health-led Integrated Care Systems.

Data on health and social care outcomes lacks clear strategy and public accessibility.

Adult social care funding relies heavily on multiple short-term, top-up announcements.

Autumn Statement funding impact on adult social care remains unquantified and unclear.

Profiteering risk in social care considered low due to falling profits and commissioning.

Short-term hospital discharge funding shows positive impact but avoids systemic issues.

Prevention and early intervention offer better value than solely hospital discharge focus.

Reform funding, including housing integration budget, has been redirected to support system.

Fragmented, uncertain short-term funding stifles long-term planning and investment in adult social care.

Delayed local government finance settlement omits minimum wage provisions for councils.

Multi-year funding settlement for adult social care remains uncertain for local government.

Adult social care workforce vacancies remain high and are worse in rural areas

Department lacks clear workforce planning for overseas staff amidst rising exploitation risks

Department's workforce plan lacks long-term strategy and fails to address low pay

Adult social care careers lack parity of esteem and pay with NHS roles

Limited progress on workforce reforms, dependent on delayed new payments platform

Department selected complex new payments system to directly fund social care providers

New social care payments system faces significant delivery risks, rated 'amber

Department lacks long-term funded plan and milestones for its social care vision

Social care charging reform remains unfunded, despite revised October 2025 implementation date

Local authority capacity and sequencing of reforms are not adequately addressed by DLUHC.

Correspondence 2 letters