MPs criticise quality of social care

The Public Accounts Committee (PAC) has claimed the government is falling short on its promise to “fix the crisis in social care” with chronic understaffing, rising waiting lists and patchwork funding putting sustained pressure on local authorities.

In a newly published report, the PAC is calling for stronger leadership, long-term financial support, and a clear workforce strategy to address key shortfalls in the adult social care sector.

The Department of Health and Social Care (DHSC) set out a 10-year vision for adult social care in 2021. That same year, the government also committed £5.4 billion funding over three years, on top of existing budgets, to reform adult social care.

In April 2023, plans for system reform were revised, scaling back short-term plans to £729 million over the period 2022-23 to 2024-25.

According to the PAC, the government has no roadmap for achieving its vision, or any targets or milestones beyond 2025, with nothing meaningful in place to demonstrate progress.

The statistics say that there is almost a 10 per cent vacancy rate in the sector, with around 152,000 vacancies in March 2023.

The PAC says there are fears that the workforce plan set out to address this shortfall is woefully insufficient to the scale of the task.

The PAC also pointed out a future reliance on overseas staff, which raises significant questions of the impact of proposed visa restrictions and risks of exploitation.

Concern was also raised about the demand for adult social care services in rural areas, against a backdrop of chronic understaffing.

According to statistics, in 2022-23, local authorities supported more than one million people with care needs, at a cost of £23.7 billion. As at Autumn 2023, there were almost half a million people awaiting attention on their case, and £2.7bn in additional funding was allocated in 2022 in response to emerging pressures.

Dame Meg Hillier MP, Chair of the Committee, said: “Years of fragmented funding and the absence of a clear roadmap has brought the adult social care sector to its knees. Waiting lists are rising, the sector is short tens of thousands of essential staff, and local authority finances are being placed under an unsustainable amount of pressure.

"The decision to dedicate a single chapter in the Adult Social Care Reform White Paper to the social care workforce does not do justice to the level of work that will be required and feels to us like a bit of a cop-out. While an NHS-style workforce strategy for social care may not be feasible, the DHSC must set out how it will how it provide leadership across the sector to identify and address workforce challenges.

"Whilst we welcome the increase in funding, we fear this will do little to address the key challenges faced by the sector in the absence of a well-funded multi-year strategy. A 10-year vision is all well and good, but this alone is not enough to bring about the fundamental changes this sector so desperately needs.”

Cllr Kaya Comer-Schwartz, social care spokesperson for the LGA said: “We strongly support the Committee’s call for long-term financial support and certainty for social care, a workforce strategy to address staffing shortfalls and a road map for reforms.

“Adult social care remains in a precarious position, with overstretched budgets, significant unmet and under met need, and remaining instability within the provider market. Any reforms need to invest in prevention and recovery in both health and social care in order to be successful.

“It is crucial that the impacts of any social care reforms on councils are thoroughly assessed and are manageable, costed and centred on people who draw on care.”