The current funding of social care across the four nations is no longer sustainable. We are an ageing population, so the number of individuals who will require social care will increase. It is therefore essential that we develop a sustainable social care service.
Currently care homes are having difficulties balancing the books. Payments for patients funded by local councils are not covering the actual cost of care provision. Analysis by the Competition & Markets Authority shows that care homes across the UK are increasing the fees of self-funding residents in order to subsidise the care of council-funded residents (Competition & Markets Authority, 2017).
Northern Ireland has had an integrated health and social care service since 1974, with the delivery of both statutory health and social care services now the responsibility of the five HSC trusts. According to the Department of Health’s strategy document Health and Wellbeing 2026: Delivering Together (Department of Health Northern Ireland, 2017), a consultation on 'proposals for the reform of adult social care and support, to consider different approaches to ensuring the longer term sustainability of the adult social care system' was scheduled to be published in April 2017. This consultation is awaited.
The Public Bodies (Joint Working) (Scotland) Act 2014 (Scottish Parliament, 2014) established the framework for the integration of health and social care in Scotland. There are 31 Integration Authorities (IAs) across Scotland and each has responsibility for integrated services for adults, at a minimum, in their area. The Act also places a requirement on NHS Boards and Local Authorities to integrate health and social care budgets throug the IAs. The IAs produce Strategic Plans for the use of these resources and give direction and make payment to the Health Board and Local Authority for delivery of the services. Detailed financial planning is restricted to an annual basis due to a yearly announcement of funds for Health Boards and Local Authorities. Both RCN Scotland and Audit Scotland have recommended that a longer-term approach to financial planning be developed, in order to allow IAs flexibility in planning and investing in the sustainability of health and social care.
In Wales, the RCN is engaged with all political parties within the Welsh Assembly to inform and discuss ways of improving the funding model to support the health and wellbeing needs of the citizens of Wales.
The Parliamentary Review of Health and Social Care in Wales published its final report on 16 January 2018 (Welsh Government, 2018). Within the report is an acknowledgement that health and social care in Wales were established as distinct sectors. Health care in Wales is almost entirely publicly funded and it is planned and commissioned by the NHS. Social care is publicly and privately funded and provided through multiple public, private and voluntary providers. The recommendations assume these arrangements broadly continue in place but the focus should be on developing ‘one system of seamless health and care for Wales.’
In 2018 it is a matter of urgency that political parties work together to develop a sustainable, equitable social care service for the 21st century.
Main Auditorium, Belfast Waterfront, 2 Lanyon Place, Belfast, BT1 3WH
Resolution, submitted by the RCN Greater Glasgow Branch
Page last updated - 05/09/2018