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WHO CARES The Covid 19 pandemic has highlighted the UK government’s disconnected management of social care. So perhaps now is the time to take stock of the way care is organised and financed. The most up to date account of the sector appears to be the 2016 Health Foundation Report, it shows that some 870,00 people were in care in the UK. A third of the budget was spent on working age adults who received roughly the same amount of public funding as the two thirds who were over 65. Of this older group 71% were in care homes with the remaining 29% were being cared for in the community. To carry out this work the care sector employs a workforce of some 1.5 million they are supported by an estimated 8% of the UK population acting as informal carers (that is 5.4 million people).  The Competitions and Markets Authority has calculated that ‘there are around 5,500 different care providers in the UK, operating 11,300 care homes with Local Authorities generally commissioning services from these independent homes who supply 95% of beds. The Local Authority funding comes from the government and the Kings Fund website tells us that ‘In 2018/19, the total expenditure on adult social care was £22.2 billion, up £800 million from the previous year. However, in real terms (ie, adjusting for inflation), total expenditure is still £300 million below the level it was in 2010/11, despite increased demand’. The Office for National Statistics predicts a 36% growth in the 85+ group between 2015 and 2025, rising from 1.5 million to 2 million. There has also been an increase in the number of younger adults with disabilities, partly due to falling mortality rates. These trends are expected to lead to a substantial increase in demand for care services in the near future. The Health Foundation summarizes the situation by adding ‘ Tackling the challenge of social care reform will require decisive political action and an appropriate funding settlement. Unless this happens we will continue to have a system whose inadequacies undermine the NHS and leave many people without the care they need. Transformation is required to make the social care system fair and sustainable in the future’.

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