The Department of Health and Social Care (DHSC) has much to do if it is to achieve its 10-year ambition for reforming adult social care, the National Audit Office (NAO) has warned.
In a report called Reforming adult social care in England, the NAO revealed that vacancies in the sector have increased by 173% in the past decade and currently stand at around 152,000. This represents a 10% vacancy rate.
According to the NAO, the DHSC is delivering on only two of its eight workforce projects – supporting international recruitment and adult social care volunteering – with the remaining six ‘in development’. Around 70,000 staff have been recruited from outside the UK in the past year, it said.
The NAO observes that the care system remains under significant pressure. Waiting lists are among the challenges causing concern, with local authorities reporting an increase of 37% between November 2021 and April 2022.
According to the report, survey data suggested that the number of people waiting more than six months in March 2023 for a care assessment was around 82,000 – almost double the figure from the end of 2021.
Concerns over provider stability were also raised by the NAO, with reported profit levels for care homes for older people close to the lowest level since 2015, when oversight from the Care Quality Commission (CQC) began. According to the CQC, the most significant financial pressures are around specialist providers, where profitability declined ‘consistently’ between September 2021 and March 2023.
Government funding is also falling short, the report found, with more than £1bn of the £1.7bn committed to reforming the adult social care system in December 2021 having been diverted to other care priorities.
According to Gareth Davies, head of the NAO, the government will need to manage some ’significant risks’ if it is to successfully reform adult social care.
‘Adult social care reform has been an intractable political challenge for decades,’ he said.
‘Government has set out its ambition to meet this challenge and now needs to demonstrate how it is delivering on these plans.
‘To maximise its chances of succeeding, government will need to ensure it understands the impact of its ambitions on local authorities and other stakeholders and establish a costed plan which ensures delivery of its long-term goals,’ Mr Davies added.
A DHSC spokesperson said: ‘We remain committed to reform and are investing up to £700 million over this year and next to make major improvements to the adult social care system.’
They added that the department had ‘made up to £8.1bn available to help local authorities tackle waiting lists, low fee rates, and workforce pressures, £570 million of which will help local authorities improve adult social care provision, in particular by boosting the workforce.’