Social work opinion is split on whether the new Labour government will improve the lives of those using social care services.

A Community Care poll with nearly 1,200 votes revealed that 41% of respondents lacked confidence in the new government’s ability to improve the lives of those supported by social workers. Almost a quarter (23%) felt “very unconfident” and 18% “quite unconfident”.

On the other end of the spectrum, almost a third (31%) expressed confidence, with 23% “quite confident” and 8% “very”.

The remaining 28% said they were “neither confident nor unconfident”.

Child protection reforms

The poll results come with the new government having given mixed signals on its approach to social care since taking power.

Labour’s first King’s Speech, earlier this month, included three pieces of legislation concerning the sector.

For children’s services, the government announced a bill to strengthen child protection that would also introduce registers of children not being educated in school.

However, the details of the bill are unclear and it’s also uncertain whether and how far the government will move forward with the previous administration’s 2023 children’s social care reform strategy, Stable Homes, Built on Love.

Adult social care cuts

Rachel Reeves, Chancellor of the Exchequer (Picture by Lauren Hurley / No 10 Downing Street)

The King’s Speech also included the long-awaited reform of the Mental Health Act 1983 and a fair pay agreement for adult social care staff, both of which were promised in the Labour manifesto.

However, the party has yet to set out any funding plans for the pay agreement. 

At the same time, the government has already made two significant cuts to adult social care funding.

In a statement on Labour’s financial inheritance from the Conservatives, chancellor Rachel Reeves announced the scrapping of long-planned reforms to the adult social care charging system, including a cap on care costs. The Treasury says this will save £1.1bn by the end of 2025-26.

And then care minister Stephen Kinnock revealed that the government would ditch a fund to resource training for adult social care workers. Both moves have been heavily criticised by sector bodies.

How confident are you that the new government will deliver for people who use social care services?

Adult social care faces its “worst financial outlook” for at least seven years on the back of rising levels and complexity of need and costs being shifted from the NHS, a survey of directors has revealed.

Despite receiving what the previous government described as the “biggest funding increase in history” for 2023-25, councils overspent their adult care budgets by £586m (2.9%) in 2023-24, found the Association of Directors of Adult Social Services’ (ADASS) annual spring survey.

This was the highest overspend in at least a decade, while councils also reported having to budget for £903m in savings in 2024-25 (4.4%), the highest annual level recorded by the association since 2016-17.

Just one in ten directors said they were fully confident they had the money to meet their statutory duties for adult social care in 2024-25, down from 35% for 2019-20 and 12% for 2023-24.

And directors reported cutting back investment in preventive services, from £1.55bn in 2023-24 to £1.43bn in 2024-25, despite their potential to reduce or delay needs for care and support

‘Worst financial outlook in years’

“This is easily the worst financial outlook for adult social care budgets that I’ve seen in the seven years of leading the survey,” commented ADASS’s director of policy and analysis, Michael Chard, in a post on LinkedIn.

On the back of the findings, the association called on the new Labour government to shift resource from hospitals to social care and community health to prevent people reaching crisis point, as well as committing to a “long-term, fully funded solution” for the sector.

In its general election manifesto, Labour offered no funded commitments on adult social care, though said it wanted to raise staff pay, improve consistency of care and enhance partnership working across health and social care to tackle delayed discharges and promoting care at home.

It also set a 10-year vision to create a “national care service” but did not define what this would mean.

In response to the ADASS report, a Department of Health and Social Care spokesperson said: “We are determined to tackle head-on the significant challenges social care faces. We will undertake a deep-rooted programme of reform to create a national care service and make sure everyone gets the care they need.”

‘Biggest funding increase in history’

In November 2022, amid significant pressures on the sector, the then government announced what it called the “biggest funding increase in history”, which involved new money and recycling resource earmarked to implement the cap on care costs and related charging reforms.

In 2023-24, this amounted to almost £2bn in extra government grant for councils to spend on adult social care plus up to an estimated £550m from raising council tax by 3% and the adult social care precept – which is ring-fenced for the sector – by 2%.

The impact of this was seen in government figures on council budgets for adult social care for 2023-24, which showed that net expenditure on adult social care was £2bn (10%) higher in real terms than in 2022-23, at £22.3bn.

ADASS’s survey, carried out from April to June this year, was answered by 145 of the 153 authorities, with the association scaling responses up to represent the whole country.

Its figures for total spending are different from the government’s but also showed a significant increase in budgeted spend, from £17.7bn in 2022-23 to £19.2bn in 2023-24 (these figures are not adjusted for inflation).

Overspend driven by mounting need

But despite this, councils collectively breached their budgets by £586m (2.9%) in 2023-24, the largest overspend recorded by ADASS in at least a decade, with 72% of authorities breaching their budgets.

Within this group, 92% of directors indicated that a cause of the overspend was the average cost of care packages outpacing their assumptions, while 89% attributed it, at least in part, to the numbers requiring long-term care exceeding their expectations.

As evidence of the increasing complexity of need that councils were meeting, ADASS found that the average number of home care hours a week councils delivered per person rose from 13 hours 40 minutes in 2021-22 to 14 hours 43 minutes in 2023-24.

In relation to the number of people in need, 22% of councils said they had seen a more than 10% rise in the number of people referred from the community, with a further 46% seeing a rise of less than 10%. Most people (about 80%) are referred to local authorities from the community.

There was an even sharper rise in referrals from people discharged from hospital, whose numbers grew by more than 10% in 45% of areas and by less than 10% in a further 37% of areas.

Cost shunting from the NHS

However, pressures also came from the NHS, with 36% of directors reporting an at least 10% increase in referrals from people who would previously have been, or were formerly, eligible for continuing healthcare (CHC), with another 37% seeing a rise of less than 10% in this group.

The NHS funds social care for people eligible for CHC on the grounds that they have a primary health need. If someone is found to be ineligible, either they or their council must fund their social care.

As of the first quarter of 2024, 51.95 people per 50,000 population were eligible for CHC in England, down from 54.65 per 50,000 two years earlier, according to NHS England data.

Almost all directors (94%) agreed that tightening eligibility for CHC was leading to councils or individuals picking up the bill for more care home placements for people with complex needs.

A similar proportion agreed that there had been a trend of NHS integrated care boards reviewing people who qualified for CHC to find they no longer qualified, leading to an increase in
people requiring council-funded social care.

Meanwhile, 84% of directors reported that frontline adult social care staff were increasingly undertaking tasks that were previously delivered by NHS staff on an unfunded basis, up from 70% in its 2023 autumn survey.

Pressures continuing into 2024-25

Directors said the pressures they faced in 2023-24 were continuing into 2024-25. While they planned to increase budgeted spend from £19.2bn to £20.5bn, authorities reported having to make £903m in savings from their adult social care budgets.

Sixteen per cent of directors said they were not at all confident they had enough money to meet their statutory duties, while a further 74% were partially confident that they would do so.

More positively, ADASS found that waiting lists for assessments, reviews and care packages had fallen, from 470,576 at the end of August 2023 to 418,029 as of the end of March 2024.

“This is welcome progress in difficult circumstances,” said the association. “Nevertheless, it is important to remain sensitive to the difficult human stories behind these numbers. These figures
are still historically high and should command the same concern as hospital waiting times.”

Agency social workers numbers are coming down in children’s services in England following significant increases in their use by councils in recent years, a sector leader has said.

Association of Directors of Children’s Services president Andy Smith told Community Care he believed the trend was the result of the planned introduction of rules later this year to curb councils’ use of locums.

Rules on locum social work

The rules are part of the previous government’s Stable Homes, Built on Love strategy to reform children’s social care and are designed to cut the costs of agency work while improving continuity of support for children and families.

They include a ban on anyone without three years’ experience in a permanent role in children’s services from taking up a locum role, a requirement for councils to agree regional price caps on what they pay agencies and a restriction on the use of agency project teams.

Agency social worker numbers have escalated in recent years on the back of councils’ increasing struggles to recruit and retain social workers in children’s services.

As of September 2023, locums represented 17.8% of the children’s social work workforce in English councils, up from 15.5% in 2021.

‘Numbers of agency workers falling’

However, Smith said there was evidence that this trend was reversing.

“There’s certainly data showing that the numbers of agency social workers are going in the right direction, are reducing,” said Smith, who is strategic director of people services at Derby council.

“Certainly, in my local area, in the East Midlands, we’re seeing that across all 10 local authorities. So our hypothesis is that the impact of the reforms that are clearly going to come into effect as we move into the autumn are starting to potentially have an effect in the right direction.”

Under plans set by the previous government, statutory guidance requiring councils to follow most of the rules would come into force this summer, with requirements relating to the price caps and data collection being implemented in the autumn.

While the new Labour government has not yet commented on publicly on the plans, Smith said he expected the statutory guidance to come into force in September, in a speech to last week’s ADCS conference.

Disappointment over project team reversal

The ADCS has campaigned strongly for curbs on the agency social work market since 2021 and Smith said the DfE’s proposals were “writ large” with the association’s ideas.

However, he added that it remained disappointed by the previous government’s decision to reverse its initial plan to completely ban the use of project teams.

These involve councils hiring agency workers en masse, often with their own management and restrictions on caseloads.

ADCS has long warned that agencies have increasingly restricted the supply of locums to project teams, preventing councils from engaging individual workers to fill gaps and charging them more per practitioner.

The number of social workers hired through teams rose fivefold from January to June 2021 to the same period in 2022, according to ADCS research.

‘Opportunity’ with new government to reinstate ban

However, the department dropped the idea of a complete ban, after some respondents to the initial consultation on the rules said there using them was appropriate where caseloads, staff absences or vacancies were high, or to support struggling authorities.

Smith said ADCS was disappointed by this “U-turn”, but added that having a new government presented the opportunity to reinstate the planned ban.

“In the first conversation I have with the minister who will have the children’s social care brief that is on the list to talk to her about,” he said.

“They could do that tomorrow. That could be done really easily and it would send out, I think, a really strong message to the sector that government is listening and it sees the value of relationships and relational social work. Social work is not a project.”

Children’s social care reform plans

In his speech to the ADCS conference, Smith also stressed the urgency of implementing the sector reforms proposed by the Independent Review of Children’s Social Care and taken forward in Stable Homes, Built on Love.

Besides the agency social work rules, these are designed to ensure that many more children are supported to stay with their families or, where this not possible, with kinship carers; that those at risk are much better protected than is currently the case, and that children who go into care receive a much better experience and, as a result, better life chances than now.

The care review projected that the reforms would cost £2.6bn over four years but would save money in the long-term by reducing the projected care population by 30,000 – roughly 30% – within 10 years.

So far, the DfE has committed £200m to testing the proposed changes, for example, through the 10 “pathfinder” areas trialling the deployment of family help teams, merging child in need and targeted early help services, and specialist child protection practitioners.

Reform cost now ‘more than £2.6bn proposed by care review’

“We simply can’t afford to derail the plans or indeed take our foot of the gas; both in terms of children’s outcomes and the finances that we are diligently trying to balance day in, day out,” said Smith in his speech.

“The longer we leave it, the more it will cost; we need to reset the system now.”

Smith told Community Care that what was required now was more than £2.6bn because of increases in service costs since the care review’s final report in May 2022.

He said he had raised the issue with new education secretary Bridget Phillipson in an initial call with her last week.

Smith also called on the government to widen the focus of children’s social care reform beyond councils to their key partners.

“We can’t realise the ambition around any reforms, and really improve outcomes for children, if it’s just seen as a local authority endeavour, he said. “It has to engage health, it has to engage the police, both strategically and on the ground, and that was really missing in the run-up to the general election.”

‘Really difficult choices’ needed on funding services

During the election, Labour made no funding commitments in relation to children’s social care, despite the Local Government Association saying councils would need an extra £5bn in 2026-27 compared with 2023-24 to maintain provision at existing levels.

At the same time, the incoming government has pledged not to raise income tax rates, national insurance, VAT or corporation tax and set itself tight fiscal rules limiting how much it can borrow to fund public spending.

Funding for councils from 2025 onwards is due to be set out in a spending review this autumn and Smith stressed that “really difficult choices” would have to be made, though this could include using existing resource in a different way.

Call to pool budgets for children with mental health

For example, he suggested pooling NHS and local authority resources to support children with significant mental health needs in an arrangement similar to the better care fund (BCF) in adults’ services.

The BCF pools local authority and NHS funding locally to help people live independently at home for longer and enable them to receive care in the most appropriate place, for example, by tackling delayed discharges from hospital. It has enabled what would previously have been NHS resource to be spent on adult social care services.

Councils have struggled significantly with finding appropriate placements for children in care with severe mental health needs. This has led to them to seeking high numbers of so-called deprivation of liberty (DoL) orders from the High Court to authorise very restrictive care arrangements, often in unregistered settings.

At the same time, some council heads have criticised the NHS for reducing support for these young people through child and adolescent mental health services.

Smith said a BCF-style arrangement could help lever investment into preventive services to avoid councils having to source expensive and restrictive placements through DoL orders.

Bolstering approved mental health professionals’ (AMHP) role in preventing detention in hospital can “vastly reduce” use of the Mental Health Act within the existing law, say service heads.

The AMHP Leads Network made the claim as charities urged the new Labour government to bring forward a bill to replace the MHA in its first legislative programme, which will be set out in next Tuesday’s King’s Speech.

MHA reform is long overdue with the Conservatives having pledged to enact the change in their 2019 manifesto and brought forward a draft bill in 2022 but then failed to legislate before they left office this month.

In November last year, then shadow health and social care secretary Wes Streeting – who is now responsible for the two services in government – said Labour would bring forward legislation to replace the MHA in its first King’s Speech.

Manifesto pledge to overhaul legislation

In its election manifesto, Labour said the current act was “woefully out of date”, its operation discriminated against black people and that the treatment of detained autistic people and those with learning disabilities was a “disgrace”.

It pledged to modernise the law “to give patients greater choice, autonomy, enhanced rights and support, and ensure everyone is treated with dignity and respect throughout treatment”, a similar prospectus to the Conservatives’ draft bill.

However, the manifesto did not repeat the promise to legislate in its first year in office.

Draft bill ‘flawed’

The draft bill’s broad aims were to reduce use of – and racial disparities in the use of – the MHA, end its inappropriate use in relation to autistic people, people with learning disabilities and empower patients and their loved-ones.

The AMHP Leads Network, while supportive of MHA reform and its objectives, has previously described the Conservatives’ draft bill as flawed, including on the grounds that it would have “little or no impact” on tackling racial disparities and enhancing the rights of patients and families.

In a statement this week, network co-chair Christina Cheney said there were “many ways in which the desired outcomes for change may be achieved without the need for legislative reform”.

“We believe that attention on key practice challenges, with the support of current legislation and codes of practice, has the potential to vastly reduce compulsion, including for those groups overrepresented or poorly served by mental health environments,” said Cheney.

Call to strengthen AMHPs’ preventive role

In particular, this should “strengthen the emphasis on and support to” AMHPs’ role under section 13 of the MHA in considering a person’s case if a local authority has reason to believe that an application may need to be made to detain them in hospital or take them into guardianship.

In many such cases, AMHPs do not carry out an assessment to determine whether to make an application – which generally must be agreed by two doctors – to detain a person in hospital under the MHA. Instead, they find less restrictive care alternatives for the person.

Cheney said this AMHPs’ role under section 13 needed to be backed by a commitment from partner agencies to remain “proactively involved” in a person’s care throughout any period of consideration, assessment and admission.

She also said the network also wanted to see greater provision of social support for people, alongside medical care.

Cheney said taking these steps now would “achieve rapid change”, allowing the new government time to “take a braver and more radical approach to mental health legislative reform that can be informed by this and other developing work in mental health, AMHP and social care networks”.

Charities urge immediate MHA reform

However, charities said overhauling the MHA – to reduce the number of people detained, end the unnecessary detention of autistic people and those with learning disabilities and tackle racial disparities – was an urgent priority.

Mental health charity Mind pointed to figures showing almost 21,000 people were subject to the act, just over 15,000 of whom were detained in hospital, as of the end of April this year.

“Too many people are being sectioned under an outdated law which enables shameful, racist injustices; often in run-down, unsafe hospitals that aren’t fit for purpose,” said its policy and campaigns manager, Gemma Byrne.

“[The] statistics show why it’s essential the new government delivers on its promise to include reforms to the Mental Health Act in its first King’s Speech next week,” she added, saying this should “truly strengthen the rights of people when they are most unwell.”

For the Centre for Mental Health, chief executive Andy Bell said: “The new government can bring the Mental Health Act into the 21st century with a comprehensive new bill, including new conditions for the use of coercion, better safeguards for patients, and faster transfers from prison to hospital.”

Alongside legislative reform, Bell said there was an urgent need to modernise hospitals so “people aren’t detained in outdated buildings and facilities”.

Impact on autistic people and people with learning disabilities

MHA reform is seen as a key step in tackling the longstanding issue of autistic people and people with learning disabilities being detained in hospitals, often for long periods of time, rather than receiving more appropriate care and support closer to home.

For Mencap, head of policy and public affairs Dan Scorer said: “Many are locked away for years in these settings where they are at increased risk of abuse and neglect, often due to a lack of the right social care and suitable housing – not because they need inpatient mental health treatment.

“The government must deliver on their promise to introduce a new Mental Health Bill as a matter of urgency and bring an end to the scandal of inappropriate detention. Overhauling this outdated law, alongside investment in community support, will be a true test of their commitment for change.”

Ending ‘scandal’ of inappropriate detention

The National Autistic Society issued a similar message, saying that MHA reform was “an essential step in ending the human rights scandal of autistic people being inappropriately detained in mental health hospitals”.

“Autism is not a mental health condition, and should not be treated as such in law,” said its policy and parliamentary officer, Sam Forrester.

He said the draft bill put forward by the Conservatives needed to be strengthened, including by “guarding against alternative routes to detention, and [placing] greater emphasis on ensuring treatment is therapeutically beneficial”.

Forrester added that there also needed to be increased investment in “high-quality community support” for autistic people to prevent them going into crisis.

“The bill must now be brought before Parliament urgently, where it can be debated and strengthened – this crisis must end now,” he added.

Labour’s return to power last week was greeted with a chorus of welcomes from adult social care organisations in England – along with a chorus of demands of the new government.

Broadly, these were for significant investment in, and reform to, the sector to address issues including unmet need, workforce shortages and inadequate care.

For many, these challenges are the legacy of the Conservatives’ 14-year period in office.

The ‘austerity’ decade

This began with the decade of “austerity” in the 2010s, during which councils’ available budgets fell by 29% in real-terms (source: National Audit Office [NAO]).

While authorities strove to protect adult social care from these cuts, their spending on the service was only marginally higher 2019-20 than 2010-11, after taking account of inflation.

Image: treety/Adobe Stock

According to the Association of Directors of Adult Social Services (ADASS), authorities had to make £7.7bn in adult social care savings during the decade to manage increasing demand and cost pressures without extra resource.

One result was a significant fall in the number of people who received long-term care, from 872,520 in 2015-16 to 838,530 in 2019-20 (source: NHS Digital).

These pressures were driven by the expected – an ageing population and growing numbers of people with multiple and complex needs – and the unexpected.

For example, the Supreme Court’s landmark Cheshire West judgment, by widening the definition of a deprivation of liberty, triggered a tenfold increase in councils’ Deprivation of Liberty Safeguards (DoLS) caseloads, from 13,700 in 2013-14 to 137,540 in 2014-15.

Modernising the law

The middle of the decade saw the implementation of the Care Act 2014, unifying and modernising the previous panoply of social care legislation into one statute that made promoting wellbeing and preventing, reducing or delaying need the service’s central missions.

Alongside this, it created rights to support for carers and rights to advocacy for those who would otherwise struggle to participate in key processes, placed councils under a statutory duty to investigate adult safeguarding concerns and sought to improve the transitions process for young people.

Photo: Gary Brigden

However, the legislation’s vision soon ran into the realities of the fiscal constraints and pressures on the service.

To take one example, a study published in 2021 found that assessments of, support for, and spending on carers fell in the years following the act’s implementation – contrary to its intent – because of funding pressures.

Care Act deemed a ‘failure’

Key aspects of the act were not implemented, including rights of appeal against council decisions and the so-called ‘Dilnot’ charging reforms, which were designed to make the means-testing system more generous and cap people’s liabilities for their personal care.

The latter were originally due to be implemented in 2016 and were then delayed until 2020 before being scrapped under Theresa May’s government in 2017 – though not for good (see below).

In its 2021 white paper, People at the Heart of Care, the government concluded that the full spirit of the Care Act had not been realised. A 2022 report by a House of Lords committee went further and declared the legislation a failure.

“Far from ensuring individuals’ wellbeing, care services tend to be reduced to a minimum and designed to enable people to survive, rather than to live and thrive,” it said.

The tragic impact of Covid

The austerity years were followed by the tragedy of Covid-19. This would have always hit social care hard given that people who used the service – older people and those with multiple health conditions – were at particular risk from the disease.

But the impact was compounded in the early stages by government policies to free up 15,000 hospital beds in March 2020 and for care homes to make their full capacity available. This led to many people with asymptomatic Covid being discharged into residential care.

Photo: thodonal/Adobe Stock

From March 2020 to April 2021, there were 27,179 more deaths than expected among care home residents, while there were 9,571 excess deaths reported among home care users over a similar timeframe (source: the Health Foundation).

In addition, over 900 care workers lost their lives to Covid up to May 2021, while the workforce was worst hit of all occupational groups by long Covid.

At the same time, many people were left at home without a service, and adult safeguarding concerns were delayed, during lockdowns, worsening unmet need, risks of harm and the strain on unpaid carers.

The devastating impact of the pandemic on adult social care triggered an increased focus on the sector – and apparent recognition of its value – from the Conservative government.

The Tories’ reform agenda

Its first response was the People at the Heart of Care white paper, published in late 2021, which allocated £3.6bn to reviving the Dilnot charging reforms, and a further £1.7bn to assorted other changes designed to improve services, from 2022-25.

These included raising qualification levels and the status of the workforce (£500m); expanding specialist housing for people with care needs (£300m); promoting the digitisation of the sector to improve productivity (£150m); enhancing commissioning (£70m), and supporting carers (£25m).

However, much of this reform agenda subsequently unravelled in the face of the severity of day-to-day pressures on services.

Severe pressures remain

The number of staff vacancies increased by 50% to 164,000 in the year to March 2022, while the number of people on waiting lists for assessments, reviews and care packages grew by 37%, to 542,000, from November 2021 to April 2022.

Meanwhile, there was a 57% rise, to over 13,000, in the number of hospital beds occupied by someone fit for discharge, in the two years to December 2022 (source: the Health Foundation), in part because of social care shortages.

Amid such pressures, council bodies argued that it was all but impossible for them to implement the Dilnot reforms in line with the planned start date of October 2023, given the scale of the changes required. These included:

• Recruiting sufficient practitioners and overhauling systems in order to be able to assess and review many thousands of self-funders coming forward to take advantage of the more generous means-test or be considered for the cap on care costs.
• Upgrading their case management systems in line with revised financial assessment procedures and to track people’s progress towards the cap.

Reforms delayed or shelved

In response, the government pushed the start date of the reforms back by two years, ploughing most of the allocated £3.6bn into shoring up day-to-day social care services, including for children. 

Photo: gguy/Adobe Stock

This was accompanied by giving authorities permission to raise council tax by 3% and the adult social care precept – which is ring-fenced for the sector – by 2% per year, along with additional grant funding, from 2023-25.

Then in July 2023, it shifted £600m of the remaining reform funding into core services, having already halved its investment in workforce development.

The Conservatives also shelved their plan to replace the DoLS, and the use of Court of Protection orders to authorise deprivations of liberty in the community, with a more streamlined system, the Liberty Protection Safeguards (LPS).

This was despite DoLS caseloads having continued to mount, topping 300,000 in 2022-23, with the average case taking 156 days, leaving many thousands of people unlawfully deprived of their liberty.

Impact of increased funding

The resulting increase in government funding for adult social care from 2023-25 has had a definite impact.

Councils budgeted to increase spending on the service by 10% in real terms (£2bn) in 2023-24 and have planned to raise expenditure by 9.2% in real terms (£2.1bn) this year.

This has helped fund two consecutive 10% increases in the national living wage, benefiting tens of thousands of care workers, chiefly in the independent sector.

Along with increased international recruitment, which was promoted by the Conservative government, at least until late last year, this appears to have had an impact on workforce sufficiency.

Skills for Care figures show that the sector vacancy rate fell from 9.9% in March 2023 to 8% in April 2024.

No let up in challenges

However, the extra funding clearly did not solve the challenges facing the sector. At 8%, its vacancy rate was more than double the economy-wide average (3.0% as of autumn 2023, according to the Office for National Statistics).

Waiting lists not only remained high but grew, by 8% to 470,576, from March to August 2023, reported ADASS. And the number of people awaiting discharge from hospital has remained stubbornly around the 13,000 mark, shows NHS England data.

Photo: IQoncept/Adobe Stock

Meanwhile, the Local Government Association (LGA) has calculated that councils would need an additional £5.1bn in 2026-27 compared with 2023-24 to maintain services at existing levels, because of funding pressures.

Lack of certainty over funding and reform

Unsurprisingly, this has prompted calls for further funding for adult social care. However, the Conservatives also faced criticism for how they resourced the sector, particularly through their reliance on short-term grants, sometimes provided with little notice.

“There are concerns that short-term funding does not support value-for-money decision-making,” said the NAO, in a report on adult social care reform published in November last year. “It can lead to a lack of time to review savings options to make good rather than quick decisions.”

The same NAO report also raised significant concerns about whether the Dilnot charging reforms were deliverable by the revised target date of October 2025.

This was not just because of the amount of work this would involve, but also because the Department of Health and Social Care (DHSC) had disbanded the programme board responsible for overseeing the changes.

Unfunded commitments to charging reform

Both the Conservatives – in their manifesto – and Labour – in media interviews – committed to implementing the charging reforms by October 2025 during the election campaign.

But, as think-tank the Institute for Fiscal Studies (IFS) has pointed out, the outgoing government left no funding to implement the changes, meaning fresh resource would need to be found by the new Labour administration.

This is in addition to all the preparatory work that would need to be carried out by civil servants, councils, IT firms who supply case management systems and care providers.

Unsurprisingly, ADASS concluded the chances of the reforms being implemented in October 2025 were “quite low”.

Labour’s offer on adult social care

The party’s election manifesto was not short of pledges on adult social care. These comprised:

• A programme of reform to create a national care service, underpinned by national standards, delivering consistency of care across the country, ensuring high-quality care and ongoing sustainability, and ensuring providers behave responsibly.
• A principle of ‘home first’ that supports people to live independently for as long as possible.
• Local partnership working between the NHS and social care on hospital discharge.
• An agreement setting fair pay, terms and conditions, and training standards for adult social care workers, following widespread consultation.
• Guaranteeing the rights of care home residents to see their families.
• Asking regulators to assess the role social care workers can play in basic health treatment and monitoring.
• Providing councils with multi-year funding settlements.

Is more austerity on the cards? 

However, while councils will no doubt welcome the predictability of multi-year funding settlements – something also pledged by the Tories – they will have noted, with alarm, the lack of commitment to increase their funding.

This is particularly so in the context of Labour’s pledges not to increase income tax rates, national insurance or VAT and limit borrowing so that public debt is on course to fall as a share of national income over the medium-term.

Based on these pledges, the current state of the public finances and likely increases in the NHS, overseas aid, defence and childcare budgets, the IFS has sketched out possible trajectories for local government funding over the coming years.

Under these, council spending would rise by between 0.4% and 2.5% per year in real terms up to 2028-29, with the even the latter falling well short of what the LGA has calculated that authorities need to stand still over the coming years.

This has led to accusations of authorities facing a further round of austerity – albeit less stringent than that of the 2010s – something that Labour has vigorously rejected.

No funding for fair pay agreement

The party also did not pledge any resource to implement its fair pay agreement for the sector, placing significant question marks against its impact.

The IFS has calculated that, if this involved setting a sector minimum wage that was £1 an hour above the national living wage (NLW), it could cost the public sector about £200m-£360m a year; a £2-an-hour boost could cost £750m-£1.2bn a year.

The party’s other pledges on social care, meanwhile, remain open to significant interpretation.

Questions for Wes Streeting and Stephen Kinnock

For example, what does “a principle of “home first” mean in practice, what will the party do differently to speed up hospital discharge and what will its proposed national standards to drive up care quality amount to?

Health and social care secretary Wes Streeting (credit: Labour Party)

Most significantly of all, what is a national care service?

The new health and social care secretary, Wes Streeting, and minister for care Stephen Kinnock will be expected to provide answers to these questions and address the lack of funding in their plans for adult social care over the coming weeks and months.

It will be through their answers that we will know how different a Labour government will be to its Conservative predecessors.

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Story updated 12 July

A former children’s social worker has been appointed as a minister in the Department for Education (DfE).

Janet Daby, the Labour MP for Lewisham East, was made a parliamentary under-secretary of state in the department yesterday, working under the new education secretary, Bridget Phillipson.

I am delighted to have been appointed as Parliamentary Under-Secretary of State in @educationgovuk & to serve alongside @bphillipsonMP, @AnnelieseDodds, @CMcKinnellMP, @Jacqui_Smith1 & @StephenMorganMP

Looking forward to break down the barriers to opportunity across our country.

— Janet Daby MP (@JanetDaby) July 9, 2024

According to her LinkedIn profile, she worked in fostering – as a social worker and then as the registered manager of an independent fostering agency – and then as a social work consultant before becoming a Labour MP in 2018.

She held various shadow ministerial positions while Labour were in opposition, most recently in relation to youth justice.

Though her portfolio is yet to be confirmed, Community Care understands that Daby will take responsibility for children’s social care issues within the DfE, but this is yet to be confirmed.

Her first ministerial visit was to meet a group of kinship carers at national charity Kinship’s offices in London, after which she referenced her past role in children’s social care.

DfE minister Janet Daby meeting a group of kinship carers (photo supplied by Kinship)

“Opportunity starts with a loving, secure home and kinship carers play a crucial role by being the constant support in young people’s otherwise turbulent lives,” said Daby.

“It was a pleasure to meet some amazing people who care for vulnerable children for my first official ministerial visit today to hear about the challenges they face. They often don’t get the recognition or support they deserve.

“I will use my 15 years of frontline social care experience to be a champion for kinship carers and their children – making sure every one of them gets the opportunity they deserve. Today was a brilliant first step.”

We will further update this article when the DfE confirms which minister is responsible for children’s social care and, if this is not Daby, what her portfolio is.

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Stephen Kinnock has been appointed as the minister with responsibility for adult social care in the new government.

The Labour MP for Aberafan Maesteg in Wales becomes minister of state for care in the Department of Health and Social Care.

His appointment comes despite him never having held the portfolio as a shadow minister, in which capacity he had oversight over the Asia and Pacific region, the armed forces and – since 2022 – immigration.

However, he does have experience of the impact of dementia on families, having lost his mother, the former minister, peer and MEP Glennys Kinnock, to Alzheimer’s Disease in 2023.

What is in Kinnock’s in-tray?

Two big items in Kinnock’s in-tray are planned reforms to the adult social care charging system and Labour’s own plans to improve the pay, terms and conditions of the sector’s workforce.

In November 2022, the then Conservative government postponed planned charging reforms, including introducing an £86,000 cap on people’s personal care costs, until October 2025. In doing so, it diverted most of the £3.6bn it had allocated to implementing the reforms into shoring up day-to-day adult social care services.

However, it did not appear to have made preparations for implementation before it left office, while think-tank Institute for Fiscal Studies (IFS) has pointed out that no funding has been allocated to the reforms.

Question marks over changes

During the election campaign, Labour confirmed it would go ahead with the reforms in October 2025, but has not allocated any funding to them in the context of the party imposing tight limits on public spending.

Kinnock and his boss, health and social care secretary Wes Streeting, will need to determine how the policy can be funded and whether the October 2025 implementation date is realistic.

Councils would need to overhaul their case management systems and their approaches to assessment and support planning, including through recruiting more staff, in order to deliver on the changes.

Fair pay agreement

In its manifesto, Labour promised to negotiate a fair pay agreement for adult social care in order to boost the workforce’s pay, terms and conditions.

However, as with the charging reforms, it did not allocate any resource to this.

The IFS has calculated that, if this involved setting a sector minimum wage that was £1 an hour above the national living wage (NLW), it could cost the public sector about £200m-£360m a year; a £2 an hour boost could cost £750m-£1.2bn a year.

At the same time, Skills for Care will shortly publish its workforce strategy for adult social care, which is designed to influence the government’s own approach to staffing in the sector.

Ideas under consideration for the strategy include tying increased qualifications for staff to higher pay and providing registered managers with a supported year of development after taking up their posts.

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Wes Streeting and Bridget Phillipson have been handed responsibility for social care in the Labour government, after it took power in the general election.

Prime minister Keir Starmer has appointed both to the cabinet roles mirroring the briefs they held in opposition.

Streeting has become health and social care secretary, giving him responsibility for the NHS and adult social care.

Phillipson, meanwhile, has been appointed education secretary, a role that has oversight for children’s social care, as well as early years, schools, further and higher education and apprenticeships.

As for their Conservative predecessors, a key question facing both Streeting and Phillipson is the degree of attention they will confer on social care compared with the more politically salient elements of their briefs: the NHS in Streeting’s case and schools and childcare in Phillipson’s.

Social care not among Labour ‘missions’

Unlike social care – for adults or children – these policy areas feature in the five “missions” that Labour has set as its key priorities as well as the six “first steps” the party has laid out as its initial actions for government.

And Streeting made no reference to social care in his opening statement as health and social care secretary, which was entirely focused on the NHS.

Labour’s election manifesto did include a number of policies on adult social care – notably establishing a fair pay agreement for care workers, in order to improve their terms and conditions – however, it allocated no funding to any of them.

Though not included in the manifesto, Streeting also confirmed in interviews that the party was committed to introducing the previous government’s planned adult social care charging reforms – including a cap on care costs – by the planned implementation date of October 2025.

However, according to think-tank the Institute for Fiscal Studies, the Conservative government allocated no funding to this, so Labour would have to find the money for this. This is difficult given the new government’s commitments not to raise the main rates of income tax, VAT and national insurance and also be on course to cut public debt, as a proportion of GDP, over the medium-term.

Limited children’s social care offer

On children’s social care, the party’s manifesto offer was much more limited than it was for adults’ services.

The only substantive commitments were to strengthen regulation of the sector and to improve inter-agency information sharing by creating unique identifiers for children and families, but Labour provided very little detail on either.

Phillipson did reference the “need to bring reform to children’s social care children’s social care and to build opportunities for our most vulnerable children” in a speech to Department for Education staff on taking up her role (credit: Schools Week).

This suggests that the party may continue with the previous government’s reforms to the sector, set out in its Stable Homes, Built on Love strategy. 

However, its manifesto made no mention of the reforms, so it remains to be seen whether the new government will take forward their implementation and allocate the required resource.

Phillipson’s letter to staff

She subsequently published a letter to staff working in children’s services, education and early years. Referencing the mission she is responsible for, the letter was framed around the government’s ambition to “[break] down barriers to opportunity and improving life chances for every child”.

The one specific pledge she made in relation to social care was that the government would “work with local government to provide loving, secure homes for children in care”.

More broadly, she said the jobs of practitioners across all services had been made more difficult by “severe financial pressures squeezing all your budgets, high workload, climbing vacancy rates, strain on care, mental health and SEND services, among many other issues”.

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Labour has returned to power with an overwhelming victory in the 2024 general election.

The party has won 412 seats, giving it a majority in the House of Commons of 174.

Keir Starmer has become Labour’s first prime minister since Gordon Brown left office in 2010 and is now appointing his cabinet. Wes Streeting has become health and social care secretary, with responsibility for adult social care, and Bridget Phillipson education secretary, with oversight of children’s services, reprising the equivalent roles to the ones they took in opposition.

Stephen Kinnock has been made minister for care, with responsibility for adults’ services in the Department of Health and Social Care (DHSC), while the government is yet to confirm who will oversee children’s social care in the Department for Education. It could be former social worker Janet Daby.

The party has been elected on a manifesto that did not reference to social work and made relatively limited commitments on social care, none of which was funded.

It has also pledged not to raise income tax rates, national insurance or VAT and to stick to tight fiscal rules, including being on course to reduce public debt as a share of national income over the medium term. As a result, it has very limited scope to raise public spending.

Call to prioritise social work

However, in the wake of Labour’s long-expected triumph, the British Association of Social Workers (BASW) and Social Workers Union (SWU) called for early discussions with the new government so social workers and those they support are “at the forefront of [its] plans from day one”.

BASW chief executive Ruth Allen (credit: BASW)

“We acknowledge that the new government faces significant challenges and will have desperately difficult decisions to make,” said BASW chief executive Ruth Allen.

“However, the problems our profession and society face run deep, and requires bold and immediate actions to address. It really is time to get it right.

“From better resourcing of social work and funding of social care, to measures that alleviate poverty, reform mental health provision, protect human rights, and much more. Ministers must hit the ground running, and BASW will be working hard to influence and hold them to account.”

John McGowan, Social Workers Union (photo: Simon Hadley)

For the SWU, general secretary John McGowan said: “Social work has been at the sharp end of poor political choices that have plunged our profession into a recruitment and retention crisis and led to a decline in working conditions, while simultaneously increasing demand on services as communities become worse off.

“We hear from members everyday about the toll this is taking, and the buck stops at those in power with the responsibility to fix it. This is the strong case we’ll be making to the new government over the days, weeks and months ahead.”

Priorities for adult social care

In its first message to the new government, the Association of Directors of Adult Social Services set out three priorities for adult social care.

“Three key issues we believe the government must prioritise are the need to improve the pay, terms and conditions of the social care workforce; provide improved support to unpaid carers; and to provide care closer to home so that those drawing on care can live the lives they want in their own homes and communities,” said ADASS chief executive Anna Hemmings.

For the Voluntary Organisations Disability Group (VODG), chief executive Rhidian Hughes said: “The government faces significant challenges ahead, including putting social care on a surer footing, addressing the cost-of-living crisis, which is disproportionately impacting disabled people, and addressing the national scandal of autistic people and people with a learning disability being detained in long-stay hospitals.

“Only by prioritising the provision of high-quality support for disabled people of all ages, will we have a fairer society where everyone is able to thrive.”

‘Urgent’ need to invest in and reform adult social care

Meanwhile, independent care provider representative body Care England said the new administration needed to “invest in and reform [adult social care] as an urgent priority”.

“There are practical measures the new government must implement within its first 100 days to secure a sustainable future for our sector,” said its chief executive, Martin Green.

The Homecare Association, which represents domiciliary care providers, said there was a need for a “care revolution”.

“We’re not just talking about tweaking the system,” said its chief executive Jane Towson. “We need a complete transformation. Yes, we’ll harness AI and robots, but let’s not forget the irreplaceable human touch. We need smart tech and even smarter policies.”

“Labour now has the chance to rewrite the rules of care. Let’s create a system that’s as innovative as it is compassionate, as efficient as it is empathetic. Supporting people at home must be at the heart of government policy”.

‘Need for system fit for the 21st century’

For the Social Care Institute for Excellence, chief executive Kathryn Smith said: “More people are requesting support, but fewer are getting the help they need. With demand increasing, local authorities do not have the money to meet it and staff numbers are not keeping pace.”

She added: “A social care system fit for the 21st century is in the national interest and the formidable challenges facing the social care sector cannot be a justification for inaction.

“The cornerstone of future policy change ought to be co-producing solutions with people with lived experience, their families and carers, as well as care providers. Only an inclusive, collaborative approach will improve the efficacy and sustainability of any policy change.”

‘£6bn funding gap’

The Local Government Association (LGA) welcomed the new government with a reference to the £6.2bn gap it has calculated councils face over the next two years between the resources they have and what they need to maintain services at existing levels. 

Much of this is driven by adults’ and children’s social care pressures, according to the LGA.

“It is important we find a sustainable and long term financial solution, as well as the powers and levers required so we can deliver on the priorities of the new government,” said new LGA chair Louise Gittins.

Tackling children’s social care pressures is ‘urgent challenge’

The financial pressures facing councils, including in relation to social care, were also referenced by the Association of Directors of Children’s Services (ADCS) in its response to the election result.

“For too long children’s needs, their rights and outcomes have not been prioritised and for too long councils have been severely underfunded in the face of rising levels of need and costs,” said ADCS president Andy Smith.

“A growing number of councils are effectively bankrupt, or dangerously close to this and many vital and valued services, including services that help children and families before they reach crisis point, are at risk.”

Smith added: “The new government has many urgent challenges to address. This must include the crisis in local government funding, growing pressures in children’s social care and the SEND system and huge challenges facing children’s mental health. “

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Just over half of Community Care readers will be voting Labour in next week’s general election, a poll has found.

With the party predicted to win a sizeable majority on Thursday (4 July), our poll found 52% of the 954 respondents would be voting Labour, with just 5% opting for the Conservatives.

Reform UK was readers’ second most popular option at 12%, closely followed by the Greens (11%) and then the Liberal Democrats (9%).

Six per cent of readers said they would not be voting at all.

No funding commitments

Despite Labour being readers’ most popular option, the party has made no funding commitments on either children’s or adult social care.

While it said it would introduce a “fair pay agreement” for adult social care workers, it has not allocated any funding to this. Likewise, the party has said it would implement the current government’s adult social care charging reforms in October 2025 but not addressed the fact that this is currently unfunded.

On children’s social care, it said it would strengthen regulation of the sector, though did not set out how, while it also refrained from committing to continuing the current government’s children’s social care reforms.

‘Social workers will have to struggle on’

Social workers commentating on our election coverage were pessimistic about the prospects of a Labour government for the profession.

“Social workers will have to struggle on, working excessive extra hours without pay,” said David. “Vulnerable children and adults will not receive the services they need as a result.”

“Clearly things are not going to substantially improve for social care, whether for children or adults. Nor are the pressures on social workers going to be addressed.”

Another social worker, Nicola, said the Labour party wouldn’t be “any different to the Tories”.

“More austerity incoming, the most vulnerable carry the weight of the burden and the top 5% continue to be shielded by all parties.”

What do you think the future holds for social work under a Labour government?