SAVE the NHS Deliver a Fair Fee for Care

Without a viable social care sector, health care costs will not reduce. It is high time Government realises the close link between the two.

In the last decade while health care budgets went up every year, social care budgets have been cut significantly.

In the UK, there are almost 1 million older people living with advanced frailty and dementia who require care in care homes. As our population ages, this number is expected to rise to 1.5 million. With only 450,000 care home beds, and the number predicted to drop by a further 140,000 in the next five years, the significant mismatch in supply and demand is obvious.

The doctors I worked with when I was an NHS surgeon tell me that there are significant delays in discharging older patients due to a lack of social care beds. The number of providers handing back contracts which pay below the cost of care, has more than tripled in 22 months.

This only exacerbates the record backlog that has seen hospital waiting lists and costs spiral out-of-control – in particular for cancer.

In the last two years the cost of care has increased more than inflation due to regulatory requirements, energy, staff costs, Brexit and covid.

Local authorities and CCGs pay far below the true cost of care, due to their undue market influence (Kings Fund and CMA report).

They pay care homes

£550- £650 per resident per week - 2.5 times less than in Western Europe. This is totally insufficient to cover care staff, food, and accommodation costs. Besides putting unfair pressure on a small number of self-funders, who subsidise care for others, staff are paid at minimal wages.

For the sake of the NHS and those who need hospital care, decisive action must be taken to address the critical issue of a fair fee for care.

The real cost of providing allinclusive care in a care home is closer to £950 per week.

With a margin for surplus, regulatory working capital and capital expenditure, Local Authorities/CCGs must pay a minimum of £1100 in the current inflationary environment which would be far lower than the £3500 per week cost of a hospital stay. This fee, index-linked with inflation and ringfenced to ensure it reaches care homes, will allow social care to survive and for pressure on hospitals to ease.

Without a viable social care sector, health care costs will not reduce. It is high time Government realises the close link between the two and takes decisive action to prevent abuse of market power. Regulation should be enacted to pay a fair

fee for care immediately.

CQC market oversight was created to monitor financial viability of large social care providers. However, without a

fair fee for care, it is irrational to expect viability of the sector and beds will continue to be lost putting further pressure on the limited 150,000 NHS beds.

“For the sake of the NHS, older people and those who need hospital care, decisive action must be taken to address the critical issue of a fair fee for care.”