Calls grow for radical reform of adult social care in England

The future of adult social care in England is once again under the spotlight, with growing calls for fundamental changes to how care services are organised, funded and delivered.

A new report from the Nuffield Trust and a speech by Baroness Louise Casey at the National Children and Adult Services Conference (NCASC) have both highlighted the need for urgent reform and stronger oversight of the care system.

The National Care Forum (NCF), the leading membership organisation for not-for-profit social care providers, has welcomed these developments, particularly the recognition that the balance between private, public and not-for-profit care provision needs to be reconsidered.

Putting not-for-profit care at the heart of reform

Responding to Baroness Casey's speech and the Nuffield Trust report, Vic Rayner OBE, Chief Executive of the National Care Forum, said: "Baroness Casey is right that social care needs fundamental reform, not more tinkering around the edges. We share that vision, and we are clear that a National Care Service should have not-for-profit care and support at its heart."

The NCF argues that strengthening not-for-profit provision would help ensure that public funding is reinvested into care services, staff development and local communities.

Unlike commercial providers, not-for-profit organisations reinvest any financial surplus into their charitable or social objectives, rather than distributing profits to shareholders.

The NCF believes this approach can help create a care system that is more sustainable and better able to provide people with choice, control and dignity.

Building a National Care Service for the future

The proposals come as the government considers the long-term future of adult social care and the development of a National Care Service.

The NCF is calling for a more strategic approach that recognises the importance of high-quality care, supports the workforce and ensures that the needs of people receiving care remain central to decisions.

It has also emphasised the importance of collaboration between government, local authorities, care providers, staff and people who draw on care and support.

The organisation has made clear its willingness to work with the Casey Commission and policymakers to turn the ambition for reform into practical changes that will benefit communities across England.

Rethinking how adult social care is organised

The Nuffield Trust's report, Governance in social care: Lessons for reform, examines how the organisation and oversight of adult social care could be improved to support lasting reform.

At the heart of the debate is the question of who should provide care and how public money should be used to deliver services that are sustainable, accountable and focused on people's needs.

England's adult social care system includes a mixture of private companies, local authorities and not-for-profit organisations, including charities. Each plays a role in delivering residential care, nursing care and support within communities.

However, the NCF believes that future reforms must involve deliberate decisions about the balance between these different types of providers, rather than allowing the structure of the care system to develop without a clear long-term strategy.

What the Nuffield Trust report adds to the debate

The report, produced jointly by the Nuffield Trust and the Institute for Government and commissioned by the Casey Commission, draws on lessons from England's social care history, other public services and international care systems.

It makes several important observations:

• There is no single perfect model for organising adult social care. Reform will involve choices about priorities, responsibilities and accountability.
• Better workforce planning and support for innovation are essential, whatever structure is adopted.
• Social care reform must be coordinated with changes to the NHS, housing and local government.
• Political commitment and sustained investment will be just as important as changes to organisational structures.

Importantly, the researchers caution that reorganising services alone will not solve the challenges facing adult social care. A clear vision for what the system should achieve must come first.

Read the full Nuffield Trust report here

BCOP and the National Care Forum

BCOP is proud to be a member of the National Care Forum, which represents not-for-profit organisations providing care and support across the UK. The NCF works with government, policymakers and sector partners to influence national policy, champion high-quality, person-centred care and ensure that the voices of not-for-profit providers, care professionals and the people they support are heard. Through our membership, BCOP supports these important national conversations while continuing to provide compassionate care, nursing services and housing for older people across Birmingham.