Anxiety as social care left out of £3bn spending boost

In an announcement at Downing Street this morning the Prime Minister stated £3bn had been allocated to the NHS to pay for independent sector capacity and Nightingale hospitals, aimed at easing winter pressures. It’s also understood a sum of around £500m has been allocated to pay for care packages where they are needed to speed up discharge from hospital, for the remainder of 2020-21.

A statement from Downing Street said the money was available immediately to “allow the NHS to continue using additional private hospital capacity and maintain the Nightingale hospitals until the end of March.”

NHS England told HSJ that, while a new deal with independent healthcare providers was still being negotiated, it expected that the NHS would be able to make use of as much IS capacity as would be needed, for elective and diagnostic care, as it needed, through the financial year.

It is not clear how far the £3bn will go towards funding that, or to covering other pressures involved in running health services while needing to have complex and expensive infection control measures in place. 

Meanwhile, HSJ understands senior NHS leaders are particularly concerned about the absence so far of a new national funding deal for social care, and of comprehensive winter planning to ensure there was enough capacity in care.

Local authorities have seen substantial costs during the outbreak with many now needing to make cuts, putting social care capacity at risk. Many fear that without additional investment the NHS will struggle to discharge patients as needed during winter, leading to hospitals filling up, as well as problems safely looking after patients in the community.

One acute trust leader told HSJ there was a prospect in their area of councils, due to the need to cut spending, withdrawing their staff from additional work speeding up discharge.

Another trust chief executive said their local councils were “massively out of pocket so they are making cuts and won’t have any funding for winter pressures”; while they “might be looking at large scale market failure” in social care. “A number of providers are saying they are within a couple of months of going under,” they said.

Professor Kate Ardern, Wigan director of public health, said without national support government risked “a repeat of the first wave response when saving hospital beds became the priority”. The first wave saw tens of thousands die in care homes, with widespread failure to prevent and control outbreaks. She argued a “whole system” funding plan was needed.

Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group chief executive Tracey Cox has told HSJ that councils may reduce their contributions to “better care fund” integration arrangements, and as their budgets tighten, there could be a “big risk to systems over the winter period”.

Government established a covid-19 social care taskforce at the beginning of June to help plan its next steps, but it has since issued no further details or funding.

Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, added: “We will also want to see a recognition of the parlous state of social care on which the NHS and thousands of the most vulnerable people depend – just putting money into the NHS will not be enough if its sister service cannot cope.

“We look forward to a different future in which social care, the independent and the voluntary and community services are seen as part of an integrated system, not as something separate, different and other.”