The Social Care Institute for Excellence (SCIE) and the Centre for Care brought together political, research and sector leaders at the Labour Party Conference in Liverpool to explore how equity can be placed at the heart of adult social care reform.
The session, ‘Placing care equity at the centre of adult social care reform’, took place on Sunday 27 September and was chaired by Baroness Glenys Thornton, Chair of SCIE. Speakers included Professor Kate Hamblin, Director of the Centre for Care; Phil Holmes, President of the Association of Directors of Adult Social Services (ADASS); Anna Dixon, MP and Chair of the All Party Parliamentary Group on carers; and Sojan Joseph, MP and Chair of the Adult Social Care All Party Parliamentary Group.
The discussion came just hours after the Prime Minister spoke to the BBC about the future of social care with ambitions for a National Care Service, bringing renewed attention to how care should be funded, organised and delivered.
Panellists discussed the inequalities people currently experience in accessing care and support, and what needs to change as the Government develops its plans for reform. The discussion highlighted the impact of unmet, under-met and inappropriately met need on people who draw on care and those who support them. Inequities created by the current system place unsustainable pressure on unpaid carers and, as highlighted by the Prime Minister in conversation with the BBC, poverty wages and low esteem are widespread across the care workforce. Discussions also highlighted the importance of prevention and early intervention, and the need to ensure people have choice and control over their care.
Crucially, a recurring message was that equity needs to be designed into reform from the outset, rather than treated as an outcome that will automatically follow structural change. The discussion considered how a future National Care Service could establish greater fairness and consistency while recognising the importance of local contexts and that people’s experiences of care are also shaped by housing, benefits, employment and other public services.
Baroness Glenys Thornton, Chair of SCIE, said:
Social care reform gives us a real opportunity to address some of the inequalities that have become embedded in the system.
What came through strongly from the discussion is that equity cannot be something we consider once the big decisions have already been made. It needs to shape those decisions from the outset.
As the Government develops its plans for a National Care Service, we need to keep asking what those reforms will mean for people who draw on care and support, their families and carers. That means using the evidence, listening to people’s experiences and making sure greater fairness, choice and control are at the heart of reform.
Professor Kate Hamblin, Director of the Centre for Care, said:
We need to recognise the vital role local authorities play in understanding their populations and developing care and support that responds to people’s circumstances.
At the same time, social care does not exist in isolation. We cannot build a National Care Service around equity if other systems people rely on, including housing and benefits, are working against that ambition.
Reform therefore needs to consider people’s lives as a whole and recognise how different services and systems combine to shape their experience of care.
Phil Holmes, President of ADASS, said:
Adult social care is a human system, but too often it can feel like a factory system. Good care starts with the person, what matters to them and what a good life looks like for them.Equity is not a bonus or a nice-to-have. It is a legal, ethical and financial imperative.
That means co-designing care and support alongside people and families and making sure people have genuine choice and control.
We have a great deal of evidence about where inequalities exist and what better care looks like. The challenge now is to use it, learn from good practice and create the conditions for that to spread.
Anna Dixon MP highlighted how inequalities in social care can leave families carrying the burden of unmet need, with the effects felt particularly by people on lower incomes and across gender and ethnic inequalities. She also pointed to the importance of fair allocation according to need, fair costs for providers and improving pay in the social care workforce.
Sojan Joseph MP drew on examples from Kent to highlight the value of prevention and early intervention, including services that take support directly into people’s homes. He also stressed the importance of co-production and ensuring national reform can respond to the very different communities and circumstances found within local areas.
The event also heard that creating a National Care Service alone would not guarantee greater equity. What is required is a firm commitment from government to establishing care equity as a foundational principle to the work due to be undertaken to build the foundations and infrastructure of a National Care Service.
