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Care Provider Alliance responds to National Audit Office Report on Adult Social Care Reform in England

10 November 2023

The Care Provider Alliance welcomes the National Audit Office Report on Adult Social Care Reform in England. It casts a spotlight on critical issues facing adult social care, which supports over a million people with a workforce of 1.6 million. 

The report confirms our longstanding concerns: the adult social care system is under intense strain. Local workforce shortages have left providers reliant on international recruitment; people in need have long waits for assessment and care; and local authorities and care providers are financially fragile.

We support the government's aspirations for reform of social care, which were articulated in the White Paper “People at the Heart of Care”. 

A central problem, though, is that HM Treasury allocated insufficient funds to realise these aspirations. On top of this, rising inflation and poor economic performance have led to cuts to an already inadequate budget.

The Health Foundation has calculated that the sector needs £8 billion p.a. extra to stand still. To meet future demand, improve access to care and cover the full cost of care an additional £18 billion p.a. is required.

The government originally announced £1.8 billion p.a. for three years for reform. Now, it has budgeted only £729m for reform activities between 2022-23 and 2024-25.

Our chief concerns are lack of funding for fair payment for care for all ages and workforce development; and delays in implementing the reform programme. 

The government cut the original allocation of £500m for workforce reform to £250m. £500m was never enough to address the pivotal workforce issue: poor pay and terms and conditions of employment.

Now, grossly inadequate funding and poor project management threaten the delivery of remaining initiatives.

We urge the Department of Health and Social Care to act on the NAO's recommendations. 

The Care Provider Alliance and its members are ready to offer their expertise and experience to assist with social care reform.

We call for immediate action to address the funding shortfalls and delays, ensuring that our workforce is supported, valued, and equipped to provide the high-quality care our society deserves.

Chair of the Care Provider Alliance, Dr Jane Townson OBE said:

“The NAO report confirms what Care Provider Alliance members already knew, though revealed some detail we were unaware of.

The government's plans for adult social care reforms lack proper funding and a credible delivery plan. 

We’re pleased that the Digital Social Care Programme is making progress, though is unlikely to meet the target. Unlike the others, this programme board engages with sector experts and reports openly on performance.

Delays in delivery of the workforce reform programme are very disappointing, as is the lack of transparency about approach and costs. 

DHSC's decision to spend £11.6m on a new IT system for administering training funds, for example, appears wasteful of time and money. Other mechanisms for grant dispersal are available and familiar to employers. The new system will not be ready until Spring 2024 at the earliest, reducing the opportunity for care workers to benefit from the funding. 

We’re staggered to read that DHSC’s analysis suggests local authorities have excess funding to meet cost pressures. There is clear evidence to the contrary.

The government’s focus is almost entirely on older adults. At least half of the costs of social care arise from meeting the needs of younger adults. As the NAO points out, profitability of the specialist providers, who support younger adults, has declined the most. Care providers of all types, though, are struggling to remain afloat.

We want to see more investment in social care; a coordinated and inclusive approach to implementing reform; and clear monitoring of performance.

The Care Provider Alliance remains committed to working with DHSC and other stakeholdersto shape care services to meet needs now and in the future.”

Notes to Editors§

About the Care Provider Alliance (CPA)

The CPA is a coalition of 10 associations representing adult social care providers in England. We advocate for the sector and ensure a coordinated response to the major issues that affect it.

The Care Provider Alliance is an informal body with a rotating chair. Membership is of the representative associations with a national membership across the whole of England. However, some CPA members also represent services in Scotland, Wales, or Northern Ireland.

Our members provide care and support to 1.2 million people. They offer a range of services, including residential care, nursing care, homecare, supported living, and extra care housing. They support children, adults of working age and older people. Services are commissioned by local authorities and the NHS or privately purchased. Together, our members employ over 620,000 care workers.

For more information on the Care Provider Alliance visit



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