Written evidence submitted by Mrs Lynne Bowers (ASC0003)

Impact of Inaction on Adult Social Care Reform

Cost to the NHS and Local Authorities

Inaction on adult social care reform is significantly impacting both the NHS and local authorities. The key areas affected include:

• Care Workforce Attrition and Lack of Continuity of Care: High turnover rates and insufficient staffing lead to inconsistent care for patients.
• Economic Inactivity: Many potential workers are unable to participate in the economy due to caregiving responsibilities.
• Carer Breakdown and Poverty: Carers often face financial hardship and burnout, affecting their ability to provide care.
• Avoidable Conveyances and Admissions: Inadequate social care results in unnecessary hospital visits and admissions.
• Delayed and Inappropriate Discharges: Patients experience delays in being discharged from hospitals or are discharged to unsuitable care settings.
• Exploitation of Vulnerable Groups: Looked After Children, young people with mental health issues, and those with learning disabilities or neurodivergence are at risk of exploitation.
• Criminal Justice System Failures: Ex-offenders struggle with reintegration due to insufficient support.
• Loneliness Epidemic: Social isolation is prevalent among those needing care.
• Obesogenic Environment and Ill Health: Poor social care contributes to environments that promote obesity and related health issues.
• Inappropriate End-of-Life Care Management: End-of-life care is often mismanaged, leading to distress f page down page down or patients and families.

The impact on patients includes avoidable mortality and morbidity, and poor quality of care, causing significant emotional distress to individuals and their families. For the public, this results in reduced GDP and increased cost of living demands.

Impact on NHS and Local Authority Reforms

Due to the pressures from adult social care, several necessary reforms within the NHS and local authorities are not being implemented. This includes:

• NHS Resistance to Reform: The NHS remains entrenched in outdated models of care, leading to overwhelmed services and a lack of modernisation.
• Local Authority Disinvestment: Repeated disinvestment in local authorities prevents them from addressing the wider determinants of health and maintaining a stable society.

As a result, patients and the public miss out on the benefits of a modern, fit-for-purpose healthcare system and a supportive social care environment.

Cost of Inaction to Individuals and Potential Changes with Reform

Inaction on adult social care reform has profound costs for individuals, including:

• Grief and Poor Wellbeing: The emotional toll on individuals and families is immeasurable.
• Wealth Inequality: Disparities in wealth are exacerbated by inadequate social care.
• Fear of the Future: People face uncertainty, feeling marginalised and fearing civil disorder and dissent.

With effective reform, individuals could experience improved wellbeing, reduced inequality, and a more secure future.

Areas Bearing the Cost of Inaction

The most vulnerable in society bear the brunt of inaction on adult social care reform. This includes:

• Elderly and Disabled Individuals: Those who rely heavily on social care services.
• Carers: Individuals providing unpaid care who face financial and emotional strain.

Contribution of Adult Social Care to the Economy and Potential Changes with Reform

Adult social care significantly contributes to the economy and HM Treasury:

• Social Care Sector: Contributes £46.2 billion.
• Civil Society: Adds £20 billion.
• Economic Inactivity: Costs associated with caregiving responsibilities.
• Inheritance and Capital Gains Tax: Financial implications of care-related expenses.
• Workforce Attrition: High turnover rates in the social care workforce.
• Poor-Quality Care and Litigation: Costs arising from inadequate care.
• Social Capital: The value of community support and networks.

Reform could enhance these contributions by stabilising the workforce, improving care quality, and reducing economic inactivity.

Government Consideration of Inaction Costs in Policy Evaluation

The costs of inaction on adult social care reform are often overlooked in government policy evaluations, including Budget and Spending Reviews. To address this, the following should be assessed:

• Population Health and Wellbeing: Overall impact on public health.
• Intervention Success: Effectiveness of implemented interventions.
• Workforce Capacity and Morale: Staffing levels and job satisfaction.
• Deprivation and Social Mobility: Economic and social impacts.
• Prevention Funding: Investment in preventive measures and their effectiveness.
• Economic Performance: Broader economic impacts beyond healthcare spending.

A Social Care Mission Board should be established to ensure cross-departmental alignment, involving sectors such as housing, economic development, education, skills development, international recruitment, transport, environment, agriculture, and the Department for Work and Pensions (DWP). This holistic approach would ensure comprehensive and effective social care reform.

December 2024