In the United Kingdom, support and care services continue to face unprecedented challenges due to spending cuts by the central government regardless of the increasing demand. Care homes have witnessed challenges. This has, in turn, resulted in a reduction in the breadth of local authority provision of care. Moreover, the cost of care has dramatically increased, reducing the number of people seeking attention. Publicly funded social care assist, support and care adults of all ages. Studies suggest that older adult’s social care is under massive pressure due to the increasing numbers of people who are not receiving the assistance they need (Bauld et al., 2018). According to the Care Act 2014, there was the creation of new expectations and demands though funding has not kept pace. Currently, the local authorities have no room for making some savings, and based on current reports; they will soon not be able to meet primary statutory duties (Knapp et al., 2018). However, there have been promises to fix social care, though they haven’t been new. Back in 1997, Tony Blair who was the prime minister to the UK argued that he didn't want the children of Britain to grow up 'in a state where pensioners only get long-term care by selling their property. Since the time of the promise, the government has been offered with reports on social care reform – four white paper, two green papers, various consultations and five independent commissions (Thorlby et al., 2018). Regardless of these reports, there has been no solution to the continuously increasing crisis. However, fixing social care is not that simple. Most individuals are not aware of what social care is, let alone how it works. This makes it difficult to make reforms which are better than what is already in existence, making it hard to sell change as better than what we've already got. This report address social care which if facing crisis in the UK.
Social care -refers to all forms of personal attention as well as other practical assistance offered to young people, children as well as adults who need extra help
Policy- refers to the principle of action which is adopted by an individual or organization.
Social care homes- this is the long-term care given to children or adults who dwell in a residential setting other than in their own home.
Privatization- is the ownership transfer of business or property from the central government to the private sector.
From the two million people who are old in England with care-related requirements, 800,000 do not get formal assistance from the government.
In 2010 October, the local government announced a significant cut which was suggested by the then newly elected coalition government, after published its public sector spending strategy – the Comprehensive Spending Review. The review was aimed at minimising the United Kingdom public sector deficit. Moreover, the report reduced national government funds to local authorities by 26%, which was to take place between 2011/12 and 2014/15. From this review, there was an earlier modest allocation reduction to the local authorities by the central government allocations by 1%, as per the 2010 Budget. Moreover, by 2013, the national government, through an announcement suggested further 10% deduction from to cover the period 2015/16 (Ferry & Eckersley, 2011).
Combination of the impact net spending cuts, the number of older adults assisted by the public social care and the increasing number of older individuals and who are planning to strains the funds in social care. This results in individuals taking a step to use their resources to gain social care. Studies have argued that the level of unmet need differs widely varies based on the form of assistance needed. However, more women (a third of women) compared to me (a fifth of men) who are above 65 years of age reveals unmet needs in their daily activities (Whalley, 2012).
There is more crucial reform which is needed in the social care sector to make its funding system fairer and create government protection from social care costs. Additionally, legislators should have plans on how to handle this issue according to the priority, values as well as public spending plans. A Dilnot-style capped cost approach which advocates for more government funding for older adults with the highest lifetime care requirements and as well protects them against using their resources in the provision of care could be flexibly be utilised by the government to solve these social care crisis.
Over the years the social care has witnessed fewer service users who are by public funding the number of people across the UK being funded by public money has increased. Though due to increased demand for social care support, there is increased personal funding as people seek social care. The number has declined since 2005/6. Looking at the decline, there is a sharp decline since 2008/9. Compared to 2005/16 where more than 15.3% of the older adults were supported, recent results show a decrease.
As suggested previously, women are mostly affected
The social care platforms are currently struggling to meet the older adults needs for more than six consecutive years of cutting the budgets of local authorities. However, regardless of this, the report has indicated that some 26 % have been able to be assisted. To the other percentage, there is no enquiry no description of what happed to that population of the older people, especially who are no longer entitled to public care. Moreover, financial and human costs are mounting (Humphries et al., 2016). From the struggle the people get, there is increased risk of deteriorating the people mental and physical health. To relive their issues, some older adults indulge in alcohol and substance use.
Additionally, the struggle results in neglect and victimization of older men women who are usually financial abuse while trying to sell their property to attain health acre. The problem in this issue is lack of funds and misuse of public funds associated with older adults. To achieve a long term solution, the government should reform the social care long-term funding, which is reliable, unlike private finance which is never sufficient. Moreover, the government should establish a sound policy framework to make, which is clear on the responsibility for funding home care as well as old person families.
Reports have argued that in the past six years, there have been massive pressures on the social care market. The national government offers grant reductions to local authorities. On the other hand, the local authorities have passed the responsibility of taking care of older adults in social care to health care providers in forms of reduced fees. Together with care workers, nurse shortages as well as higher regulatory standards across the country, there is unprecedented pressure to several social care providers. Studies conducted in social care by Watkins et al., (2017), in England suggest that constraints associated with spending constraints observed from 2010 to 2014 were linked to more than 45 368 people, a number which was higher compared to the expected number of deaths’ trends followed before 2010. From this study, people aged beyond sixty years in care homes were the majority of the people who died at the period of study. Also, the study discovered that changes in real Public social care per capita had a significant link to the observed mortality, mainly due to changes in several nurses. Generally, this problem is occurring due to neglecting of older adults by the government and delegation of these responsibilities to local authorities who in turn, delegate the roles to the social care workers. To solve this issue, there is a need of the central government to provide more reliable and generous support, care as well as security to the older adults in the community. Failure of the government to take this step will result in prolonging of the significant challenge and political shortcomings in this era.
Several social care providers majorly rely on the increasing number of older adults who can fund their care. People relying on local authority contracts usually suffer the most. Due to the lack of funds allocated to the publicly funded social care homes, the homes often face the critical challenge of shortages of the workforce. Currently, the situation is becoming worse, which is threatening to undermine policies to assists older adults at the public social care home. Therefore, the failure of the large scale provide is no longer a question of ‘if’ but ‘when’ such failure would jeopardise offering of the care which is usually depended on by many old people. The effects of lack of individual funds to cater for personal attention is very obvious; the older adults will lack care and live miserable lives before lastly dying of disorders associated with older adults, poverty and even hunger. The cause of this problem is the lack of the national government to provide sufficient health care workers to cater for the increasing number of people. Due to the scarcity of resources, the government can solve this challenge by applying a strategy of achieving more with limited resources. The strategy could involve the use of integrated care and better commissioning of social care homes. However, this strategy would not cover the funding gap; however, it can be a possible emergency solution to the current condition, which is going out of hand.
Currently, reports indicate that local authorities usually protects the most vulnerable older people who have the most critical needs, while neglecting the other population citing independent (Watkins et al., 2017). Due to the funding which reaches the local authority, most families are encouraged to draw family and community resources to cater for their social care. This is done to decrease state dependence for support. This challenge is integrated with unpaid carers workers who are expected to work even harder to assist these older adults. Mulholland (2015), argues that the number of older people who live with long-term health disorders like arthritis, dementia, as well as depression is rapidly growing. The study, as well as UKHCA (2016), suggest that the number of older individuals who will not be able to manage their domestic chores on their own may reach 44% by 2030. This means that there is a larger population demanding social support. Therefore, offering discriminative care based on a particular condition is very wrong. This results in too many people suffering in and even results in difficulty lives and deaths. With a central and government and the people in question being taxpayers. This case should never occur. Therefore, the problem here is neglecting based on individual needs and conditions. Since the government seem to have failed in their duties, the legislature should come up with more relate legislations which outsourcing services delivery to the private sector, though they should set a monitoring body and policies which firmly ensure complete care of the older adults. However, UKHCA (2016), suggest that privatisation almost always the answer to this crisis. I believe that the government is sourcing some funds to the private sector; home care can be significantly advanced.
Studies reveal that the significant visible pressure manifestation on social and health care budgets is the increasing growth in hospital delayed discharges. However, this is due to funding pressures which result from workforce shortages and demand for services in local authorities, social care and the NHS providers. Regardless of this pressure, all bodies working with older adults should work more effectively and together to solve a common problem which imposes a fundamental cost on the NHS. In a study conducted by Chiu et al., ( 2017) on prolonged length of hospital stay suggested that, Of 1658 participants, 251 which is approximately 15.1% had a significant or minor postsurgical complication at the time of the visit. These complications were linked to with on prolonged length of hospital stay (PLOS). Other notable complications include; abdominal bleeding anastomosis leakage and Intestinal obstruction, which had a most significant impact on the patient. Therefore, it is clear that the prolonged hospital stay just increased the complications of the older adult rather than solving the issue.
Additionally, personal finance is being partially used, which impacts the older adult. So the cause of this is issue is simply lack of clear rules no patients study in the hospital. Setting enough budget and setting policies can be a critical idea for solving this problem. Hence the government should consider setting some.
While citing this crisis, studies have suggested that the funding outlook in the coming five years is very uncertain (UKHCA, 2016). The terms agreed by the central government does not seem to meet the funding gap, which exists between the resources that are set to achieve maximum acre and the need by the end of 2019. Watkins et al. (2017) suggest that public spending on social care will fall to less than 1% of GDP. This gives the potential for the local authorities to make efforts to achieve more utilising the existing resources. Mulholland (2015), suggests that, in England, Public spending on care was estimated to be £525bn in 2017/18. However, £18bn was spent on adult social care. All over the United Kingdom, £22.7bn spent on social care, which is approximately 1.1% of GDP. Comparing this funding need to the broader the health spending which was estimated to be £153bn 2017/18, this is similar to 7.1% of GDP. Just like social care funding, broader health funding is expected to grow by 2023/20 to 7.9%. Lack of funds will create more suffering and pressure to the older adults since their needs will be stretched, and even more, people will require social care. Therefore, the cause of this is simply government inability to plan for its citizens, especially older adults. To solve this issue, the government must revise the existing laws to cover all the individuals (taxpayers).
2010 to 2015 government policy: health and social care integration
The Health and Social Care Act 2012
The Equality Act 2010
The Social Value Act of 2012
This report indicates that the witnessed social care crisis continued to deepen over the last years, and the observed trend in funding will continue to be seen until crucial new money comes into the social care platforms. It is also evident that social care is being underfunded and neglected for some years many years now. Every part of the government working together through changes to the legislation can be useful in implementing positive changes to the current system. Additionally, the demand for social health is increasing day by day, but there are no resources to meet the demand, which is just like running up a down escalator. From the number of people in society who require social care, it is evident that the ‘old’ need social care. This also reveals that more funds are needed each year to withstand the current demand. However, it's unfortunate that the government seem not to support public expenditure.
What legislations can be applied to completely cater for old people social care needs and what time is needed to develop these legislations?
How can we source more funding from the government regardless of the current funding cuts to achieve better public social care and what other alternative funding can we have?
Bauld, L., Chesterman, J., Davies, B. and Judge, K., 2018. Caring for older people: an assessment of community care in the 1990s. Routledge.
Chiu, H.C., Lin, Y.C., Hsieh, H.M., Chen, H.P., Wang, H.L. and Wang, J.Y., 2017. The impact of complications on prolonged length of hospital stay after resection in colorectal cancer: A retrospective study of Taiwanese patients. Journal of International Medical Research, 45(2), pp.691-705.
Ferry, L. and Eckersley, P., 2011. Budgeting and governing for deficit reduction in the UK public sector: act one'the Comprehensive Spending Review'. The Journal of Finance and Management in Public Services, 10(1), pp.14-23.
Humphries, R., Thorlby, R., Holder, H., Hall, P. and Charles, A., 2016. Social care for older people: home truths. King's Fund.
Knapp, M., Cambridge, P., Thomason, C., Beecham, J., Allen, C. and Darton, R.O.B.I.N., 2018. Care in the community: Challenge and demonstration. Routledge.
Mulholland, L., 2015. Adult social care in crisis as' efficiencies' exhausted. Nursing Older People (2014+), 27(6), p.6.
Thorlby, R., Starling, A., Broadbent, C. and Watt, T., 2018. What’s the problem with social care, and why do we need to do better?. London: The King’s Fund.
UKHCA, 2016. An Overview of the Domiciliary Care Market in the United Kingdom
Watkins, J., Wulaningsih, W., Da Zhou, C., Marshall, D.C., Sylianteng, G.D., Rosa, P.G.D., Miguel, V.A., Raine, R., King, L.P. and Maruthappu, M., 2017. Effects of health and social care spending constraints on mortality in England: a time trend analysis. BMJ open, 7(11), p.e017722.
Whalley, R., 2012. Social care: need for and receipt of help. Health and Social Care Information Centre, Health Survey for England.
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