A problem shared… is that a problem halved or doubled?
A recent report by the NHS Confederation calls for a ‘re-imagining’ of the NHS if the service is to emerge on a stronger footing from Covid-19. A ‘triple whammy’ of rising COVID-19 infections, a major backlog of treatment and reduced capacity due to infection control measures put NHS providers at risk; if they are to emerge from the pandemic on a stronger footing, they will need extra investment and support for front-line services.
These are challenges that will resonate all too clearly with social care providers. But does a problem shared make it any more likely to solved?
A second report from the Institute for Fiscal Studies (IFS) casts considerable doubt on any quick recovery for social care.
Even before COVID struck, social care was grappling with financial pressure. Competition and Markets Authority and the Local Government Association data cited in the IFS report suggests that councils have been underpaying social care providers for years - by £1.2–£1.4 billion in 2018–19, potentially growing to £1.4–£1.7 billion in real terms by 2024–25.
And now, according to the IFS, councils have the costs of COVID-19 to factor in: increased spending on local services has been accompanied by reductions in income from sales, fees and charges (SFCs) and commercial activities. And, as to the speed and extent of recovery? Several questions remain: How high will unemployment rise, how quickly and fully will the economy recover? What COVID related service provision changes will continue, and what will this imply for service delivery costs? These add to known pressures arising from the care of our ageing population, such as increases in the demand and cost of key services.
The NHS Confederation describes the current time as the “moment of truth” for the Government and its stewardship of the NHS. Its report states: “Either it embraces what we have learned in recent months and provides the support and investment the NHS and social care need to get back on track and reform for the long term. Or they continue with short-term fixes, bail-outs and ever-increasing targets and regulation that continue to stifle NHS staff from ‘locking-in’ [essential] changes.” Given the state of council finances, I think I know which option my money is on.
The NHS Confederation report [online] NHS Reset: a new direction for health and careInstitute for Fiscal Studies report [online] COVID-19 and English council funding: what is the medium-term outlook?