This is a once-in-a-generation opportunity to reform adult social care
3 min read
As President of the Association of Directors of Adult Social Services (ADASS), I hugely welcome the renewed national focus on adult social care.
ADASS represents the 153 directors responsible for adult social care in councils across England. Our members see every day the extraordinary contribution social care makes. But they also see the pressures created by a system that remains opaque, confusing and underfunded.
Successful reform depends on creating three strong foundations.
First, a fair and sustainable funding settlement that is clear about the responsibilities of the taxpayer and of people who need care and support. Second, proper recognition and reward for a skilled, dedicated workforce. Third, a modern approach to organising social care alongside other public services so that people experience joined-up support and better outcomes.
The Prime Minister’s personal leadership is hugely encouraging. Sustained attention from the very top is essential, and the additional workforce measures announced by the Secretary of State for Health and Social Care — including a national collective pension scheme for care workers — show that government commitment is tangible, not just rhetorical.
The political direction has been set, but the Casey Commission now has the vital task of turning ambition into workable policy. Previous reform efforts have been derailed by premature speculation and lobbying. ADASS will work constructively with the Commission, government and partners, rather than rushing to endorse or dismiss individual options before they have been properly developed.
No reform will be perfect. But we have a major opportunity to deliver a system that is fairer, clearer and more sustainable — and we must not allow it to end with another false start.
Three issues must remain in the minds of those tasked with delivering much-needed reform.
First, care for adults of all ages. Recent public debate chiefly presents social care as an issue for older people, yet more than a third of adults supported are of working age. Reform must work for everyone, focus on shared human rights, avoid arbitrary cliff edges between age groups and recognise unpaid carers of all ages.
Second, a fully funded workforce settlement. ADASS fully supports the principles behind workforce reform, including the Fair Pay Agreement. However, councils cannot be left to absorb new responsibilities without adequate resources. ADASS members would very much like to keep the faith, but it remains unclear how current earmarked funding can possibly build a strong enough foundation.
And third, a broad, local vision for social care. A National Care Service needs much more definition. Social care must not be viewed narrowly through the lens of the NHS. Its purpose is to help people live good lives, remain independent and connected, and contribute to their communities.
Health and care integration matters, but it must start with people and neighbourhoods. Social care should be recognised as integral to prevention and wellbeing, and also to skills, employment, housing and local economic renewal. That is also the real promise of neighbourhood health — it won’t come from another top-down NHS organisational restructure.
ADASS has a strong interest in the Rewiring the State agenda. There is a powerful opportunity for regional mayors and strategic authorities who see adult social care as a regenerative force rather than a demographic burden. However, whether from Whitehall, regional mayors, Integrated Care Boards or local authorities, we need a new sort of leadership, one which properly devolves choice and control to citizens and communities alongside a wider reimagining of public service. More added value, less added bureaucracy.
Adult social care reform is long overdue. ADASS is ready to help government turn its powerful commitment into lasting change. There will never be a better opportunity.
Phil Holmes is President of the Association of Directors of Adult Social Services (ADASS)
