Reshape health and social care around need, says King’s Fund commission
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The way that health and social care are currently organised and funded creates confusion, perverse incentives and much distress for individuals and families.
Releasing its report one day after the Demos recommendations, an independent commission established by The King’s Fund has concluded that a new settlement is needed for health and social care to provide a simpler pathway through the current maze of entitlements
The commission, chaired by Dame Kate Barker, proposes a new approach that redesigns care around individual needs regardless of diagnosis, with a graduated increase in support as needs rise, particularly towards the end of life. The final report of the commission recommends:
- moving to a single, ring-fenced budget for the NHS and social care, with a single commissioner for local services;
- social care for those whose needs are currently defined as ‘critical’ should become free at the point of use;
- the economy improves, free social care should be extended to those whose needs are currently defined as ‘substantial’;
- by 2025, some support should be provided to those whose needs are currently defined as ‘moderate’ but this should continue to be on a means-tested basis;
- integrating Attendance Allowance, the benefit paid to older people with care and support needs (which would be renamed Care and Support Allowance) within the single budget for health and social care.
Although mounting funding pressures are being faced in both the NHS and social care, the commission’s report challenges politicians to look beyond the deficit and engage the public in a debate about future care and how it will be funded.
The commission calls on the Government to plan on the assumption that public spending on health and social care combined will rise to between 11 and 12 per cent of GDP by 2025. These levels will be broadly comparable to current expenditure on health alone in many other countries.