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Short-termism and lack of oversight has crippled adult social care says NAO

Short-term funding and the lack of a long-term vision has hampered planning, innovation and investment in adult social care. The current accountability and oversight arrangements are ineffective for overseeing the care market, according to a report by the National Audit Office.

The NAO says current accountability and oversight arrangements for adult social care are ineffective and although the CQC rates most care as good, the Department of Health and Social Care lacks visibility of how effectively local authorities commission care and the outcomes achieved. It has no legal powers to intervene or hold individual authorities to account. This limits the Department’s ability to assess how well money is being spent, or what additional funding is needed to support care users. The Department has increased its focus on adult social care in response to COVID-19; it has taken steps to increase its capacity and address data gaps, and in February 2021 published a white paper with proposals to improve the data it collects and its oversight of local authority delivery of social care.

“Short-term funding settlements have hampered long-term planning for adult social care. The NAO has previously emphasised the importance of clarity over funding beyond the end of a spending review.1 Uncertainty has made it difficult for local authorities, facing significant financial pressures, to plan how much care they could purchase beyond the current financial year, constraining much needed innovation and investment. For 2019-20, the Department assessed that most local authorities pay care providers below a sustainable rate for care’” says that NAO.

It adds that, despite many years of government papers, consultations and reviews, the Department has not brought forward a long-term plan for care. The pandemic has delayed promised reforms as government prioritises the COVID-19 response. The Department will be leading reform plans and has committed to bringing forward proposals in 2021. Reforming the sector will be a significant challenge and will need a whole system, cross-government approach.

Gareth Davies, the head of the NAO, said: “The lack of a long-term vision for adult social care coupled with ineffective oversight of the system means people may not get the care that best supports them.
“The Department of Health and Social Care has increased its focus on adult social care in response to the COVID-19 pandemic. It needs to build on this to ensure that its long-awaited reforms deliver affordable, high quality and sustainable adult social care for the future.”

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