National Association of Financial Assessment Officers 17 October 2018 Glen Garrod President of the Association of Directors of Adult Social Services (ADASS) and Executive Director of Adult Care and Community Wellbeing Lincolnshire County Council Glen.garrod@lincolnshire.gov.uk

12 White Papers, Green Papers & consultations since 1998 2000 Green Paper 2005 Green Paper 2006 White Paper 2008 Public consultation 2009 “The Big Care Debate” 2009 consultation 2010 White Paper 2010 Policy paper 2011 ‘engagement exercise’ 2012 White Paper 2013 Consultation on funding reform Successive governments have tried & generally failed, huge amount of time and efforts gone into policy 1.34m was the estimated number of jobs (excluding personal assistants and NHS jobs) in the adult social care sector in England in 2016-17 6.6% was the vacancy rate for jobs across the care sector in 2016-17 £16.8 billion is the sum of £14.8 billion of net current expenditure on care by local authorities and £2.0 billion allocated from the NHS through the Better Care Fund in 2016-17 27.8% was the turnover rate across all care jobs in 2016-17 £7.50 was the median pay per hour for a care worker in the independent care sector in 2016-17 11.3% was the vacancy rate for registered managers in 2016-17, the highest vacancy rate in care 16% of registered nurses in 2016-17 who were non-British European Economic Area nationals, the highest percentage for any care job 2 million was the Centre for Workforce Intelligence’s 2014 principal projection of the demand for full-time equivalent jobs in adult social care by 2035 The Adult Social Care Workforce in England NAO 2018

Social Care: ? In virtual worlds State Funded Self Funding DWP Carers Allowance IPC PHB DP PiPs ISF Attendance Allowance Continuing Health Care? Nb. Insurance schemes in self-funding and private pensions Nb. In DWP state pensions

So, What’s Next Green Paper for Adult Social Care Green Paper on Supported Housing Fair Funding Review National Programmes (STP v BCF) The £20 Billion Integration The Comprehensive Spending Review (CSR) Nb. LGA, CCN and Independent Age have all produced ‘contributions’ to the Green Paper Not just older people but WAA – Nb. budget survey – WAA 2nd greatest budget pressure after unit prices Housing is part of our solution to manage budgets and better meet needs A national tax/hypothecated or local taxation (inherent problems) – Barker versus Dilnot The experience of council’s of the two Ensuring the NHS spends it on primary/community/prevention Integration (the narrative has become more deterministic) and Integrated Care (500,000 PHBs) CSR – The ask of the Treasury just got harder

Towards the Green Paper – what should sustainable social care look like a long term approach to funding reform recognises needs of working age as well as older people addresses costs of a sustainable & valued workforce seeks to achieve a stable and responsive provider market ensures a fair balance between individuals, families and the state in how care is funded educates the public about the value of social care Source: ADASS evidence to Communities and Local Government and Health Select Committees Joint inquiry on the long-term funding of adult social care https://www.adass.org.uk/media/6273/adass-evidence-to-h-clg-select-committee-final.pdf You should also note that ADASS believes the Care Act (2014 but enacted 2015 – so very recent) represents good contemporary legislation – it’s just that Part 2 never was enacted. ADASS submission to the Select Committee

Paying for Adult Social Care Nine different policy options have been proposed at various times during the prolonged discussion of the future funding of social care. They were analysed by both organisations: Increasing Income Tax by 1% Increasing National Insurance for both employees and employers by 0.5% Charging National Insurance to the working population over the age of 65 Introducing an age-related levy of 0.7% to the working population aged 40 and over Introducing a one-off payment at age 65 Increasing Inheritance Tax by 2% Increasing Council Tax by 3% Increasing Corporation Tax by 1% Increasing business rates by 3% Source: Independent Age Report published September 2018 Not just the mechanism but the quantum as well

Cash for care – who gets what?   Several Green paper contributions – CCN, LGA, Independent Age I have now had a response from Penderels regarding the total number of PA's in Lincolnshire, please see below; Personal Assistants Totals DP/CHEQUE 750 TPSA 875 BACS 333 Grand Total 1958 ------------------- Attendance Allowance £4.6b Carers Allowance £2.3b LA Managed PB ? LA Direct Payments £1.2b (direct payments) NHS Personal Budgets ? Independent Living Fund £0.16b

Carers ‘Scotcash’ Transition Increased use of Digital Technology Some Final Thoughts… Carers ‘Scotcash’ Transition Increased use of Digital Technology Experience of running a WRU in Durham in the late 80’s/early 90’s – mostly campaigns and tribunals/reviews/appeals

Nb. my experience of working in Falkirk in the 90’s On Thursday 30 August, Scotcash were pleased to welcome a ministerial visit to their Glasgow office