This recommendation comes from a new report by The King’s Fund, Fixing social care: the six key problems and how to tackle them, which outlines major flaws in the current system and sets out proposals for long-term reform.
At present, each local authority in England conducts its own assessments of individuals’ care needs and financial situations using national criteria. However, The King’s Fund warns that this has led to wide disparities across the country, with some areas offering far less support than others.
The report argues that a national assessment framework could improve consistency, reduce the so-called ‘postcode lottery’ in care, and prevent local authorities from rationing support due to tight budgets. It also suggests that such a move could lead to greater efficiency across the sector.
The think tank further calls for more people to become eligible for publicly funded social care. It describes reforms such as a cap on care costs and a more generous means-tested system as “the very minimum” changes required. Alternatives, such as free personal care similar to the Scottish model, or a social insurance system like Germany’s, should also be explored, the report says.
Other recommendations include:
- Rebalancing the cost of care so that funding is shared more fairly between the state and individuals, with those who can afford to contribute doing so.
- Recognising that while the government’s proposed £500 million Fair Pay Agreement is a positive step, it will not alone solve deep-rooted problems in workforce recruitment and pay.
- Ensuring that care providers are not forced to absorb unsustainable cost increases far beyond what local authorities pay.
- Conducting an overdue review of NHS continuing healthcare, which the report says plays an overlooked but vital role in social care.
Simon Bottery, Senior Fellow at The King’s Fund and author of the report, said:
“It would be a major change to move away from local authority-led assessments, but this approach works well in other countries. Now is the time to explore whether it could deliver a fairer, more efficient system here too.
“The Casey Commission should consider this and other ideas in the report. However, the government must also ensure that local authorities have the financial resources they need to deliver fair and effective care now, even before the commission’s findings are published.”
The King’s Fund’s report identifies six critical challenges facing the sector: access, quality, workforce pay, market fragility, disjointed services, and the postcode lottery in performance. It concludes that lasting reform will depend on creating a system that is fairer, more consistent, and sustainable for the future.
