Government announces plans to tackle NHS waiting lists and social care crisis

08/09/2021

The UK Government has announced plans to reform health and care, in a bid to reduce elective care waiting lists in the NHS and address the ongoing crisis in social care.

The plans include a new ‘Health and Care levy’, which the Government estimates will raise an additional £12 billion per year on average to fund health and social care across the UK. The total raised over the initial three-year life of the plan is estimated to be £36 billion.

Adult social care and NHS waiting lists for elective care, planned appointments and procedures, are hugely important to many people affected by neurological conditions.

Analysis by The Neurological Alliance has shown that thousands of people have been waiting over a year for appointments, and the number of people waiting more than a year has risen dramatically since the onset of the pandemic.

On adult social care, the most recent available data showed that in 2013 nearly 14% of adult social care spend was on care services for people with neurological conditions. Our 2018/19 patient experience survey showed that nearly half of respondents felt their care needs were being met to a small extent or not at all.

Capping social care costs

The Government estimates £5.4 billion of additional funding will be put towards adult social care over the next three years.

The Government is also introducing a cap on the amount of money people will have to pay towards their care across the course of their life. From October 2023 no-one in England should have to pay more than £86,000 for adult social care but this is not as simple as it might seem.

Once introduced, care costs that will count towards the cap include the cost of a care home that an individual’s local authority is willing to pay for. If an individual wanted to choose a different care home that was more convenient for them but more expensive, they would have to pay the full cost.

If an individual receives care at home, only the cost of the number of hours their local authority thinks they need, set at the price their local authority is willing to pay, would count towards the cap.

For those who receive care in a care home daily living costs such as food, energy bills and accommodation will not count towards the cap, the Government confirmed to the BBC.

The new measures introduced by the Government will also mean that from October 2023, people with assets of less than £20,000 will pay nothing towards their social care costs. Those with assets between £20,000 and £100,000 will receive means tested support from the Government to help cover the cost.

The Government insists that after the initial three-year period, more funding will move from the NHS to adult social care.

Addressing the ‘backlog’

 According to the Government, £30.6 billion over three years will go to the NHS to help reduce waiting lists in elective care, that have dramatically worsened during the pandemic, provide additional money for other NHS spending across the UK and support a shift towards prevention.  

The Government estimates the £9 billion proposed for elective care, on top of the £1 billion that was included in the 2020 Spending Review, could deliver the equivalent of around nine million more checks, scans and procedures across the NHS.

The Government also estimates that by 2024-25 the NHS in England can aim to deliver around 30 per cent more elective activity than it delivered before the pandemic, after accounting for the impact of an improved care offer through system transformation, and advice and guidance.

This is an important area for people with neurological conditions, many of whom have seen waiting times for appointments, tests and treatments soar. We also know that services are under huge pressure as people begin to re-engage with the NHS as lockdown eases.

Details on how exactly this money will be spent are thin and we expect to know more when NHS plans and a White Paper on the integration of health and social care are published later this year.

The Levy

From April 2022, the Government intends to put new 1.25 per cent levies on both earned income and on employers’ wage bills to raise funds for health and social care. The levy will be based on National Insurance contributions and will be paid by working adults including – from 2023 those over state pension age. The levy will also include a 1.25 per cent increase in dividend tax rates.

Long overdue

Georgina Carr, Chief Executive of the Neurological Alliance said:

“We know that thousands of people with a neurological condition do not access the right care, and many have faced overwhelming costs in the pursuit of good care. Yesterday’s announcement represents a once in a lifetime opportunity to change that, and to begin to build a care system we are proud of.    

Whilst additional investment is very welcome, the reality is £5.6 billion for social care over three years does not meet the immediate needs of the social care system.  Core issues such as workforce, quality of and access to adult social care services remain largely unaddressed.

Waiting times for neurology and neurosurgery are soaring across England, leaving many people waiting for a diagnosis or for treatment that could help to alleviate pain, slow progression or even prolong their life. This investment could go a long way to change that, provided services have the workforce and infrastructure to make the most of the investment.

Together with the Care and Support Alliance, we urge the Chancellor to deliver substantially more investment into councils’ budgets in the autumn Spending Review in order to meet social care funding needs now.

In the longer term, we call on NHS England and NHS Improvement to work with us and the wider neurological community to set out a funded National Neurology Plan, which includes measures to reduce waiting times, develop a workforce fit for the future across health and social care and to improve services for people with neurological conditions.”

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