Simon Bottery

Defiant nuns flee Austrian care home for their abandoned convent in the Alps - BBC News Sisters Bernadette, Regina and Rita needed a locksmith to get back into their convent, defying Church leaders.

Fantastic headline. Too unusual (and too good) a story to look too hard for morals but there something here about the desire for independence, isn’t there? #socialcare www.bbc.com/news/article...

Fair Pay In Social Care Is A Fine And Progressive Policy – But Who Is Going To Pay For It? | The King's Fund There are lots of unknowns about the government’s proposed fair pay agreement in social care, says Simon Bottery, but the biggest is who will have to swallow the cost.

Fair Pay In Social Care Is A Fine And Progressive Policy – But Who Is Going To Pay For It? | The King's Fund
www.kingsfund.org.uk/insight-and-...

Adult social care reform and the cost of inaction: government response to the Health and Social Care Committee (HSCC) report

The objectives are part of the government's response to the @CommonsHealth report on the cost of inaction in adult social care. The full response is here
www.gov.uk/government/p...

Interesting to see in print the government's three 'core objectives' for adult #socialcare. They are sensible and coherent, even if they do skip over the key issue of eligibility. A surprise, though, to see them at all after a year when social care strategy was largely avoided.

Among the other findings: the government doesn’t know the impact of recent increases in employers’ national insurance contributions on the #socialcare market. MPs says they should find out now and consider actions to tackle adverse impacts.

Central government has focused too much on monitoring relatively small grants and too little on working out what impact our overall spend on adult #socialcare has on the lives of people. That’s one key finding of MPs in a new report today. committees.parliament.uk/publications...

Fury as Labour drops cross-party talks to fix social care crisis Gathering with health representatives from opposition political parties called off at last minute branded a ‘missing opportunity’

Despite the dramatic headline, it seems that Casey has simply decided to meet the parties separately at first and bring them together later. It should be quite hard to work up to a ‘fury’ about that. #socialcare www.telegraph.co.uk/politics/202...

Spending Review 2025 document This is the full Spending Review 2025 document in print, web and HTML accessible versions.

The full spending review documents are here Spending Review 2025 document www.gov.uk/government/p...

Why the delay? Internal wrangling over the figures /which budget the money will come from? Desire to get max publicity for a good news story? Neither is a good enough excuse for the uncertainty, and it does nothing to improve the govt's credibility on #socialcare.

There is a promise of 'over £4bn' for social care in 2028/29 compared with 2025/26. But £4bn more than what? Existing grant funding? Local authority spending power? Is some of this paying for fair pay? We just don't know. Again, 'further details to be set out shortly'.

First the fair pay agreement. It is not mentioned by name in the SR documents, though the costs of it are apparently included and more news is promised soon. However the lack of information will only add to provider scepticism about the likely adequacy of funding.

If you want to know how today's spending review affects #socialcare, you are going to have to wait. There is no clear sum to fund a fair pay agreement and promises of 'over £4bn' for social care in 2028/29 are unclear. Puzzled, frustrated thread >
news.sky.com/story/spendi...

LTC Care System Profile: England

NEW COUNTRY PROFILE: #England 🌍

In this system profile, @blimeysimon.bsky.social (@thekingsfund.bsky.social) and @natashacurry.bsky.social (@nuffieldtrust.org.uk) unpack the country's long-term care system. 🔍

Read now: goltc.org/system-profi...

'We moved into the same nursing home and found the friendship of a lifetime' Peter and Kathleen met at Archers Court Nursing Care Home in Sunderland and are now inseparable

This is the sort of news story care homes need. While it is of course nice to read about exotic animal visits (and there are lots of those stories in local newspapers), this is the one that makes people reassess their image of residential care. #socialcare www.chroniclelive.co.uk/news/north-e...

Delayed Discharges: Why It’s Hard To Say How Many Are Due To Social Care Capacity | The King's Fund We don’t know how many delayed discharges are due to lack of social care capacity, say Simon Bottery and Sarah Arnold, and that’s because we stopped counting.

Fed up with headlines claiming #socialcare is responsible for specific - and usually high - numbers of delayed discharge? After crunching the data we can say that… we just don’t know the true figure, because we stopped asking. Time to start again, though. www.kingsfund.org.uk/insight-and-...

In your lifetime, you are more likely than not to develop #dementia or care for someone with it, a new @CareQualityComm report reminds us.
That’s a strong, self-interest argument for a fairer, better funded #socialcare system, isn’t it? www.cqc.org.uk/publications...

The complications of actually introducing a fair pay agreement - a policy untried anywhere else in the world - suggests to me the cautious approach is the right one. But if I were a careworker, I’d almost certainly feel differently.

If you’re a pessimist (realist, perhaps) you’d maybe settle for a more modest pay increase now, one that makes as big a dent in vacancies as possible at a more limited cost, and hope it leaves some financial headroom for spending on other short and long-term #socialcare problems.

If you’re an optimist, you may want a generous fair pay agreement and hope the substantial figures it will involve will a) be fully funded (otherwise quality goes backward) and b) be ‘baked in’ to the #socialcare system by the time wider reform is contemplated in 2028 and beyond.

In practice a decision about pay levels will be made - presumably - this year (and factored into the spending review) but the first phase of Casey will not report until 2026 and the second by 2028. So pay is out there on its own as a problem to be tackled.

Putting all this together, what we needed was a government that would weigh up all the reform options and come up with a coherent, phased, long-term plan for #socialcare, including pay. But that is not what where we are.

And then there’s wider reform. Our current social care system restricts publicly funded support to those with the highest needs and lowest assets, allows individuals to face catastrophic costs, has issues with quality. Etc. etc. etc. www.kingsfund.org.uk/insight-and-...

But there are also other demands even within #socialcare. Providers want higher fees to cover NICs costs. Local authorities want more money to meet rising demand. People who draw on services want better support.

To state the obvious, even £1.5bn of extra spending would be tough at a time when every other public service is calling out for more investment in the upcoming spending review. Despite significant above-inflation increases, the NHS is struggling already. www.kingsfund.org.uk/insight-and-...

Of course, this doesn’t come cheap. Band 3 pay would cost £1.5bn/year for care worker pay, says the report. To introduce pay scales with differentials would cost a further £1.8bn/year = £3.3bn. (Reduced benefits spend/increased tax would cut the net cost to £2bn, it says).

But what about the ‘social care’ argument? This seems strong too. It would reduce turnover and vacancies (the report estimates ‘band 3’ pay would cut them by 90,000) and improve consistency of care. There are also (admittedly small) improvements in quality.

It predicts real gains. 1 in 5 careworkers are in poverty. Linking to band 3 would benefit 603,000* workers, with an average £2,050/year rise. It would narrow gender/ethnicity pay gaps. This is the ‘social justice’ argument for focusing on pay.
*all numbers are @thefabians

For the Labour movement, the instinct to prioritise spend on pay is clear. The @thefabians report wants a short term rise to the real living wage but followed by alignment with NHS band 3 by the end of this parliament (and new pay bands linked to the ‘care pathway’ in the next).

This question isn’t an idle one. The @UKLabour
government promised a fair pay agreement in #socialcare in its first term and the legislation is going through parliament. The cut in migrant visas also makes pay (to boost recruitment) a very live one.

Interesting @thefabians report which - for me - begs questions about the extent to which pay should be the immediate #socialcare priority. Crudely, should you ‘blow the budget’ on it or accept more limited change and investment in other areas? Thread🔽
fabians.org.uk/publication/...