#Dilnot Commission – funding care and support

Almost a year ago the Government set up the Dilnot Commission to look at the future funding of care and support in England. Chaired by Andrew Dilnot, with the support of two commissioners Jo Williams and Norman Warner, the Commission is charged with making recommendations on how to achieve an affordable and sustainable funding system/s for care and support for all adults in England, at home and in other settings. Andrew explains it in the 60 second video below:

What is care and support?

Care and support is usually referred to as social care. It is enabling support, it helps people to be independent, active and healthy throughout their lives. It is the support required to enable people to do day-to-day things such as live at home, work, cook, shop, care for their family, engage with their friends, family and community, and essentially lead a fulfilling and independent life for as long as possible.

This support is provided by a range of services, including support to live independently, benefits for disabled people, practical support such as meals on wheels, day centres and care homes, home adaptations and adjustments and other housing support. Services are also available to provide support for carers.

Who needs care and support, who provides it and who funds it currently?

All of us, at some stage in our lives, are likely to require care and support. Most people who currently use care and support services are people who are disabled, who have a long term health condition or illness, people who have had an accident or injury, and older people.

Care and support is provided by local authorities who pay for (commission) or provide support services, funded by general and local taxes. These services are means and needs tested. People who are not eligible for support from local authorities, pay and provide for support themselves or with the help of their families. Voluntary and community organisations provide some support, as do private companies. Support is also provided by family and friends, there are 5.2million carers in England and Wales, you can read a post about one of them here.

Care and support is funded in three ways: people pay for some or all the charges for the support they receive; families provide support or pay towards its cost; you and I, everyone in society, pays through local and general taxes.

So what are the commission doing and why?

The Commission are looking at future options for funding care and support. They are using five criteria to assess options: sustainability and resilience; fairness; choice; value for money; and ease of use and understanding.

They need to do this because the current system is not sustainable. We are living longer than before and we are living healthier lives – this means that we need more care and support than we have done in the past. This is a good news story and it requires a positive response. The other reason is that our expectations have changed, people expect and want more choice and control, and care and support needs to change to meet this expectation.

What do we know so far?

The Commission launched a call for evidence at the end of last year to gather ideas about what future options could look like. You can read the summary of the 250 responses they received in the summary document on their website here. They also commissioned TNS-BRMB to carry out qualitative research to gather the views of the general public, a summary of their results can be found here. The final report and recommendations will be published on 4 July.

What we absolutely do know is that change needs to happen. I also think we can safely assume that this is going to get swallowed up into a political issue, see the report in today’s Observer, and @rich_w‘s blog post commentary “Our politicians have a moral imperative to ensure the future of social care funding is known, sustainable and fair“.

I agree wholeheartedly with Rich, at least I think our politicians *should* have a moral imperative, that said I’m not sure they do, and I think that is the bigger problem here. I believe that social care has an identity crisis, and if not an identity crisis certainly an image problem, consequently it is not high enough on the agenda of the general public or their politicians. The vast majority of people don’t recognise themselves as health or social care users, they are just people, who need some support. Until social care gets itself to a point where it can define clearly what it is, how it helps, and openly discuss its limitations (whether financial or otherwise) we’re in trouble.

I am looking forward to reading Dilnot’s report, and I’ve enjoyed the twitter discussions so far. I feel though that we need to continue to widen this conversation to ensure we really make a long term difference…and force our politicians to face up to their responsibilities.

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7 thoughts on “#Dilnot Commission – funding care and support

  1. Thanks for the link, George, and agreed with your point at the end there about an identity crisis.

    Interestingly, there are parallels here with issues in the disability movement (insofar as a “movement” exists). Some research the Disability Rights Commission did around identification with disability showed that around 50% of people who had rights under disability equality law didn’t identify as a disabled person. This had major implications for how the DRC communicated, and I think there is a fair bit social care can learn from this scenario.

    A document capturing the DRC’s experience is here.

    (By the way, one of the other issues here is how fragmented the social care economy is. With so many providers, local authorities and representative organisations / think tanks etc., it makes a unified message a very hard thing to achieve…)

  2. Thanks for commenting Rich. Your comment about parallels to the disability movement, which I completely agree with, is also of course the experience of carers – so many people don’t recognise themselves as carers, consequently not receiving what little support may still have been available to them.

    So we can agree that social care is unclear and has an identity crisis, that there are parallels to the disability movement and (I think) to carers. Completely agree about the fragmentation of the social care economy. That said, I don’t think it’s that hard to understand – at least in what it could or couldn’t be – I don’t think it’s even like we need to get completely into the nitty gritty of what-could-be-considered-social-care, that vast majority of people don’t have the slightest idea what it is. We really do need to do better.

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