• Building a society for all ages – National Ageing Strategy
• Shaping the Future of Care Together – care and support Green Paper

The social care green paper, Shaping the Future of Care Together, proposes a National Care Service – paid for through a new funding model, underpinned by national entitlements and using for the first time a single, transferable needs assessment.

The green paper acknowledges that the current means-tested model of social care funding is unfair to some, and that demographic changes make it unsustainable. It predicts for example that, by 2026, 1.7 million more adults will need care than do today – with the care for each costing an average of £30,000. It presents five alternative funding models for care (not accommodation):

• Pay for yourself – with individuals paying for their own care, potentially with the help of privately arranged insurance. This option is ruled out.
• Partnership – with the state contributing varying amounts according to income (around a third for the well-off; all for the least well-off), and the individual paying the remainder.
• Insurance – similar to the partnership model, but with the state also providing or encouraging insurance schemes – paid through instalments or as a lump sum, before or after retirement, or after death.
• Comprehensive – with everyone over retirement age required to pay into a state insurance scheme, according to savings and assets.
• Tax funded – with taxpayers paying for free social care for all. This option is ruled out.

For accommodation costs, it proposes a universal deferred payment mechanism, with costs charged posthumously on a person’s estate.

The green paper also promises a single, national needs assessment. According to the new funding model, once a person is assessed as needing care, they will get a proportion of their costs paid for, and it will remain the same even if they move across council boundaries. The green paper puts forward two options for reconciling the roles of central and local government:

• A part-national, part-local system – where councils could supplement or subtract from national funding, based on their own assessment.
• A fully-national system – where national government would determine care costs, and councils would be the channel for funding and support.

The government has recently put forward the idea of individual rights and entitlements (rather than targets) as a means of public service improvement – for example in Building Britain’s Future and Power in People’s Hands (PDF file, 74 pages, 1.6 MB). The social care green paper sets out six entitlements, including the right to ‘stay independent and well for as long as possible and to stop your care and support needs getting worse.’

Access two Improvement Network briefings on the 'green paper' and the 'national ageing strategy'.

Building a society for all ages – National Ageing Strategy

Introduction

Building a society for all ages is the cross-Government ageing strategy, which aims to address the challenges and make the most of the opportunities of demographic change. The document has forewords from Gordon Brown, and from the lead ministers in DWP, DH and CLG. The strategy builds on Opportunity Age, the first ageing strategy, published in 2005, which has now been largely delivered. The document is out for consultation until 12 October.

What does it say?

The strategy sets out a number of new initiatives, including:

• An Active at 60 package and all-in-one cards which will provide people with greater opportunities to stay active and involved in their later life.
  
  
• Enabling different generations to have the opportunity and ability to keep in touch with one another through digital inclusion projects and exploring what more we can do to address the needs of changing family structures through a Grandparents Summit this autumn.
  
  
• Promotion of flexible opportunities to support those who want to continue working longer, including 50+ self-employment. To support this, there will be a review of the Default Retirement Age to 2010 to reflect the change in economic circumstances since it was introduced.
  
  
• Making it easier for people to prepare better for later life with a new interactive one stop shop for helping people planning ahead. This will help people in mid-life to make decisions on financial, health, careers and other issues.
  
  
• Working with local areas to develop a Good Place to Grow Old Programme with a National Agreement to promote the importance of ageing issues at a local level, and an innovative service delivery fund to test new approaches to delivering services for older people.
  
  
• At a national level the new UK Advisory Forum on Ageing will be responsible for providing advice to ministers across Government on additional steps that Government and partners need to take to improve well-being and independence in later life.

What does it mean for public services?

The strategy includes a chapter on better public services for later life, which emphasises the need for all public services to:

• end unjustifiable age discrimination
• give older people a stronger voice in shaping services
• make services fit for an ageing society

The DWP is also planning to broker an agreement between central Government and the national umbrella bodies that represent local government and PCTs to help them respond better to an ageing society in their area. This will be modelled on the Putting People First concordat on the transformation of adult social care.

Shaping the Future of Care Together – care and support Green Paper

Introduction

The Government’s long-awaited Green Paper on care and support was published on 14 July. It is a response to the growing pressure on social care budgets because of demographic change, and to the widespread perception that the current system for funding adult social care is unfair and incomprehensible. The document is out for consultation until 13 November.

What does it say?

Media coverage of the Green Paper has focused almost exclusively on the options for the future funding of care and support. However, fair funding is only one element of the vision for a National Care Service that is set out in the document. The six elements that everyone should be able to expect are:

• prevention services – the right support to stay independent and well for as long as possible and to delay care needs getting worse
• national assessment – care needs will be assessed and paid for in the same way across the country
• joined-up services – all the services will work together smoothly
• information and advice – the care system will be easy to understand and navigate
• personalised care and support – services will be based on personal circumstances and need
• fair funding – money will be spent wisely and everyone will get some help meeting the high cost of care needs.

Making the vision a reality will require:

1. more joined-up working across health and social care
2. a wider range of services
3. better quality and innovation

The three suggested funding models for the National Care Service are:

• partnership – the responsibility for paying for care would be shared between the Government and the person who has care needs. The Government provides between a quarter and a third of the cost of care, more for people on a low income. Today’s 65 year-olds will need care costing on average £30,000.
  
  
• insurance – the same as partnership but the Government could help people to prepare to meet the costs that they would have to pay for themselves, through an insurance-based approach. As well as receiving between a third and a quarter of the cost of care, the Government would make it easier for people to take out insurance to cover care costs. It is estimated that the cost of insurance could be around £20,000 to £25,000.
  
  
• comprehensive – everyone who can afford it would pay into a state insurance scheme meaning everyone who needs care will receive it free. It is estimated that the cost of being in the system could be between £17,000 and £20,000.

In addition, two approaches to how the new system will operate are also set out as ways of managing the tension between national consistency and local flexibility. These are:

1. a part-national, part-local system in which local authorities can set the amount of funding that is put into an individual's care.
2. a fully national system, in which central government sets the amount of funding people can expect to get.

Reactions

The Green Paper has been broadly welcomed because it has raised the profile of social care and seeks to tackle an increasingly difficult issue for local government. The LGA, however, has voiced its strong opposition to any attempt to introduce a national funding system for care and support, as it says this will undermine the ability of councils to commission and deliver joined-up person-centred services, as well as reducing democratic accountability.