What is next for adult social care?

Social care

On 7 September 2021, the government set out its new plan for adult social care reform in England. This included a lifetime cap on the amount anyone in England will need to spend on their personal care, alongside a means-test for local authority financial support.

These plans were part of the Build Back Better campaign announced by the government which has been created to repair the health and social care systems following the devastating impact of the COVID-19 pandemic.

Like similar plans to revolutionise Integrated Care Systems (ICSs), the government wants to bring various agencies and organisations together to reform social care.

How will social care be funded?


From October 2023, the government will introduce a new £86,000 cap on the amount anyone in England will need to spend on their personal care over their lifetime.

In addition to this, the upper capital limit (UCL), the point at which people become eligible to receive some financial support from their local authority, will rise to £100,000 from the current £23,250. The UCL of £100,000 will apply universally, irrespective of the circumstances or setting in which an individual receives care. The lower capital limit (LCL), the threshold below which people will not have to pay anything for their care from their assets will increase to £20,000 from £14,250.

As part of these changes, there has been a proposed amendment to the Care Act 2014 to the way that people within the means test progress towards the cap. This amendment, subject to Parliamentary approval, will ensure that only the amount that the individual contributes towards these costs will count towards the cap on care costs, and people do not reach the cap at an artificially faster rate than what they contribute.

To allow people receiving means-tested support to keep more of their own income, the government will unfreeze the Minimum Income Guarantee (MIG) for those receiving care in their own homes and Personal Expenses Allowance (PEA) for care home residents, so that they rise in line with inflation.

The cap will not cover the daily living costs (DLCs) for people in care homes, and people will remain responsible for their daily living costs throughout their care journey, including after they reach the cap. For simplicity, these costs will be set at the equivalent of £200 per week in 2021 prices.

The means test for financial support will continue to work in the same way as it does currently by determining what someone can afford to contribute towards the costs of their care based on their assets and pension.

What else will change?


As well as the Build Back Better policy proposals, the government also released a white paper in March 2022 entitled People at the Heart of Care: adult social care reform, which went further to pledge fundamental changes to the social care system in the UK over the next three years.

These include:

  • Investing at least £300 million to integrate housing into local health and care strategies, with a focus on increasing the range of new supported housing options available
  • At least £150 million of additional funding to drive greater adoption of technology and achieve widespread digitisation across social care to support independent living and improve the quality of care
  • Releasing £500 million so the social care workforce have the right training and qualifications
  • A new practical support service to make minor repairs and changes in people’s homes to help people remain independent and safe in their home
  • Increasing the upper limit of the Disabilities Facilities Grant for home adaptations such as stairlifts, wet rooms and home technologies
  • Up to £25 million to support unpaid carers
  • More than £70 million to improve the delivery of care and support services, including assisting local authorities to better plan and develop the support and care options available

What does this all mean for tendering opportunities?


With additional funding for adult social care products and services being released, that can only mean one thing – more tender opportunities and potential contracts.

Pushing the adoption of technology, training and qualifications and working with local authorities to develop support services all present fantastic opportunities for organisations in those areas.

If you would like to be made aware when relevant tender opportunities come up in your industry or field of expertise, contact us today on 0330 1331 041 or info@klowconsulting.com to see how we can help.

Integrated care systems – what direction are things moving in?

Integrated Care Systems

In 2019, the NHS set out plans to revolutionise Integrated Care Systems (ICSs) as part of its Long Term Plan.

The proposals included:

  • Giving people more control over their own health and the care they receive
  • Encouraging more collaboration between GPs, their teams and community services, as ‘primary care networks’ to increase the services they can provide jointly
  • Increasing the focus on NHS organisations working with their local partners, such as Councils, as ‘Integrated Care Systems’, to plan and deliver services which meet the needs of their communities

Since the plan was first published in January 2019, health and social care are both areas that have been massively impacted by the COVID-19 pandemic, making the idea of a care system that is better integrated and gives patients more choice and control over their own healthcare sound almost impossible at this point in time.

In February 2022, a white paper was published entitledIntegration and innovation: working together to improve health and social care for all, which sets out legislative proposals for a new Health and Care Bill, which will make the legislation set out in the paper become law.

The paper held the pandemic up as an example of what could be achieved if everyone in the health and care systems pulled together. It also recognised that there was a lot to be done to rebuild these decimated systems to not only get them back to where they were pre-pandemic, but to better than they have ever been.

How exactly will it work?

According to the February white paper, ‘instead of working independently, every part of the NHS, public health and social care system should continue to seek out ways to connect, communicate and collaborate so that the health and care needs of people are met’ and ‘health and care services, local government, NHS bodies, and others (will) work ever more closely together…with common purpose and in partnership’.

The Bill sets up a series of Integrated Care Systems to cover England. The ICSs will include an Integrated Care Board (ICB) which will assume the commissioning responsibilities currently undertaken by clinical commissioning groups. There will also be an Integrated Care Partnership (ICP), a secondary part of the system intended to give a voice to the wider health and care community.

Place level commissioning within an integrated care system will align geographically to a local authority boundary and the Better Care Fund (BCF) plan will provide a tool for agreeing priorities. This will be further supported by other measures including improvements in data sharing and enshrining a ‘triple aim’ for NHS organisations to support better health and wellbeing for everyone, better quality of health services for all, and sustainable use of NHS resources.

The future

The new legislative proposals in the paper that will be upheld by the Health and Care Bill ‘aim to build on the incredible collaborations we have seen through COVID’ and ‘shape a system that’s better able to serve people in a fast-changing world’.

The Bill also builds upon the original proposals made in the Long Term Plan and also looks at issues such as ‘removing transactional bureaucracy’ to make purchasing decisions easier, making better use of technology to support staff and patient care, and pledges to address staff shortages.

These are all potential opportunities from a tender or Framework point of view.

But, with a more ‘integrated’ system comes more partners and organisations. With the NHS, local authorities, the voluntary sector and others all working together to provide health and social care products and services in local areas, who will act as the Commissioner in a potential tender situation? If you are accepted onto one Framework, will you be eligible to join others?

One thing is for sure, tenders in health and social care are changing and we need to stay abreast of these changes.

Here are some suggested links for further reading:

For more information or to discuss how we can work with your organisation to help you win and manage health and social care contracts, contact us today on 0330 1331 041 or info@klowconsulting.com.

What is the NHS System Oversight Framework and what does it mean for procurement going forward?

At the end of June, NHS England (NHSE) announced plans to transform the way integrated care systems (ICSs) buy non NHS goods and services in a document entitled NHS System Oversight Framework 2021/22.

But what is the significance of this framework? And what will it change for companies and organisations looking to land NHS contracts?

What is the NHS System Oversight Framework?

The NHS System Oversight Framework for 2021/22 replaces the NHS Oversight Framework for 2019/20, which brought together arrangements for provider and Clinical Commissioning Groups (CCGs) oversight in a single document.

The purpose of the document/framework is to reinforce the system-led delivery of integrated care, in line with the vision set out in the NHS Long Term Plan, the White Paper Integration and Innovation: Working Together to Improve Health and Social Care for All, and aligns with the priorities set out in the 2021/22 Operational Planning Guidance.

This framework applies to all Integrated Care Systems (ICSs), Clinical Commissioning Groups (CCGs), NHS trusts and foundation trusts and focuses on five key metrics:

  1. Quality of care
  2. Access and outcomes
  3. Preventing ill health and reducing inequalities
  4. People; finance and use of resources
  5. Leadership and capability

The approach to oversight is characterised by the following key principles:

a. working with and through ICSs, wherever possible, to tackle problems

b. a greater emphasis on system performance and quality of care outcomes, alongside the contributions of individual healthcare providers and commissioners to system goals

c. matching accountability for results with improvement support, as appropriate

d. greater autonomy for ICSs and NHS organisations with evidence of collective working and a track record of successful delivery of NHS priorities, including tackling inequality, health outcomes and access

e. compassionate leadership behaviours that underpin all oversight interactions

Implementation of the framework

While the scope of this framework reflects the role of NHS England and NHS Improvement as a national regulator of NHS provided and/or commissioned  services, it also recognises that ‘the vision for ICSs is based on the core principles of equal partnership across health and local government: subsidiarity, collaboration and flexibility’ and that ‘delivering the priorities for the NHS depends on collaboration across health and care, both within a place and at scale’.

But implementing the framework won’t be easy and straight forward.

NHS leaders are looking for specificity in how oversight will operate within a system context and there will need to be a high degree of flexibility to design approaches that best reflect local circumstances and maintain ownership and engagement across the full range of system partners.

But implementing the framework won’t be easy and straight forward.

NHS leaders are looking for specificity in how oversight will operate within a system context and there will need to be a high degree of flexibility to design approaches that best reflect local circumstances and maintain ownership and engagement across the full range of system partners.

When will the framework be implemented?

The existing statutory roles and responsibilities of NHS England and NHS Improvement in relation to trusts and commissioners remain unchanged for 2021/22. The framework sets out how NHS leaders and organisations will be required to operate with their partners in ICSs from April 2022.

The oversight framework will be updated further for 2022/23. The updated document is expected to confirm ICSs’ formal role in oversight including:

bringing system partners together to identify risks, issues and support needs and facilitate collective action to tackle performance challenges

and

leading oversight and support of individual organisations and partnership arrangements within their systems.

What does it all mean going forward?

The thinking behind the framework is that local NHS procurement teams will be able to change the way they buy non-NHS goods and services and move towards a more system-level way of working, and away from procurement teams dedicated to single organisations.

ICSs will be able to “tailor their procurement organisation structure based on their respective level of maturity, spend profiles, associated phasing of roles and local considerations” but the lack of data harmonisation at local, regional and national level and clarity around best practice approach could make implementation difficult.

With regards to companies who are looking to supply the NHS at a local level, they will have to keep an eye on how this framework develops between now and April 2022 and establish relationships with the ICSs who will soon be in charge of their own procurement and spending.

If you are looking for help with securing NHS contracts, contact the K Low Consulting team on 0330 1331 041 or info@klowconsulting.com.