In 2019 The King's Fund discussed the following eight key problems facing social care and called for reforms to address them:
- means testing: social care is not free at point of use like the NHS
- catastrophic costs: some people end up paying large amounts and even selling their homes to pay for care
- unmet need: many people go without the care and support they need
- quality of care: a wide spectrum of concerns, from 15-minute care visits to neglect and lack of choice and control
- workforce pay and conditions: staff are underpaid, leading to high vacancy rates and turnover
- market fragility: care providers go out of business or hand back contracts
- disjointed care: health and care is not integrated around the individual and causes issues such as delayed transfers of care from hospital
- the ‘postcode lottery’: there is unwarranted variation between places in access to care and its quality.
The pandemic has shone an uncompromising light on the social care sector. In this article, Simon Bottery explores how COVID-19 has exacerbated these pre-existing challenges.