National Insurance rise bombshell as big-budget social care reform NOT working report says

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The findings by the Centre for Policy Studies (CPS) think tank have come as a row has exploded over plans to pay for the reforms with a hike in National Insurance Contributions (NICs) of between 1 and 2 percent. The tax on 25 million workers in Britain is aimed at ending the scandal of people being forced to sell their homes to pay for social care.

As Tory MPs and small businesses line up to criticise tax raid, the CPS has warned that pilot schemes on the Government’s aims to integrate social care and health are failing with “no compelling evidence” that the expensive reforms will work.

With the report, ‘Is Manchester Greater?’, the CPS represents the first attempt to establish such an evidence base, scrutinising the performance of pioneering integration schemes in Greater Manchester, West Yorkshire and then more broadly across England in the years before the pandemic.

It attempts to evaluate their performance compared both to other areas of the country, and the original targets set.

The report finds that, in Manchester, there was a 65 percent rise in delayed transfers of care under devolution — far higher than the national average — and generally weaker or unchanged performance on other health outcomes.

In fact, the research could not identify a single target set out in Manchester’s own plan that the devolved system was on course to meet before the pandemic struck.

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The CPS claims that the data also shows a significant decline in productivity, with a 9 percent increase in the size of the region’s NHS workforce relative to its population, and a 23 percent increase in the number of senior managers.    

This poor performance came in spite of the upfront £450 million transformation fund, which, if repeated nationwide, would lead to a staggering £11 billion funding increase for the NHS and social care, almost the equivalent of the entire NHS budget increase in 2021/22.

Now is not the time to push through costly and disruptive reforms that are not supported by the data

Karl Williams

According to the CPS, in Greater Manchester, where integration is most advanced, results have been generally poor.

In particular, despite the £450 million cash injection, there has been a 65 percent increase in delayed transfers of care – the benchmark for whether health and social care systems are working properly together.

The report notes that outcomes in West Yorkshire, where integration is under direct NHS supervision, have been better, especially in terms of delayed transfers of care – but there is still no evidence of substantive overall improvement.

The CPS has also warned that there has also been an alarming rise in emergency readmissions, and in the number of senior managers hired.

Karl Williams, report author and Senior Researcher at the CPS, said: “The Government’s determination to tackle the long-term problems facing health and care provision is welcome, but it is important to take the time to get things right.

“Everyone seems to be in such fervent agreement that the ICS model of integration and collaboration is the future of the NHS that hardly anyone appears to have looked properly at whether this approach works in practice. This report does just that – and the data does not support the speed or scale of the planned changes.

“Ministers need to take a step back and let the pilot schemes run their course so we can properly evaluate their success. Now is not the time to push through costly and disruptive reforms that are not supported by the data, especially given the current pressures on the NHS and its staff – which as widely reported, is already facing a record backlog of more than five million people awaiting treatment because of the pandemic.”

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