Berkshire Care Association is the voice of Adult Social Care Providers in Berkshire. We believe passionately that Adult Social Care providers play a vital role in supporting individuals and their families at the some of the most difficult times of their lives. We support our members to deliver the highest possible standards of care and support by the sharing of knowledge, skills, and best practice. In addition to this we are the voice of care providers in Berkshire and as such we work with our statutory and non-statutory partners across the health and social care sector to ensure that the voice of care providers is heard.

Open Letter to Rt Hon Wes Streeting MP

Secretary of State for Health and Social Care

Department of Health and Social Care

13^th November 2024

Concerns Over National Insurance Rise and Financial Pressures on the Care Sector

Dear Secretary of State,

On behalf Berkshire Care Association (BCA) and our members, who are adult social care providers, we write to express urgent concerns regarding the implications of the 2024 Autumn Budget on the social care provider market. This Budget has generated significant anxiety among social care providers, who employ the majority of the 1.59 million people (as of 2023/24) working across the adult social care sector in England.

As the representative body for the more than 350 social care providers across Berkshire, BCA supports care homes, nursing homes, domiciliary care, learning disability providers, supported living, day services, and many more. Local Care Associations like ours, along with our provider members, play a critical role within the Health and Social Care Neighbourhood Model, delivering person-centred care and support throughout our communities and neighbourhoods.

We are deeply concerned that, unless fully addressed, the financial pressures introduced in this Budget could severely compromise the stability and sustainability of social care services in our region. Social care, chronically underfunded for years, now faces an existential risk due to mandated wage cost increases set to take effect from April 2025:

• National Living Wage: Set to rise by 6.7% to £12.21, with rates for younger workers increasing by 16.3% to £10 and for apprentices by 15.2% to £8.60.

• Employer National Insurance (NI) Contributions: Increasing by 1.2%, with a lowered threshold to £5,000.

While these wage increases are critical to attracting and retaining talent, they impose a severe financial strain on social care providers already constrained by fixed fees set by Local Authorities, this can disproportionately affect small providers and those in the learning disability sector. Unlike industries such as retail or leisure, where prices can be adjusted to offset increased costs, social care providers rely on Local Authority fees for financial sustainability.

This dynamic creates substantial challenges, as providers lack the resources to absorb these rising costs without sufficient support. The impact on the sector could be devastating, resulting in:

• Provider Closures: Rising wage costs may force some providers out of the market, creating further strain on Local Authorities and the NHS.

• Workforce Attrition: The many providers currently paying above the National Living Wage (NLW) may be compelled to revert to the new NLW, leading to attrition as workers seek higher-paying roles elsewhere. Such workforce losses could exacerbate pressures on the NHS, increasing A&E attendance and delaying hospital discharges.

• Negative Outcomes for Service Users and Increased NHS Pressure: Disruptions in care services will inevitably impact vulnerable populations, placing additional strain on local healthcare systems and almost certainly increased length of stay in hospital due to delayed discharges.

We are also concerned that, while NHS employers will receive compensation for the increased NI contributions, there is no declared commitment to similarly support social care providers. This discrepancy undermines our shared aim of aligning support for both health and social care, as emphasised in the Darzi report. Divorcing social care reform from NHS support could prevent us from achieving effective, sustainable outcomes for those who rely on our services. Moreover, three strategic priorities for the NHS—Hospital to Community, Analogue to Digital, and Treatment to Prevention—can only be fully realised through robust partnership and integration with the wider social care sector. Additionally, the overall costs of healthcare delivery would be increased as people would spend more time in the most expensive healthcare setting (the acute hospitals) rather than the most cost efficient (the community).

In light of these concerns, we respectfully request assurance that these additional wage costs, due to take effect in April 2025, will receive full funding to support the sector’s stability. Such a commitment would alleviate significant uncertainty and enable providers to make sound decisions for the future. Prompt action to provide these assurances could prevent premature provider exits, helping to mitigate further pressure on the system especially as we enter the winter season.

As Berkshire’s local Care Association, we are fully committed to working with both Local Authorities and our provider members to minimise disruption to local essential services and ensure optimal outcomes for those in our care. We look forward to your support and partnership in addressing these pressing matters.

Thank you for your attention and consideration.

Yours sincerely,

Peter Lomax

Executive Chair

Berkshire Care Association

Berkshire Care Association is proud to be part of both regional and national care alliances. This gives us the opportunity to inform and be part of a wider representational voice nationally.
They include: