This document encloses the draft Care and Support Bill for public consultation and pre-legislative scrutiny in Parliament during the second session.
‘Care and support’ covers different types of help – financial, practical and emotional – that allow people to manage day-to-day living. It is something that everyone will experience at some point in their lives, whether they need it themselves, know a family member or friend who does, or they provide care themselves.
The draft Care and Support Bill follows the Government’s White Paper Caring for our future: reforming care and support (July 2012), which sets out a long term programme to reform care and support. Our vision is for a modern system which promotes people’s well-being by enabling them to prevent and postpone the need for care and support and to pursue opportunities, including education and employment, to realise their potential. The draft Bill is the next step in delivering that vision.
The draft Bill takes forward the recommendations of the Law Commission report on adult social care. In May 2011, following a three year review, the Commission concluded that existing care and support legislation is outdated and confusing, and recommended wholesale reform of the law; the Government agrees. As the Commission observed, the law makes it difficult for people who need care and support, and carers, to know what they are entitled to and for local authorities to understand their responsibilities.
In summary, the draft Bill will:
- modernise care and support law so that the system is built around people’s needs and what they want to achieve in their lives;
- clarify entitlements to care and support to give people a better understanding of what is on offer, help them plan for the future and ensure they know where to go for help when they need it;
- support the broader needs of local communities as a whole, by giving them access to information and advice, and promoting prevention and earlier intervention to reduce dependency, rather than just meeting existing needs;
- simplify the care and support system and processes to provide the freedom and flexibility needed by local authorities and care professionals to innovate and achieve better results for people; and
- consolidate existing legislation, replacing law in a dozen Acts which still date back to the 1940s with a single, clear statute, supported by new regulations and a single bank of statutory guidance.
The draft Bill will therefore include the following key provisions:
- new statutory principles which embed the promotion of inpidual wellbeing as the driving force underpinning the provision of care and support;
- population-level duties on local authorities to provide information and advice, prevention services, and shape the market for care and support services. These will be supported by duties to promote co-operation and integration to improve the way organisations work together;
- clear legal entitlements to care and support, including giving carers a right to support for the first time to put them on the same footing as the people for whom they care;
- set out in law that everyone, including carers, should have a personal budget as part of their care and support plan, and give people the right to ask for this to be made as a direct payment;
- new duties to ensure that no-one’s care and support is interrupted when they move home from one local authority area to another; and
- a new statutory framework for adult safeguarding, setting out the responsibilities of local authorities and their partners, and creating Safeguarding Adults Boards in every area.
There will also be a small number of critical health measures that:
- establish Health Education England (HEE) as a non-departmental public body (NDPB) to provide the necessary independence and stability to empower local healthcare providers and professionals to take responsibility for planning and commissioning education and training;
- establish the Health Research Authority (HRA) as an NDPB to strengthen its ability to protect and promote the interests of patients and the public in health and social care research, as well as providing assurance that the HRA will continue streamlining the research approvals process and encouraging investment in research; and
- allow for the abolition of the Human Fertilisation and Embryology Authority (HFEA) and Human Tissue Authority (HTA) by amending the Public Bodies Act 2011; this is subject to a public consultation.
The provisions in the draft Bill largely apply to England only (and therefore extend to England and Wales). Some provisions relating to health research and the abolition of the HFEA and HTA extend to England and Wales, Scotland and Northern Ireland.
Comments on
Department of Health
Draft Care and Support Bill
The Royal College of Physicians of Edinburgh (the College) is pleased to respond to the Department of Health’s call for comments on the provisions in the draft Care and Support Bill.
The College has the following comments on the draft Bill:
Part 2- Health
Chapter 1: Health Education England
The College welcomes the high level supervisory responsibility of Health Education England (HEE) in terms of the governance of Local Education and Training Boards (LETBs). We would appreciate further clarification over whether HEE will require a subnational structure in order to carry out these duties effectively.
Clause 60 - Advice
The College notes the statutory responsibility of HEE to make arrangements to seek advice from relevant individuals and organisations on education and training. Although not on the face of the Bill, the College expects this to include Royal Colleges and anticipates this being explicitly cited in Regulations in due course.
Chapter 2: The Health Research Authority
The College welcomes efforts to rationalise healthcare research and standards across the UK, and the obligation placed on the Health Research Authority (HRA) to consult devolved authorities on research ethics committees’ policy documents.
Schedule 2
The College notes the indication in this schedule that if a hospital is ready to discharge a patient and the local authority cannot provide the next stage of care and support required by the patient, the local authority would be charged for additional days of care provided at the hospital.
The College is concerned that patients may ultimately be disadvantaged by a proposal that is intended to improve their care, as the financial penalty may have an overall detrimental effect to an integrated health and care budget. This proposal would require careful monitoring, as while it may compensate hospitals for medically unnecessary patient stays and act as a lever to expedite discharge, we have concerns that a patient may be moved into inadequate and inappropriate facilities due to pressure over avoidance of financial penalties.
Schedule 5: Health Education England
The College notes that once funding has been allotted to HEE by the Secretary of State, it cannot be changed without the agreement of HEE (or exceptional other circumstances such as a change of government), and welcomes the stability and element of protection this will provide for funding of training and education in times of stress on financial budgets.