Rebalancing Care and Support in Wales: RCN Wales Consultation Summary

RCN Wales wants to know your opinions! Rebalancing Care and Support A Welsh Government Consultation

Why do we care? What is Rebalancing care and support? A consultation into a white paper on social care arrangements in Wales. This short presentation outlines the key features of the white paper The white paper will impact RCN Wales members working in social care and the community. What does RCN Wales want from you? RCN Wales wants to make sure the nursing voice is heard Your opinions! We want to know what you think about social care arrangements and the white paper. The white paper will effect the way social care is commissioned in Wales Please email all responses to: policy&publicaffairs.Wales@rcn.org.uk Deadline: 22nd March 2021

Summary 1. National framework. A framework for commissioning care and support will be developed to rebalance the market with the aim of improving quality and transparency. 4. Social care funding. The Welsh Government s Inter Ministerial Group on Paying for Social Care is examining options for the future resourcing to be made available to the adult social care sector. 2. National Office for social care will be established to develop and deliver the national framework. 5. Workforce. Equal rights for carers and a commitment to the real living wage. 3. Regional Partnership Boards (RPBs) strengthened. Provided with a sharper set of tools to deliver their core aims of jointly assessing and planning for population needs.

National National Framework Framework AIM: To simplify the commissioning process and ensure greater visibility of service standards. VISION: Setfee methodologies*, develop more standardised commissioning processes, and increase transparency of service performance. RCN Wales Question RCN Wales Question 1. Would a national framework improve commissioning? WHO: Organised regionally and delivered locally. 2. What should the role of nursing be in commissioning? DETAILS: Value for money will remain important, and care and support that is commissioned by local authorities and local health boards will continue to need to demonstrate efficient use of tax payers resources. * *Fee methodologies are an allocation tool used to determine how social care will be funded and allocated. More predictable, standardised approaches to fee setting will reduce provider competition for staff through marginalising pay differences .

National Office National Office Function within government or a public body, led by a small executive team. In both options, full engagement with local authorities, health boards, the independent sector and other key partners will be secured through an advisory board. RCN Wales Question 1. What should the role of the 1. What should the role of the CNO be in social care? CNO be in social care? The national office will maintain an overview of the stability of the social care market and be a basis for driving national policy initiatives. It will consolidate activity of some national fora including the National Commissioning Board, working with Social Care Wales, with responsibility for supporting social care research and service improvement in Wales. 2. What should the role of 2. What should the role of nursing be in the National nursing be in the National Office? Office? 3. Should RCN Wales be on the 3. Should RCN Wales be on the advisory board? advisory board? Separately, the national direction will be strengthened through establishing a professional voice for the social care and the social care workforce at a national level within Welsh Government.

Regional Partnership Boards (RPBs) AIM: Better facilitate integrated working VISION: Bring partners together to jointly review population needs and plan the models of care and support that people will need. DETAILS: RPBs bring together health boards, local authorities and the third sector to improve partnership working. Every health board region has a RBP. RPBs seek to meet the care and support needs of people in their area. RPBs functions will be extended so that they will be able to: 1. employ staff to enable the full discharge of their functions 2. have clear governance arrangements to improve the accountability of pooling budgets and improve the transparency of joint commissioning. 3. set their own priorities for regional commissioning and delivery 4. hold integrated budgets to deliver integrated regional services 5. monitor progress against agreed regional priorities, sharing data between partners where appropriate 6. and establish within each RPB a planning and performance monitoring framework that refines the 5 year strategic planning cycle and makes use of up to date population, outcome, and market information. RCN Wales Questions 1. Should RCN Wales be included in RBPs? 2. What role should nursing have on RBPs? 3. Would extending the scope of RBPs improve social care?

Role of Local Authorities and health boards Local authorities and local health boards will remain the principal commissioning bodies for social care services. Local authorities and local health boards can exercise their commissioning functions either directly or delegating them to the RPB. RCN Wales Questions 1. what should the role of local authorities and health boards be in social care commissioning? Commissioning activities will be undertaken in accordance with the national framework, ensuring the full and fair use of national framework methodologies. 2. How could communication between health boards and local authorities be improved?

Social Care Funding Social Care Funding RCN Wales Questions 1. Should social care be free? The Welsh Government recognises the biggest challenge facing the social care sector is the funding position The Inter-Ministerial Group on Paying for Care ( the IMG ) has been considering the possibility of raising additional funding for adult social care in the context of Professor Holtham s proposals for a hypothecated levy to create a social care fund social care levy 2. Should Wales adopt a social care levy? 3. How should social care 3. How should social care be funded? be funded? The IMG has considered a range of options for the potential use of any additional funds raised. This included all personal care and accommodation free, along the lines of the NHS. However, an initial cost of this is an estimated additional 700 million a year, well beyond the Welsh Government s ability to provide. As a result, the IMG has focused on developing funded options that are potentially sustainable and deliver better quality care. What is a social care levy? A tax increase or levy to raise additional funds for social care in Wales. This would be acceptable to the public. It would also be fair and effective in raising the money.

Workforce Workforce The Welsh Government has accepted the recommendations of the Fair Work Commission and is committed to working with partners towards implementing the Real Living Wage across social care. RCN Wales Questions 1. What should the role of nursing be in social care? Fair work means a more productive, happier workforce, greater levels of commitment and engagement, less absenteeism and lower staff turnover The consultation also seeks to allow equal rights for carers. This gives carers the equivalent rights to the people that they care for by extending their right to an assessment for support. 2. How should the Welsh Government encourage nursing staff to keep nursing in social care? The important role of nursing is not mentioned in the consultation document 3. Any other views on workforce matters?

What RCN Wales want to know Your opinions! We ve asked a number of specific questions throughout the presentation, if you have anything else to add please send all comments to policy&publicaffairs.Wales@rcn.org.uk By the 22nd March 2021 Consultation document: https://gov.wales/sites/default/files/consultations/2021-01/consutation-document.pdf