Fair access to care services (FACS): prioritising eligibility for care and support
The social care and NHS policy context - The social care and NHS policy context
Since SCIE’s 2010 guide was published, the basic approach to community care assessment and eligibility has remained the same, but many other things have changed. The Coalition Government, elected in May 2010, has introduced widespread reforms in the NHS, education, welfare benefits and other areas of public policy and provision. Following the passage of the Health and Social Care Act 2012, a major programme of NHS reform and reorganisation is now under way.
Many aspects of the NHS reforms will have an impact on social care, notably the transfer, to GP-led CCGs, of responsibility for commissioning the majority of NHS services. The responsibility for public health has transferred to local authorities, with support from Public Health England. The general emphasis in the reforms is on promoting prevention and integrated working. New joint health and wellbeing boards have been established to lead the development of joint and integrated planning, commissioning and provision, and to coordinate joint strategic needs assessments and local health and wellbeing strategies. Healthwatch England will take responsibility for ensuring the views of people using health and care services are gathered and registered, both locally and nationally.
The Mental Capacity Act requires staff in health and social care to focus on the capacities and capabilities of people with mental impairments, and on enabling them to make as many decisions about their own care as possible. Care providers have a duty to assess capacity for specific decisions, look to least restrictive care options and be aware of the Act’s provisions for Deprivation of Liberty Safeguards (DOLS).
In 2011, ministers produced a vision statement for adult social care, ‘Capable communities and active citizens’.  This set out the future direction for social care, based on six principles:
The Department published in 2011,  and refreshed in 2013,  a statement of policy on adult safeguarding. This sets out six cross-agency Safeguarding Adults principles and describes outcomes, from the individual’s perspective, of applying these principles. The statement acts as a bridge between the current No Secrets guidance  and the duties and powers contained in the Care Bill.
Following a comprehensive review of adult social care law by the Law Commission,  in July 2012 the government published its White Paper on adult social care policy, ‘Caring for our future: reforming care and support’,  together with a draft Care and Support Bill.  The Care Bill, published and introduced to Parliament in 2013, includes most of the Law Commission’s recommendations for consolidating the numerous pieces of adult social care legislation, accumulated piecemeal over the previous 60 years, with a single statute based on modern principles. A new national framework for assessment and eligibility is proposed, with defined procedures to be set out in regulations. The Bill includes the government’s decisions on new arrangements for funding long-term care. Subject to parliamentary approval, the care and support parts of the Bill, including deferred payments, are due to be implemented in 2015, and the cap on care costs clauses in April 2016.
There have also been developments in a number of related strategic policy areas:
- Under the National Dementia Strategy  and the ‘Prime Minister’s challenge on dementia’,  the government is seeking to increase early diagnosis, supporting improvements in health and social care for people with dementia and their families, and promoting dementia-friendly communities.
- The government has issued an implementation framework for mental health services policy, ‘No health without mental health’,  setting out the action expected of the NHS, local government, social care commissioners and providers to put the policy into practice.
- The government has made commitments in ‘Recognised, valued and supported: next steps for the carers strategy’  to involve carers in designing and improving carer support, enable them to stay in education or employment and help them remain physically and mentally well.