Adult social care winter letter 2024 to 2025 - GOV.UK
Building winter resilience in local health and care systems
I look forward to working with local government and the adult social care sector as we embark upon an ambitious long-term programme of reform with a view to creating a National Care Service.
My purpose in writing this letter is to set out priorities for improving service resilience in the short term, ahead of and during the winter period.
The principles guiding these short-term priorities are similar to those that will underpin that longer-term reform:
a ‘home first’ approach that supports people to live independently for as long as possible
a relentless focus on ensuring high-quality care
close involvement of people receiving care and their families and carers
Close partnership working and joint planning between adult social care, the NHS and other community partners is vital to the successful delivery of these priorities.
Those principles will also run through the development of our 10-year health plan, on which we will be launching a national conversation this autumn. As the Prime Minister set out in his speech at the King’s Fund on 12 September, that plan will be based around 3 big shifts – from an analogue to a digital NHS, from hospitals to communities, and from sickness to prevention. Much closer integration of health and social care services will be an essential part of this, with health and social care teams working together in local neighbourhoods to provide joined-up, person-centred and preventive services.
NHS England has written to integrated care boards (ICBs) and NHS provider organisations, confirming priorities for winter planning and preparedness. This letter complements those messages - and reinforces the importance of a joined-up approach to planning across the health and care system for this winter. I want to highlight a range of issues where it will be particularly important for local authorities, care providers, the voluntary and community sector, and the NHS to work together to plan and provide effective services.
I am conscious that planning for winter will already be front of mind for colleagues in local systems, including through the adult social care capacity plans made under the Market Sustainability and Improvement Fund (MSIF) and the intermediate care capacity plans under the Better Care Fund (BCF).
We hope that the decision not to implement charging reform in October 2025, in light of the wider state of public finances, provides greater planning certainty and means you are able to focus your efforts on resilience over the winter period.
Support will continue to be available to local areas as they undertake joint planning ahead of winter. The department is working in partnership with the Local Government Association (LGA), the Association of Directors of Adult Services (ADASS) and the Social Care Institute for Excellence (SCIE) to offer a range of universal and targeted support to local authorities through the Partners In Care and Health programme and the Better Care Fund support programme. You can discuss your support requirements with your regional care and health improvement adviser.
Workforce
We recognise that the adult social care sector faces ongoing workforce challenges - and we are committed to working with the sector, both in the short term and over the course of this Parliament, to tackle these challenges together. The government recently launched an additional workforce recruitment and retention survey on Capacity Tracker for Care Quality Commission (CQC) registered providers to complete. The survey has been designed with the purpose of increasing understanding about the current workforce picture within local areas and we would ask you to encourage providers to share their views and experiences with recruiting and retaining staff.
Alongside improving domestic recruitment and retention, we are also committed to improving the way international recruitment works in adult social care, ensuring individuals work for legitimate providers, and tackling the exploitation of workers. Regional partnerships have received £16 million this financial year to support them to prevent and respond to unethical practices in the sector. This includes funding support for international recruits to understand their rights and establishing operational processes with regional partnerships to support individuals to switch employers and remain working in the care sector when they have been impacted by their sponsor’s licence being revoked.
Care workers deserve to be recognised and supported for the important work they do. They are essential to those who draw on care and support, helping them maintain their quality of life, independence and connection to the things that matter to them. Looking beyond this winter, we will engage with the sector including workers and trade unions over establishing the first ever Fair Pay Agreement for care professionals. We will shortly be reaching out to sector partners about this and look forward to engaging with local government representatives and drawing on the wealth of expertise within local authorities to help shape these landmark reforms.
Support for family carers
It will be essential for local health and care systems to continue to support people providing care for their family and friends throughout the winter period. This will include identification of family carers and routes to access support so they can look after their own health and wellbeing, not just the health and wellbeing of the people they care for. The ADASS Supporting Carers Hub is a useful resource of practice and ideas from social care teams and other organisations on how they are improving support for carers. In developing plans to address these points, local authorities should involve people who draw on care and support, and their family carers in co-producing decisions about their care.
Preventing avoidable hospital admissions and supporting timely discharge
NHS England’s letter to ICBs and NHS provider organisations sets out priorities for improving urgent and emergency care resilience and the importance of ensuring absolute focus on improving patient experience and protecting patient safety over the winter period. Local authorities and adult social care providers will already be working with the NHS to help keep people well and independent for as long as possible, prevent avoidable hospital and care home admissions, and support timely and effective discharge for those admitted to hospital. There remains a big gulf between where we are now and the quality and accessibility of preventative, person-centred services we all want to see in local communities, but I know the ambition to improve this is shared across local and central government.
While it will take sustained reform over many years to address these challenges fully, work to prepare for winter presents an immediate opportunity for leaders to provide clear focus on providing joined-up health and care services, improving service resilience, and improving outcomes.
Local authorities should continue to work with ICBs to ensure an integrated approach across health and social care to meeting people’s urgent and emergency care needs, including:
ensuring that capacity and demand plans (for both home-based and bed-based intermediate care) support NHS plans for preventing avoidable hospital and care home admissions and reducing discharge delays, while improving outcomes for patients
keeping intermediate care capacity and demand plans under regular review and taking corrective action where services are not expected to meet projected demand
making the most effective use of same-day emergency care and virtual wards to prevent unnecessary time spent in hospital for people who can more appropriately receive acute care in other ways, with support where necessary to enable people to stay in their own homes or their usual place of residence
using data on length of discharge delays (from the discharge ready date metrics) and the new data on reasons for discharge delays to understand the incidence and length of discharge delays, what is driving those delays, and what immediate actions can be taken to tackle these delays
for people with complex discharge needs, minimising delays in agreeing people’s post-discharge needs and in arranging appropriate post-discharge support, with a focus on enabling people to continue their recovery at home or their usual place of residence wherever possible and full involvement of patients, families and carers
supporting NHS winter surge planning, including considering contingency arrangements for a significant flu or COVID-19 wave
Business continuity and working with providers
Local authorities should ensure good business continuity plans are in place for a range of risks in the winter period which could affect adult social care provision. In particular, local authorities and care providers should maintain business continuity plans to prepare for localised disruptions caused by severe winter weather, including disruptions to energy supply, disrupted transport and staff shortages, while considering the impacts of these events on ‘business as usual’ activities over the colder winter period. Colleagues should refer to the government’s Adverse Weather and Health Plan, to support planning and response to adverse weather in winter; and work with local resilience forums (LRFs), local organisations and those working in the care sector to identify and prioritise those most at risk during the colder winter period.
It is also essential that providers continue to follow ongoing infection prevention and control (IPC) guidance including the infection prevention and control resource for adult social care and the acute respiratory infection (ARI) guidance for adult social care. Vaccination continues to form part of our defence against respiratory disease and providers should follow advice for this year once this is issued. As with previous years, COVID-19 and flu vaccines will continue to be offered to frontline workers and eligible cohorts as set out in the flu and COVID-19 seasonal vaccination programme for autumn and winter 2024 to 2025. Also, for the first time, this year a vaccine against respiratory syncytial virus (RSV) will be offered to those aged 75 to 79, as well as adults who turn 80 in the first year, and will be available via GP practices.
The sector will be aware of the mpox clade I situation. With no cases of mpox clade I confirmed in the UK, the overall risk to the UK population and to the social care sector remains low. UK Health Security Agency (UKHSA) is actively monitoring the situation and supporting preparedness for the sector, including advice relating to travel.
Finally, I would like to express my thanks for your work to drive improvement in local services and better meet the needs of people who draw on care and support, particularly in the context of the financial challenges that I know local authorities continue to face. I look forward to working with you in future.
Yours sincerely,
Stephen Kinnock
Minister of State for Care