Minister McGovern gave the keynote address at the NCASC conference in Liverpool, calling for more councils to commission homecare neighbourhood by neighbourhood. According to the text published on GOV.UK, she called the approach the opening move toward a National Care Service.
What the minister wants councils to do
McGovern said she wants more local authorities to buy homecare this way and, over time, all of them. As she described it, one or two main providers would cover each small area, with small teams of familiar care workers whose patch lines up with local health neighbourhoods. She said the government would update its local authorities priorities document, first published last year, and that she plans to publish models to support the change early next year.
She noted that the Prime Minister has already committed to making personal care free of charge for older people, funded through changes to the triple lock. She also pointed to £40 million in additional GP funding that he announced this week. Baroness Casey, she said, is looking at what further change is needed in the years ahead.
The case she put forward
The minister said 18 million people will be 65 and over by 2050. She added that by then there will be twice as many people in the oldest group, those 85 or above. Citing the Office for Budget Responsibility, she said its forecast this year has the health budget growing by about one percentage point of national income every ten years, which would mean 13% of GDP going on health by 2075.
She also said almost one in five councils in England turned to exceptional financial support over the past five years, 36 of them this year, although adult social care is not the trigger in every case.
On hospital pressures, McGovern said frail people currently wait 566 minutes on average in A&E, which she put at nine and a half hours. According to the minister, older and frail patients make up around 4% of the population yet take up 70% of unplanned hospital bed days.
Examples cited
She pointed to Walsall, where Better Care Fund money was shifted into rehabilitation delivered by a joint NHS and council team. According to the speech, delayed hospital discharges fell 26% between September 2022 and September 2026.
She also cited Homecare Association modelling for Bristol. It suggested that grouping care visits by geographic area could cut the workforce time capacity needed by 35% and mileage by 65%. McGovern stressed that the aim is not to shrink the workforce but to make better use of its skills.
She said NHS Chief Executive Jim Mackey, who also addressed the conference, shares her commitment to the vision. She acknowledged it would be "easier said than done" and that councils and providers are being asked to break long-standing habits.
