Decision details

Health and Care Act 2022 - Reforms Affecting Adult Social Care* - OCT22/CAB/38

Decision Maker: Cabinet

Decision status: Recommendations Approved

Is Key decision?: Yes

Is subject to call in?: Yes


The purpose of this report is to seek Cabinet approval to fund resources. The resources will be deployed in analysing, planning, and preparing for the implementation of changes brought about by the Health and Care Act 2022.  


Cabinet considered the report and RESOLVED to:


1.    Approve the drawdown of up to £0.65m from the Transformation Fund for funding resources during 2022/23 to support the Council to prepare for the changes arising from the Health and Care Act 2022; 


2.    Note and approve: 

a)    the unfolding requirements from the Health and Care Act 2022; 

b)    the likelihood of further resource requests will be part of future reports; 

c)    the expected full programme cost for Peterborough City Council of £1.95m over a 32-month period; 

d)    the potential programme joint costs could be lowered by from synchronised working with Cambridgeshire County Council;  

e)    any further government funding received about the implementation of these reforms will be applied to reducing future requests or replenishing the drawdown on Transformation monies; and  

f)     the high-risk nature of the ASC Reforms. 


Reasons for the decision:

The Health and Care Act 2022 takes forward elements of the Government’s vision and reform agenda for adult social care, as set out in the white paper: 

a.    Building Back Better: Our Plan for Health and Social Care (September 2021) and  

b.    People at the Heart of Care: Adult Social Care Reform White Paper (December 2021). 


The Health and Care Act 2022 introduces reforms (ASC Reforms) that have a significant impact on adult social care, the care provider market, and on Peterborough’s residents who currently are, or in the future will be, in need of adult social care support. 


Consequently not delivering this programme means: 

1.    the local authorities fail to meet our statutory requirements 

2.    failure to submit our Fair Cost of Care Review and Market sustainability draft proposals by mid-October 2022 and verified and budgeted by end-Feb 23, will result in a loss of funding from 23/24 for the Care changes. 

3.    failure to implement Cost of Care accounts by Oct 23 will result in service users being unable to register care payments towards the cap on care costs. 

4.    failure to implement Fair Cost of Care to the provider market is likely to mean a collapse in the care market in Peterborough. 

5.    failure to implement new data requirements will lead to a breach of statutory duties around minimum data returns and impair the ability for the local authorities to benchmark data to manage demand. It will also impair the Local Authority’s ability to plan care effectively for the needs of service users. 

6.    failure to properly prepare for the new CQC Assurance regime could lead to poor performance ratings and significant reputational damage.  

7.    failure to have an internal workforce strategy, puts us at risk of not complying with our statutory duties to undertake a larger number of care needs and financial eligibility assessments and absorb the wider system pressures this creates such as increased contact with our front door services and customer care. Business as usual is seriously disputed with poor outcomes for the people we support.  

8.    failure to have an external workforce strategy will prevent us from: 

a)    being able to bid for funding around workforce skills that is made available as part of reform and/or  

b)    maximising the opportunity to have a more stable and better skilled workforce who deliver better quality of care which leads to better care outcomes for the people we support and a reduced burden on us in managing poor performance. 


Alternative options considered:

Three generic options were considered: 

a)    The Do-Nothing option would put the Council in breach of future statutory duties. This option was rejected. This was on the grounds that future service users would not be able to access vital services. 

b)    The Do-Later option was considered. After consultation with colleagues across the affected directorates, it was discarded. This was on the grounds colleagues judge we are on the critical path to implement the reforms. As noted in the risk assessment, future changes to the make-up of Government could affect this position.  

c)    The Do-Some option was considered. The proposal in this report phases the work. This includes delaying work in time to receive further Government guidance. Consequently, this option is recommended and detailed in the report. 


Interests and Nature of Interests Declared:


Background Documents:

Source document 


1.             Building Back Better: Our Plan for Health and Social Care (September 2021)  

2.            People at the Heart of Care: Adult Social Care Reform White Paper (December 2021).  

3.             County Councils Network report 



Publication date: 17/10/2022

Date of decision: 17/10/2022

Decided at meeting: 17/10/2022 - Cabinet

Effective from: 21/10/2022

Accompanying Documents: