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    The Autumn Budget and cost of care in complex injury claims

    The Chancellor’s 2024 Budget, leading to reforms in National Insurance costs to employers, will be an important element to consider in amongst the existing inflationary factors that continue to affect the cost of care. But how exactly does the Budget affect this cost and what might the implications be for the gap that already exists between the costs of care provided by an agency and those directly employed by a claimant?

    The impact of the Budget

    The changes of most relevance to care arise in two forms:

    • National Minium Wage – The Government has now confirmed a 6.7% increase in the NMW will apply from April 2025, reaching £12.21 per hour. Carers are typically at the lower end of the pay scale and any such increase is likely to see an upwards push on carer wages generally.
    • An increase in Employer National Insurance Contributions (ENIC).

    The main points to note in respect of ENIC are the following changes that will apply from April 2025:

    1. ENIC has risen by 1.2% to 15%.
    2. The level at which employers begin to pay ENIC has reduced from £9,100 per year to £5,000 per year.
    3. The Employment Allowance (which allows employers to reduce their ENIC liability) has increased from £5,000 to £10,500 (per business, not employee). The previous £100,000 ENIC limit for this Employment Allowance to be applicable will be removed.  

    The changes mean that employers (whether that be the claimant who is directly employing the carer or the agency that is doing so) can avoid paying ENIC only up to the first £5,000 of their liability, so that contribution arises sooner and at a higher level.

    The positive is that the Employment Allowance will increase, which might be offset against the level of ENIC. It is important that Employment Allowance is factored in to directly employed regimes given the significant effect it has on the annual figures. Some care experts are prone to excluding this or leaving it for legal submission.

    ENIC calculation

    ((Employee cost – (Nil rate x Number of carers)) x ENIC rate) – Employment Allowance

    Pre-Budget =

    ((Employee cost – (£9,100 x Number of carers)) x 13.8%) – £5,000

    Post-Budget =

    ((Employee cost – (£5,000 x Number of carers)) x 15%) – £10,500

     

    Direct employment models (ignoring add-on costs)

     

    Package

    (Carer wage based on Keoghs’ care data analysis)

    Pre-BudgetPost-BudgetBudget impact

    1 carer

    40 hours per week x £16 x 60 weeks = £38,400pa

    No ENIC dueNo ENIC dueNo effect

    2.1 carers

    84 hours per week x £16 x 60 weeks - £80,640pa.

    Plus ENIC £3,491

    Total £84,131

    Plus ENIC £21

    Total £80,661

    Reduction

    £3,470pa

    (4.1%)

    3.5 carers

    24 hour sleeping care

    140 hours per week x £16 x 60 weeks = £134,400

    Plus ENIC £9,152

    Total £143,552

    Plus ENIC £7,035

    Total £141,435

    Reduction

    £2,117

    (1.5%)

    4.2 carers

    24 hour waking care

    98 hours per week x £16 x 60 weeks = £94,080

    Plus 70 hours per week x £18 x 60 weeks = £75,600

    Base total = £169,680

    Plus ENIC £18,141

    Total £187,821

    Plus ENIC £11,802

    Total £181,482

    Reduction

    £6,339

    (3.4%)

    7.7 carers

    24 hour, one sleeping, one waking

    238 hours per week x £16 x 60 weeks = £228,480

    Plus 70 hours per week x £18 x 60 weeks = £75,600

    Base total £304,080

    Plus ENIC £27,293

    Total £331,373

    Plus ENIC £29,337

    Total £333,417

    Increase

    £2,044

    (0.6%)

    8.4 carers

    24 hour, two waking carers

    196 hours per week x £16 x 60 weeks = £188,160

    Plus 70 hours per week x £18 x 60 weeks = £151,200

    Base total £339,360

    Plus ENIC £31,283

    Total £370,643

    Plus ENIC £34,104

    Total £373,464

    Increase

    £2,821

    (0.8%)

     

    Changes to ENIC should be of no effect in the case of low-level care regimes and it should reduce the value of the majority of directly employed regimes. We start to see increases in the current cost of care for those highest-level care packages that involve periods with the double up of carers.

    The above analysis does factor in the Employment Allowance, which will be more generous in future. This is a reminder of the importance of ensuring such an offset is factored in.

    Agency care models (ignoring overheads and profit margin)

    Employment Allowance applies per business, not per employee, so the benefit of the Employment Allowance will not be seen to the same extent in the context of agency care. Agencies supply a large number of carers and will soon burn through their Employment Allowance, such that the offset provided will be of little to no effect in the wider context of all the carers they supply.

     

    Package

    (Carer estimated wage in line with ASHE 6115)

    Pre-BudgetPost-BudgetBudget impact

    1 carer

    21 hours per week

    21 hours per week x £15 x 52 weeks = £16,380pa.

    Plus ENIC £1,005

    Total £17,385

    Plus ENIC £1,707

    Total £18,087

    Increase

    £702

    (4%)

    1 carer

    8 hours per weekday

    40 hours per week x £15 x 52 weeks = £31,200pa.

    Plus ENIC £3,050

    Total £34,250

    Plus ENIC £3,930

    Total £35,130

    Increase

    £880

    (2.5%)

    3.5 carers

    24 hour sleeping care

    140 hours per week x £15 x 52 weeks = £109,200

    Plus ENIC £10,674

    Total £119,874

    Plus ENIC £13,755

    Total £122,955

    Increase

    £3,081

    (2.6%)

    24 hour waking care

    98 hours per week x £15 x 52 weeks = £76,440

    Plus 70 hours per week x £17 x 52 weeks = £61,880

    Base total = £138,320

    Plus ENIC £13,814

    Total £152,134

    Plus ENIC £17,598

    Total £155,918

    Increase

    £3,784

    (2.5%)

     

     

    The agency’s cost of employing carers, ignoring any offsets for Employment Allowance, will increase by around 2-4%, depending on the level of the care package. That increase might be mitigated to some extent by the significantly higher hourly rate that they actually charge for their services when overheads and profit margin are factored in. However one might equally anticipate that, in order to maintain profit margins and also to offset similar increases in the costs they will now face to staff publicly funded social care packages, an increase in the hourly rates charged will follow. 

    Agency v direct employment

    It has long been noted that agency care tends to be more expensive than direct employment in significant packages, and the trend has been towards agency care in recent years due to issues with the supply of carers. When we now compare the effects of the Budget on both care models it is apparent that, in the majority of care regimes, that gap between the costs of agency care and direct employment is only likely to widen, as the costs of many directly employed packages fall whilst the costs of agency packages only look set to increase further.

     

    For more information, please contact: Andrew Williamson, Partner, Care & Rehab SIG member