People's safety at risk from 'cliff edge' of a lack of social care say NHS leaders

NHS leaders are demanding the government make social care its ‘top priority’ as people’s safety is at risk from a lack of care provision.

A July poll of 243 NHS leaders has found 99 per cent are seeing a social care workforce crisis in their local area and almost all think it is worse than a year ago and will deteriorate further this winter.

According to the NHS Confederation, NHS staff spoke of ‘unsustainable pressure’ on services, driven by severe capacity challenges affecting social care which failed to keep people well at home and support them to leave hospital safely.

The NHS Confederation’s report on a lack of care revealed most NHS leaders (85 per cent) said the absence of a social care pathway is ‘the primary cause of delayed discharge of medically fit patients’.

In the week to 26 June, more than half of medically-fit patients remained in hospital unnecessarily.

Hospitals across Nottinghamshire declared a ‘critical incident’ on 26 July with staff in its hospitals being told: “Across the system we care continuing to see significant levels of Covid-19 in hospitals, high numbers of patients needing care for other conditions, alongside extended waiting times for patients for hospital beds.

“This paired with difficulties in discharging patients due to a lack of capacity across the care sector as well as staff absence due to Covid-19, is causing significant strain on the system.”

GP: Patient with ‘no family or package of care’

One GP contributing to the report said: “Last week I had to clean urine off the floor to prevent a patient slipping over as they had no family or package of care.”

One NHS leader said: “The number of patients delayed for a social care package is broadly equivalent to the number of patients with COVID-19. It is dreadful for the patients experiencing the delays who come to real harm. The system is doing real damage to people.

“Twenty-five per cent of falls in my organisation are in patients who are medically fit for discharge.

"Moreover, the significant majority are elderly and probably in the last 1,000 days of life and we are robbing them of precious time by holding them in hospital. It is shameful.”

Staff working ‘for literally less than peanuts’

Meanwhile, 165,000 job vacancies in the social care sector has been estimated by the charity Skills for Care.

A PCN manager contributing to the report said: “People can't afford to live right now and you want them to come to or continue working in some of the hardest jobs mentally and physically for literally less than peanuts”.

James White, head of public affairs and campaigns at dementia charity Alzheimer’s Society, said: “As underpaid, overstretched care workers struggle to make ends meet as living costs spiral, people with dementia face being abandoned without the care they so desperately need. The need to invest in the social care workforce, giving them parity with the NHS, has never been more urgent.

"People with dementia are the biggest users of social care services and are at the sharp end of this crisis. We face people being driven from their jobs in droves, leaving people with dementia at risk.”

The Health Foundation projects the government would need to spend an extra £9.3bn on social care by 2024/25 to expand access to social care, pay more for care to sustain the care sector and pay higher wages to staff.

Only £5.4bn of the £36bn raised through the government’s national insurance rise over three years will go to social care. And the majority of this will fund the cap on costs – protecting individual’s savings rather than to improving services themselves.

NHS and social care will ‘sink or swim together’

With hospital patients facing long delays for treatment, NHS leaders are calling on the government to back social care with a fully funded pay rise to boost recruitment and retention, improve career progression and invest more in the care sector to ‘stop the exodus of staff’ leaving for better paid jobs in sectors like hospitality.

Emphasizing that NHS and social care will ‘sink or swim together, NHS leaders said ‘the care delivered by social care services is critical to the wellbeing of the nation’.

Two reports have recently been published on the health and social care workforce. The Health and Social Care Committee’s Inquiry on Workforce: Recruitment, training and retention in Health and Social Care and another, by an expert panel (convened by the Committee) which rated the government’s fulfilment of its commitments on the NHS and social care workforce as inadequate.

Dr Jane Townson, chief executive of the Homecare Association, which represents 2,300 home care provider, said: “The health and social care workforce should be an urgent priority for the government’s new leadership.

“A new workforce strategy for social care is long overdue. There must be a clear understanding going forward of what it would take to meet projected demand and how to recruit, reward and retain staff. Skills for Care data has shown a four per cent drop in filled homecare posts, despite ADASS reporting rising demand. There is no question that under-staffing is linked to rising unmet need.

“We welcome the Committee’s call for parity with NHS staff and for the cost of care to take into account salaries equivalent to NHS Band 3."

Vic Rayner chief executive of the National Care Forum (NCF), which represents not-for-profit care providers, said: “The resoundingly stark message from both healthcare and social care leaders is that urgent action is needed now.

“Alongside urgent action on pay, terms and conditions, there is also an urgent need to create a dedicated and fully funded social care workforce plan to enable a long-term approach to workforce development, recruitment and retention, to meet significant demographic change.”