Last week the NHS released its latest monthly statistics on the number of patients facing delays in their transfers to care services. They make for grim reading. They show that higher demand for adult social care and pressure on local authority social care budgets is seriously affecting NHS performance, and threatens the overall sustainability of the health and social care systems.
With the NHS seemingly facing one of the biggest crises in two decades, solving this social care crisis has become a critical political problem for the government.
There is no getting away from the fact that more and sustainable funding for social care is urgently needed. But even when the government finds the cash this isn’t going to be enough to turn this problem around. Britain’s social care system will also need radical workforce and industrial strategies to halt the crisis.
The statistics paint a gloomy picture of a health and social care system in crisis. There were 195,000 unnecessary days spent in hospital in December, a 27% increase on December 2015. A growing proportion of these are because people in need of residential or home care services are unable to secure them; almost half are now at least partially due to social care services, and the number of people waiting for home-based care packages has almost doubled in a year. Shockingly, the average person waiting in hospital for care services (NHS or social care) in December had been there for a whole month.
The recent parliamentary vote to trigger Article 50 will do little to allay fears in the sector that the care system is heading for a crash. A new IPPR report out last week finds that there are 60,000 EU nationals in the social care workforce (1 in 20). With uncertainty about the future of freedom of movement, it’s unclear whether the sector will be able to rely on this migrant workforce in future. With the government examining non-EU migration, it’s also unclear providers will be able to turn to the 191,000 non-EU migrants (1 in 7 of the workforce) it currently relies on.
Relying on migrant labour in the care sector has masked the absence of an effective plan for the workforce in social care, with employers turning to migrant labour to fill posts that may otherwise be difficult to recruit for. But that option is looking increasingly unviable. Our research shows that the number of people needing daily physical assistance will double by 2030, and the UK will need to have recruited and trained 1.6 million health and social care workers up to 2022 in order to replace those leaving the profession and meet increased demand. In the face of this challenge – one we’re currently not on track to meet – it’s time for the government to have a proper workforce strategy.
Care work is currently low-paid, with many workers even earning below the minimum wage, and there are few opportunities to progress into better jobs. Improving conditions in the sector will be essential if the potential workforce gap caused by Brexit is to be plugged. With continued stories of poor quality care and trust in the system low, it is also essential that the care system offers better training for the people who ultimately deliver the care most of us will need at some point in our lives.
Jobs and career pathways in care must be improved if the current crisis is to be solved. Doing so will require raising the status of care workers with stronger enforcement of qualifications and minimum standards, and a meaningful effort ensure all care workers are paid at least the minimum wage. The government will also need to work with care providers to create an innovation-based industrial strategy for care, and find new ways to deliver higher-quality care more efficiently. Pump priming investment in technologies that enable care workers to spend more time caring and less time on admin is just one way this could be achieved.
While some of this can be done with little money, turning around the system’s current direction of travel won’t be possible without a sustainable funding solution for care.
With an ageing society Britain’s social care crisis will only get worse, so the government can’t afford not to take this seriously. Another sticking plaster just won’t work, only a comprehensive strategy with a proper workforce plan will be enough.
