Sally Greenbrook is Policy Manager at the British Geriatrics Society and Tweets at @SallyGreenbrook, Liz Jones is Policy Director at the National Care Forum and Tweets at @NCF_Liz, and Ann Mackay MBE is Director of Policy at Care England and Tweets at @CareEngPolicy.
Late last year the BGS ran the #BGSTimelyDischarge blog series, highlighting the plight of older people stuck in hospital who medically do not need to be there, but cannot access the care they need at home. Through this campaign, we sought to tell the story from a variety of angles – the patient who can’t get home, the doctor who is caring for a married couple separated for the first time, the discharge coordinator who feels their team is letting patients down and the care provider who cannot get the staff needed to provide homecare. We sent all the published blogs to the Secretary of State for Health and Social Care, Sajid Javid MP, along with an open letter signed by BGS, Care England, the National Care Forum, Age UK, Independent Age and the Chartered Society of Physiotherapy. In this letter, we suggested three immediate steps the Government could take to relieve the crisis in social care, as part of the solution to the ongoing problem of delayed discharges from hospital.
While we haven’t yet heard back from the Secretary of State, we were pleased to see that on Christmas Eve it was announced that the Government had accepted the recommendation of the Migration Advisory Committee to add care workers to the Shortage Occupation List. Organisations such as the National Care Forum and Care England have been calling for this for some time and it was one of the three steps we asked the Secretary of State to take. Opening the doors to allow care workers to come to the UK from other countries has the potential to relieve the pressure. Although the move is extremely welcome, employing overseas workers through this route is complicated and costly for providers, as this briefing from the National Care Forum explains. It will be important for the Government to support providers to ensure that they are all able to access staff through this immigration pathway. Integrated Care Systems, local authorities, Clinical Commissioning Groups and providers should now work together to reduce the cost and the burden on social care employers in navigating the complexity of the Shortage Occupation List system.
This step alone is not sufficient to address the crisis in provision of social care and we are hearing from members across our three organisations that this issue is as desperate as ever. BGS members tell us about some care homes experiencing COVID outbreaks and closing to new admissions, making discharge from hospital to those care homes impossible. Northumbria Healthcare NHS Foundation Trust have announced their intention to be the first NHS Trust in the country to directly provide social care and we have heard one other example of hospital staff considering providing 24-hour care to patients at home while waiting for a care home bed or package of care to be made available. A survey of National Care Forum members found that 66% of home care providers are having to refuse new requests for home care and 43% of care home providers are closing to new admissions. A survey of Care England members further exposes the desperate situation care providers find themselves in with over 95% of members stating that they are finding it difficult to recruit staff.
This situation will not be fixed solely by adding care workers to the Shortage Occupation List. When we wrote to the Secretary of State last year, we also asked him to give care workers an immediate pay rise and bonus, to help retain those staff already working in the sector and to make care work a more attractive career option. Both the National Care Forum and Care England have made these calls previously, including in evidence provided to the Low Pay Commission for their annual report on the National Minimum Wage, with Care England noting that ‘for too long, the LPC’s recommendations … have not been matched by adequate government funding’. We stand by these calls as we believe they will help to address the immediate workforce crisis in the sector. However, we all know that long-term reform of social care is desperately needed, and it was a welcome relief when the long-awaited Social Care White Paper was published in December. While we do not believe the White Paper goes far enough to reform social care, it is a start and we urge the Secretary of State to move forward with this work as a priority by setting out a vision, a workforce strategy and a plan for sustainable funding.
It is essential that action is taken swiftly to relieve the pressure on the NHS and to provide care both to those who need it now and over the coming months, and to ensure that the system is sustainable for the future. Older people have a right to good care and quality of life and they should not have to wait any longer.
