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EU Referendum
What next for the sector?

CMM is offering readers the opportunity to put their questions to senior decision-makers. Is there something affecting your business that you’d like an answer to? Are you facing specific pressures you’d like to know how to tackle? Send your questions to CMM.

Q. What impact, if any, will the decision to leave the European Union have on social care?

A. Harold Bodmer, late President, Association of Directors of Adult Social Services, Patrick Hall, Fellow, Social Care Policy, The King’s Fund and Sharon Allen, Chief Executive, Skills for Care.


People’s needs for care won’t stop

Harold Bodmer, late President, Association of Directors of Adult Social Services

The political turmoil that has followed the vote for the UK to leave the European Union cannot fail to have affected all of us working in the public sector, and there are many questions currently unanswered about how many services will be affected in the future – including adult social care.

Is it worth remembering that hundreds of thousands of people continue to be cared for and supported by adult social care services – so our role remains crucial regardless of what’s going on around us. Also, the people that work for, and receive services from, adult social services will be just as worried about what’s happening as we are, and it’s part of our role to help deal with that.

The Association of Directors of Adult Social Services (ADASS) will monitor the unfolding events closely and seek to take part in relevant discussions. We expect some of the main issues to affect our sector to include staffing, the potential for discrimination, and of course, the potential impact on the economy and funding for adult social care.

Skills for Care estimates that staff with EU nationality made up 6% of the adult social care workforce in England in 2015 – some 80,000 jobs. Its figures show that the loss of non-British EU workers would be felt far more in some regions than in others. The proportion of the social care workforce doubles from the average 6% to 12% (20,000 jobs) in London and rises to 10% (21,000) in the rest of the South-East, but is as low as 1% (1,000) in the North-East.

There is no doubt that for a sector already under pressure, the loss of any of this valuable workforce would have a profound effect. Vacancy rates are already at 5%.

We want to strongly convey our support to the 80,000 EU staff and other colleagues from outside of the EU who may be concerned. Every minute of every day, while we continue to analyse and understand the impact of the referendum and current events on this vital public service, millions of people are receiving a service from adult social care thanks to the contribution of those staff.

We will, of course, be ensuring our safeguarding processes support people who may be victims of the recent rise in hate crime, and working to support communities to come together. This includes giving support to employers of social care staff who have experienced discrimination in recent weeks.

Of course, it’s normal to feel unsettled at times of great change, but while we wait for negotiations to begin, and for more detail to emerge on everything from public sector funding to the employment of EU nationals, the most important thing to remember is that people’s needs for care won’t stop.

It is vital that social care comes together

Patrick Hall, Fellow, Social Care Policy, The King’s Fund

Simon Stevens recently claimed that ‘when the economy sneezes, the NHS catches a cold’. If this is true, then social care is in danger of a much more life-threatening infection if the social and economic risks of Brexit crystallise in the coming months and years. It is vital that social care comes together as a system to think through how it will adapt to the new environment. Leaders across the constituent parts of the sector will have to fight to ensure that progress toward a fairer and more sustainable future for care is not pushed off the national agenda.

The first task is to reassure the migrant workforce on which social care in the UK heavily relies. Providers should demonstrate that they value their contribution. The atmosphere after the result has been a worrying one for EU and non-EU migrants alike. Frankly, the sector depends on migrant labour and should be open and clear about the potential impact of ending free movement within the EU and any moves to reduce non-EU immigration.

It will also be important for the sector to act collectively to influence the British withdrawal process. Vic Rayner of the National Care Forum has acted quickly to draw together the views of leaders and has produced a number of resources to help providers think through the implications. This collaboration should be turned into a more permanent coalition to make the case for social care during negotiations.

The system is already approaching crisis. The homecare market is at real risk due to a combination of fee pressure, recruitment problems and an overly-transactional commissioning approach. Commissioners themselves face a potential shift in market power in the care home sector; as smaller providers exit, supply becomes scarcer and the remaining firms will begin to gain leverage over public purchasers. The worry is that if local authorities are forced to make even deeper cuts to expenditure, due to a renewed austerity drive, they will fail to meet their statutory obligations.

This is reflected in the Association of Directors of Adult Social Services’ Budget Survey 2016, with only 2% of directors confident in their ability to meet savings targets by 2020. It could be argued that they are already struggling to meet their obligations, particularly with regard to the broad and aspirational opening clauses of the Care Act, relating to the promotion of wellbeing and the reorientation to preventing need rather than providing care only at crisis point.

Leaders across the system must continue to make the case for social care (in terms of welfare and economic contribution) and the need for a new financial settlement, coupled with long-term reform. This will require clear-thinking about influencing political decision-making when the policy and news agenda are full.

For the new Prime Minister and her team of negotiators, addressing the approaching crisis in social care will be a key test of her promise of ‘a country that works for everyone’.

The answers we seek will take time

Sharon Allen, Chief Executive, Skills for Care

To the 90,000 EU nationals working in social care – we value you and what you do. As the post-Referendum arguments continue to rage, my main concern is that we find answers to some pretty fundamental questions, including what will be the impact on the social care workforce?

Why does this matter so much to me? It’s simple – ours is a rapidly-growing sector, in which the number one issue is how we can attract, keep and develop a high-quality workforce. Without enough people working in our sector, it follows we simply cannot ensure that our citizens can be supported to live independent and fulfilling lives.

It matters that we debate what a post-Brexit, social care world will look like, because we know from our National Minimum Data Set for Adult Social Care that approximately 6% of our current workforce, of some 1.5 million people, are EU nationals. To all of them and their colleagues working hard to support people, day and night, I say, ‘we value you and what you do’.

We also know that our sector will need to recruit an additional 400,000 people by 2030. How can we find those workers to ensure that people in our communities can have choice and control, and to support our health system, so that people are not, for example, delayed waiting to be discharged from hospital, but can get home?

The social care workforce is as diverse as our society. It includes many from the EU and all corners of the globe. The workforce reflects, and supports, our local communities and the people who need care and support. Many nurses (and nursing is a critical need) have joined us recently, following international recruitment drives, and we all know that outstanding care of any kind depends on those delivering the care feeling appreciated and valued.

We need to continue to value all members of the workforce, wherever they come from, for their commitment and dedication – we’ve tweeted about this using #loveourEUstaff which has been such a popular tag across both social care and health services. It’s also why we shared our workforce data and our range of workforce development resources with the National Care Forum to help create the #unitedwecare hashtag, which has been enthusiastically supported by employers and their teams.

The answers we seek will take time, but in the meantime, there are resources available for employers to help with the challenges of getting and keeping good quality staff. Our Finders Keepers toolkit is an interactive resource to take employers through from pre-employment through to how to keep a motivated team. I Care…Ambassadors are a great way to promote different roles in our sector, to develop staff skills and confidence and to promote your organisation.

Core values like humanity, inclusion, dignity, and celebrating and promoting diversity are the bedrock of good, person-centred social care. They are offered daily to millions of people by our diverse workforce. We must all work together to ensure this message is included in the debates over the coming months and, even more so in times of insecurity, we must be certain of this.

Harold Bodmer was the late President of Association of Directors of Adult Social Services. Twitter: @1ADASS

Patrick Hall is Fellow, Social Care Policy at The King’s Fund. Email: P.Hall@kingsfund.org.uk Twitter: @PHallKF

Sharon Allen is Chief Executive of Skills for Care. Email: sharon.allen@skillsforcare.org.uk Twitter: @sharonallensfc

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