NHS leaders across England say staffing gaps and a lack of capacity in social care are putting the care and safety of patients in the NHS at risk. The statement is in response to a new NHS survey published this week.
Almost 250 NHS leaders responding to an NHS Confederation survey say that patients are being delayed in hospital much longer than they should, with the knock-on impact resulting in higher demand on A&E departments and longer ambulance response times.
NHS leaders stand in support of their social care colleagues and are urging the Government to increase investment in care services, including by boosting wages for care workers. They say failure to act will leave more and more vulnerable people without the care and support they need, as well as piling further pressure on front-line NHS services.
The stark results from the survey of NHS providers, primary care and integrated care system leaders paint a picture of a social care system struggling to cope with demand and a pressing need for a long-term pay and funding strategy for the sector.
Nine in ten leaders report that the pressure from the fallout of a lack of appropriate and timely social care pathways for people leaving the hospital is having the biggest impact in A&E, with almost the same number (86%) saying this is having a huge knock-on effect on ambulance response times. Almost three-quarters also say their efforts to bring down waiting lists are being hampered by a lack of social care capacity.
Of the nearly 250 NHS leaders who responded to the survey, almost all said that the one immediate single change the Government could make now to alleviate the pressure on the social care system would be to increase pay for social care staff.
NHS leaders recently called on the Government to immediately implement a national care worker minimum wage of £10.50 an hour.
They warned that without an increase above the hourly wage seen across many other industries, including that paid to staff working in supermarkets and across retail, as well as the NHS itself, the social care sector in England will continue to hemorrhage staff.
An acute trust executive director in the South West accused the Government of presiding over a “national scandal.”
‘If the social care capacity shortfall was solved then we would not be holding ambulances at all, we would have almost no problems with elective recovery and our emergency departments would not be crowded and unsafe,’ they said.
Another acute trust chair in the East of England added, ‘The result of using nearly 20% of our beds for patients who are medically fit but need packages of care to return home is an overcrowded A&E, twelve-hour trolley waits and much-delayed ambulance handover times. The connection is very clear to us…Until we find a solution to social care staffing and funding, the situation can only get worse.’
Professor Martin Green OBE, chief executive of Care England, said, ‘The NHS Confederation’s social care workforce survey highlights the enormous impact the funding and workforce crisis in social care is having on the NHS. The Government must understand that health and social care are two interdependent systems and social care needs immediate extra funding to improve pay and conditions and then a long-term workforce strategy that aligns with the NHS workforce plan. If the Government fails to focus on the social care workforce, the impact on the NHS will be catastrophic”.
Professor Vic Rayner OBE, chief executive of the National Care Forum, said ‘This survey of NHS leaders comes on top of two Health and Social Care Select Committee report this week and confirmation of 165,000 vacancies in the adult social care sector by Skills for Care last week.
‘The resoundingly stark message from both healthcare and social care leaders is that urgent action is needed now. This survey is clear – the lack of social care capacity is causing huge pressures across the healthcare system and having a very real human impact on people, their families, and the entire health and care workforce.
‘When healthcare and social care leaders stand side by side to urge the Government to increase investment in care services and boost wages for care workers, then it really is time to listen. 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.’
NHS leaders fear that the knock-on effect of a social care sector left with only skeleton staffing will continue to risk patient safety, further exacerbate waiting times, and drive demand for health services ever higher.
1.4 million older people are currently estimated to have an unmet need for social care, yet despite this, there have been dramatic falls in spending on social care in England, with figures showing a 12% decrease per person over the decade to 2018/19.
Leaders are warning that the social care system is in urgent and radical reform and are urging the next Prime Minister to commit to significant investment in the sector, with the accusation that the social care system is far from ‘fixed’. The Health Foundation projects the Government will need to spend an extra £2.5 billion just to meet future demand and over £9 billion to improve access to care by 2024/25.
They are now calling on the Government to rapidly deliver on its so far unmet manifesto pledge to transform the struggling sector.
Visit the NHS Confeferaration website to read the report in full.
In other news, the Ombudsman’s annual review of complaints launched today, giving a concise overview of the state of local government complaints over the past year.