Health December 3, 2019
Leading manifestos fail to address workforce gap in social care

By Francesco Tamilia - Accountable Care Journal

New analysis by the Nuffield Trust has revealed that 90,000 extra social care staff are required to meet key manifesto pledges by the Labour and Conservative Parties. If the plans set out in the manifesto pledges are to be met, the extra staff will be required immediately.

The analysis revealed that around 165,000 over 65s in England need help at home with three or more basic daily activities, such as getting dressed, washing and eating, who are not currently receiving any care services.

To provide just one hour of care per day to this group, a minimum of 48,000 home care workers, rising to just under 90,000 home care workers for two hours of care a day, would be required.

Commenting on the analysis, Natasha Curry, Deputy Director of Policy at the Nuffield Trust, said that the next Government “needs to grasp the nettle and put forward clear proposals for funding and staffing social care if thousands of people are not to continue to suffer. ”

What is the problem with social care?

The current social care system in England is widely regarded as inefficient and unfair. Increasing demand is not compensated with adequate funding, and services have suffered as a result. Over the period between 2010–11 and 2017–18, local authority spending on adult social care fell by 8 per cent in real terms.

One of the core reasons for struggling services is that the social care workforce is not keeping up with increasing demand. According to Skills for Care’s report on social care workforce in England in 2019, 7.8 per cent of roles in adult social care were vacant, equivalent to 122,000 vacancies at any one time. The report also highlighted how the vacancy rate increased by 2.3 percentage points between 2012/13 and 2018/19.

In a previous report, the National Audit Office condemned the Department of Health and Social Care for “not doing enough to support a sustainable social care workforce as the number of people working in care is not meeting the country’s growing care demands. ”

There are numerous barriers to recruitment into the sector. In addition to insufficient funding, high staff turnover and a high vacancy rate, social care workers often need to deal with low pay, poor working condition and unstable contracts.

Solutions are made more difficult due to a limited understanding of how the social care sector operates. In fact, it is often understood to be a part of the NHS. The King’s Fund report on the next steps for social care funding reform found that “the public has little understanding of how social care operates and even less understanding of how it is funded. Although some people have direct or indirect experience of arranging social care, this does not give them insight into the system as a whole. ”

The public’s perspective of social care should not be regarded as a secondary problem and the approval of new reforms will need the public’s backing to become a reality.

What pledges have the major parties made on social care in their manifestos?

Both the Conservatives and Labour have recognised failings in the social care sector and acknowledge that change is required to meet the growing demands of the population.

In his first speech as Prime Minister, Boris Johnson said he was determined to finally “fix the crisis of social care once and for all” with a clear plan. However, the Conservative manifesto does not commit to a specific long-term plan for social care. The party pledges that the system’s priority must be to “give every person the dignity and security that they deserve in old age” but fails to go into sufficient detail about how this would be achieved through policy change.

Meanwhile, Labour reiterated its’ commitment to the introduction of a National Care Service in its’ 2019 manifesto. The party pledges to introduce free personal care for all older people, “providing help with daily tasks such as getting in and out of bed. ” 

While well-received by Labour supporters, the Nuffield Trust Director of Policy, Natasha Curry, called Labour’s proposal a ‘missed opportunity’ as “it is not yet clear how that extra taxation will be raised,” expressing her concerns that the proposals only apply to those over 65 years old.

Due to increasing demand and overwhelming pressure on existing services, the next government will need to fundamentally reform the social care system. New reforms should include significant increases in the social care workforce and boost funding in the sector.

What’s the solution?

Nuffield Trust analysis and research of the English social care advises focus on four main areas:

  • Clarity and consistency
  • Fair and transparent funding
  • A realistic strategy for the workforce
  • Stability for organisations providing care

Nuffield Trust full report available here.

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