We cannot have a healthcare workforce plan that does not address social care
Whilst it was never billed as a joint health and care workforce plan, it feels like a missed opportunity for joined up policy making. Given the scale of its problems, it is disappointing that social care is still waiting for its big moment. Sadly, it is still seen as a support act to health rather than having equal billing.
There was a welcome recognition in the plan that the NHS does not operate in a vacuum but the acknowledgement that the plan is ‘predicated on access to social care services remaining broadly in line with current levels or improving’. This is surely a bold statement considering the survey results from the 2023 Association of Directors of Adult Social Services (ADASS) Spring Survey. This suggested councils are likely to go into this winter with waiting lists higher than in 2021 and these could rise further during the winter without more staff.
It is welcome that the plan also gave a nod to the fact that one of the biggest challenges to the social care workforce is competition from the NHS. It also makes a commitment that the implementation of the plan ‘shouldn’t exacerbate workforce shortages that exist elsewhere in the social care sector’. Flexible, integrated pathways are mentioned which would clearly help provide options to address the need for more flexible working arrangements and better career development. All of this is encouraging. However, without a long-term funding solution for social care that would help move social care workers’ pay towards parity with their counterparts in health, much of this will remain window dressings.
Recruitment and retention of care staff will remain a real challenge and the impact of that will be devastating for those who rely on care services. There is currently over half a million hours of homecare unable to be delivered due to lack of staff and, as reported by ADASS, councils are not confident that going forward, they will be able to offer the minimum social care support required by law.
What is needed is a strategic workforce plan for the social care sector that looks across the system and addresses the challenges inherent in both the health and care systems. We simply can’t deliver the benefits of integration without a comprehensive reform that sets out a clear road map for workforce integration, including alignment of roles and system deployment models that can help tackle key issues around recruitment and retention.
None of this will happen without a coordinated approach. Collaboration between policymakers, healthcare organisations, and stakeholders is needed to prioritise investment and training, to include a greater focus on digital and technology - two areas that will have a major impact on the future of social care but where there is the biggest skills gap in the care workforce.
Any plan also needs to focus on improving employment conditions for care staff. They also need opportunities to acquire and improve their skills and to benefit from opportunities to progress. What is also clear is that investing in the social care workforce can provide a significant return on that investment. Last year we spent £19bn on adult social care in England, employing 1.5m people – more than the NHS. If that workforce was focused more on early intervention and prevention, for example preventing falls, keeping people out of hospital and supporting them back to independence after admission, that could make a real difference in reducing pressure on the health service.
Ultimately, social care should not be in competition with healthcare for scarce resources and talent but working together to achieve the same aim of delivering better care through a high performing, highly skilled workforce. That will only happen if there is a focus on developing a skilled and valued care workforce and the political will to make social care a priority and give the service parity with the NHS. Both are celebrating their 75th birthday this year. We can only hope they’ll both have reasons to celebrate.