Our health and care system is currently “gridlocked and unable to operate effectively”. That is the deeply concerning description headlining a new report published on Friday.
And this is not an analysis from a think tank or a union or other organisation with a political brief or beef. These are the words of the system regulator, the Care Quality Commission.
The CQC has just published its annual assessment of health and social care in England, its State of Care report, with particularly dire warnings focused on social care.
The regulator’s conclusions are fairly straightforward to understand. It said capacity in adult social care has reduced while unmet need has increased; put another way, demand is outstripping supply.
“The report noted that workforce shortages across all sectors need to be addressed, but the problem was ‘particularly acute’ in adult social care.”
Placing that in context for what it means for patient flow and the system in general, the CQC said only two in five people were able to leave hospital when they are ready to do so.
This, it highlighted, was contributing to record-breaking waits in emergency departments following a decision to admit, and dangerous ambulance handover delays.
The report noted that workforce shortages across all sectors need to be addressed, but the problem was “particularly acute” in adult social care.
The regulator has called for a “properly” funded workforce plan that recognised the adult social care “workforce crisis” as a national issue and ensured that pay and rewards attracted and retained staff.
Of course, the CQC report’s findings and its associated recommendations have not come out of nowhere and should surprise no one, especially those with the power to change the situation.
We know the health and care system as a whole is struggling, but particularly social care, as evidenced by a recent stream of serious warnings from the sector.
Earlier this month, Skills for Care revealed there were now 165,000 vacancies in the adult social care sector in England and a decrease in the workforce of around 50,000 people from the previous year.
Specifically, it said nursing had the top vacancy rate among all adult social care staff groups in England and was also among the professions with the highest turnover rates.
Earlier this week, an organisation representing more than 160 social care providers appealed to the chancellor to ensure the sector was given more funding and that a workforce plan was published.
The National Care Forum’s chief executive, Professor Vic Rayner, published an open letter to Jeremy Hunt on Tuesday following his first financial statement since taking over at the Treasury.
Mr Hunt had, as most people know, confirmed the abolition of the proposed health and social care levy, a new tax to be launched in 2023 and designed to enable extra health and care spending.
It would have seen around £12bn a year provided to tackle NHS backlogs and improve social care, with funding raised from a 1.25% increase in National Insurance payments.
Mr Hunt had not only trashed the new levy but also put all government departments on standby that they would need to redouble their efforts to find savings and to expect some spending cuts.
In a strongly worded response, Ms Raynor had highlighted in her letter that public spending cuts to adult social care would be “disastrous”.
The one saving grace, I suppose, is that the new chancellor previously served as Secretary of State for Health from 2012 to 2018 and, until he picked up his latest role, was chair of the Commons’ Health and Social Care Select Committee.
So, he knows what’s going on under the bonnet in terms of the health and social care system, and where the pressures are. This should at least give the sector a fighting chance in the battle with other departments that Mr Hunt is less familiar with to avoid cuts.
I would like to point out that nursing in social care is very much an area that Nursing Times is aware needs more focus, attention, awareness and investment.
That is why I have sought to give people, like England chief nurse for social care Deborah Sturdy and others, a platform to speak at events like our annual Workforce Summit and careers fairs.
Similarly, last year we created a new category at the Nursing Times Awards specifically for Nursing in Social Care and for which I am looking forward to seeing this year’s winners revealed next week.
Collectively, the warnings from Skills for Care, the NCF and now the CQC surely cannot be taken lightly and must not be ignored by the government, whatever its other problems are right now.
A properly funded workforce plan for social care, including nursing staff, has been talked about for far too long. Today’s report from the regulator makes that loud and clear.
It is needed now, for the sake of everyone working and relying on it, and also because it is surely part of the solution to unlocking some of the wider pressures on the system, namely delays with hospitals, ambulance serves and primary care and community care.