Health and care leaders need to recruit the equivalent of the population of Newcastle, the care regulator said, as it warned of a gridlock that is paralysing services and risking people’s health.
It is getting “tougher and tougher” to access care, with one of the main reasons for the gridlock a lack of workforce, the Care Quality Commission (CQC) warned.
There are around 132,000 vacancies in the NHS and 165,000 across social care – which the CQC said is roughly equivalent to the entire population of the city of Newcastle.
Chief executive Ian Trenholm said the recruitment challenge health and care leaders face “is going to translate into real difficulty” this winter and in the years ahead.
People who are ill can't go back to work because they're in a backlog, in some kind of queue waiting for care— Ian Trenholm, Care Quality Commission
The regulator said it has seen a significant rise in the last year in the number of people stuck in hospital because there is not enough social care for them upon discharge.
In some cases almost half the hospital is full of people who are medically fit to be discharged but are waiting for social care support, it said.
Beds are available but some care homes are closing their doors to new arrivals because they cannot provide safe staffing levels.
And some nursing homes are having to re-register as care homes because nursing staff are leaving and they are struggling to recruit replacements.
Mr Trenholm said the impact of the gridlock is that people are struggling to see their GP or dentist, wait for longer to get to hospital, and once there can become stuck.
He said: “And this is not just a care consequence. There’s an economic consequence to all of this as well.
“People who are ill can’t go back to work because they’re in a backlog, in some kind of queue waiting for care.
“But also if they’re looking after somebody, they often have to change the way they work in order to look after a loved one because the social care services aren’t available in the way that people would want.”
There needs to be more focus on long-term planning and investment rather than short-term sticking plasters— Kate Terroni, chief inspector of adult social care
Figures from the Association of Directors of Adult Social Services show that more than half a million people (542,002) were estimated to be waiting for assessments, reviews or care to start as of April 30 this year.
Separate data from the workforce body Skills for Care show that the number of filled posts fell – by about 50,000 – between 2020-21 and 2021-22 for the first time on record.
The CQC report also warned that the rising cost of living could result in more care staff leaving for better-paid work.
It said the amount commissioners pay for homecare is affecting providers’ ability to recruit and keep staff and reward them fairly.
At a recent conference organised by social care bodies, presentations were delivered on how homecare providers can advise staff about accessing foodbanks or claiming benefits to top up wages, it said.
The regulator also pointed to an unprecedented number of care workers in the south east resigning in May and June because of fuel costs.
The CQC said that, without action, more health and care staff will quit, services will be further stretched, and people will be at greater risk of harm.
The government needs to approach any imminent tightening of budgets with their eyes open to the consequences for the people who rely on and rightly expect good quality and timely treatment and care— Sally Warren, The King’s Fund
This will be especially pronounced in more deprived areas, where access to care outside hospitals is under the most pressure.
Kate Terroni, chief inspector of adult social care, called for a “real step change” in thinking about how to attract and keep staff.
She said: “The money announced by Government to help speed up the discharge of people from hospital when they are medically fit to leave, as well as to retain and recruit more care workers is welcome – but there needs to be more focus on long-term planning and investment rather than short-term sticking plasters.”
Mike Padgham, director of the Independent Care Group, which represents providers in York and North Yorkshire, called the report a “damning indictment of the way the country continues to treat the care of our most vulnerable”.
Caroline Abrahams, charity director at Age UK, said older people are suffering avoidable harm and staff are “overwhelmed and pushed to breaking point trying to do the right thing”.
Dr Rhidian Hughes, chief executive at the Voluntary Organisations Disability Group, said: “Government has the power to repair the gridlock reported by CQC, but political distractions and turbulence risk setting us off course.”
Sally Warren, director of policy at The King’s Fund, said: “The government needs to approach any imminent tightening of budgets with their eyes open to the consequences for the people who rely on and rightly expect good quality and timely treatment and care.”
The Care Quality Commission’s report identifies the same priorities for improvement set out by the Health and Social Care Secretary in our Plan for Patients— Department of Health and Social Care spokesman
A Department of Health and Social Care spokesman said: “It is vital we provide patients with the level of care they expect and deserve. The Care Quality Commission’s report identifies the same priorities for improvement set out by the Health and Social Care Secretary in our Plan for Patients.
“The plan – ABCD – is designed to address ambulance pressures, bust the backlog, support care and discharge from hospital and improve access to doctors and dentists.
“The NHS has set out its winter plan including launching rapid response teams to help people who have fallen at home as well as 24/7 care traffic control centres to manage demand and capacity across the country.”
NHS medical director Professor Sir Stephen Powis said staff are working hard to keep patients safe amid record demand and workforce pressures, and that people should continue to come forward for the care they need.
