Health and care leaders need to recruit the equivalent of the population of Newcastle, the care regulator for England said, as it warned of a gridlock paralysing services and risking people’s health.
It is getting “tougher” to access care, with one of the main reasons for the gridlock a lack of workforce, the Care Quality Commission warned. 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.
The regulator said it had seen a significant rise in the last year in the number of people stuck in hospital because there was insufficient social care for them upon discharge. In some cases almost half the hospital was full of people medically fit to be discharged but who were waiting for social care support, it said.
Beds were available but some care homes were closing their doors to new arrivals because they could not provide safe staffing levels. And some nursing homes were having to re-register as care homes because nursing staff were leaving and they were struggling to recruit replacements.
There were around 132,000 vacancies in the NHS and 165,000 across social care – which the CQC said was roughly equivalent to the entire population of the city of Newcastle. Mr Trenholm said the impact of the gridlock was that people were struggling to see their GP or dentist, and were waiting longer to get to hospital.
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 a 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.”
Figures from the Association of Directors of Adult Social Services showed that more than half a million people (542,002) were waiting for assessments, reviews or care to start as of April 30 this year. Separate data from the workforce body Skills for Care showed the number of filled posts fell by about 50,000 between 2020-21 and 2021-22.
The 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 paid for homecare was 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 could 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 would quit, with services further stretched, and people at greater risk of harm. This would be worse in more deprived areas, where access to care outside hospitals was 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 were suffering avoidable harm and staff were “overwhelmed and pushed to breaking point trying to do the right thing”.
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."
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