More than 50 NHS leaders in Wales claim social care is in a state of "national emergency" and have called on the Welsh Government to provide a long-term pay and funding strategy for the sector. A new survey by the NHS Confederation, a national membership body representing all organisations that make up the NHS in Wales, found that 100% of health service bosses agreed there is a crisis in the social care workforce.
Social care services play a crucial role in caring for people at home, keeping people well for longer outside of hospital and enabling faster, safer discharges home. The sector also plays a critical part in protecting NHS capacity and its ability to deliver high-quality, safe care.
However, the NHS Confederation and its members claim social care services are facing significant challenges, including vulnerabilities in funding and market stability, growing unmet need and high levels of staff vacancies. The impact of these challenges means people are missing out on vital care and support, leaving them less independent and more likely to rely on healthcare services.
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The organisation says this crisis is impacting every single part of the NHS from ambulance services and emergency departments to elective care, diagnostics, GPs, mental health services and community care. NHS leaders in Wales, who say they are standing in support of their social care colleagues, are now urging the Welsh Government to increase investment in care services.
Along with increases in pay, almost nine in 10 healthcare leaders supported an increase in investment to expand overall social care capacity and improve career profession opportunities to boost recruitment and retention. Some 93% said this would be the most effective action that could be taken, with 95% of leaders surveyed feeling it would be 'very' or 'quite' effective to have better integration between health and care services. They say failure to act will leave more vulnerable people without the care and support they need, as well as adding further pressure on frontline NHS services.
The Welsh NHS Confederation is calling on the Welsh Government to:
- Provide sustainable funding for social care with a fully-funded pay rise to enable recruitment and retention, alongside greater overall investment and career progression opportunities.
- Support better integration between health and social services to achieve seamless care and support for the patient.
- Provide sufficient, ring-fenced funding and longer-term investment to transform out-of-hospital care and allow and long-term service development.
- Publish locality-based delayed discharge data so there is clear information and evidence of the current issues in providing packages of care to people leaving hospital.
- Introduce performance measures that focus on quality-based outcomes, prevention, community services and whole-system collaboration.
Director of the Welsh NHS Confederation, Darren Hughes, said: "This isn’t just about the NHS and social care. This is about empowering people to live the best lives they can.
"If we don't want the system to fall over this winter, we need immediate short-term intervention, as well as a sustainable plan and funding model in the long-term. Decisive action is needed now to commit to making it attractive to work in social care and increase the numbers of social care staff.
"This is not a new problem, but one that has snowballed over the years to the point of crisis. We know steps are being taken to alleviate pressures, but these are not having a great enough impact. Of course, this not the only challenge the NHS is dealing with but working together to improve patient flow and ultimately giving more patients the care they need and deserve is the top priority for NHS leaders.
"Without immediate action, both the NHS and social care could face an endless winter where people are being failed by the very systems that should be there to support them at their most vulnerable."
Jonathan Griffiths, president of the Association of Directors of Social Services (ADSS) Cymru commented: "All leaders across health and social care will need to work very hard this winter to find additional capacity in the system.
"However, delayed discharge is just one symptom within a wider set of challenges in the integration of health and social care support for people, and as such it cannot be considered in isolation. We must consider other factors and variables, including inappropriate hospital admissions, risk managed decision making and crucially, workforce supply."
Commenting on the survey, Welsh Conservative and shadow social services minister Gareth Davies MS said: “For NHS leaders to come out like this and say social care is in crisis proves that the Labour Government in Cardiff Bay is not meeting its obligations to the people of Wales.
“People in social care are vulnerable and the workforce are hard-working, and if we are in a state of crisis then the safety of both groups are at risk. The crisis in social is wide-ranging, with a huge impact on hospitals who can’t discharge healthy patients, leading to bed blocking, overcrowded A&Es and slow ambulances.
“It is not a silver bullet, but the Welsh Conservatives have argued hard for better pay for carers – such as by linking them to NHS payscales at relatively little cost to the Labour Government – but ministers said no. This is the cost of Labour.”
A Welsh Government spokesperson said: "We have invested significantly to support the recruitment and retention of social care staff in Wales and have mounted an intensive recruitment campaign over the summer months.
"We introduced the real living wage for social care workers earlier this year, making £43m of funding available for 2022/23, and will consider the impact of Real Living Wage uplift as part of the Draft Budget planning for 2023-24. We continue to work with the sector through the Social Care Fair Work Forum to improve terms and conditions.
"Local authorities are working with health boards to increase community bed capacity for the winter."
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