Will The Measures Announced In The Autumn Statement Begin To Address the Crisis In Social Care?

"It's really worrying to see high and rising numbers of older people stuck in hospital when medically fit to leave, especially as the busiest time of year for the NHS is still a couple of months away”

On average, every day throughout October 2022, over 13,000 hospital beds were occupied with patients deemed fit for discharge, but who were unable to leave hospital. This figure is three times the average pre-pandemic.

The Need For The NHS And The Adult Social Care System To Work Together

It's really worrying to see high and rising numbers of older people stuck in hospital when medically fit to leave, especially as the busiest time of year for the NHS is still a couple of months away, expresses Age UK Charity Director, Caroline Abrahams.

The performance of the NHS is inseparable from that of the adult social care system. Consequently, in the Autumn Statement, the government committed to invest up to £2.8 billion in 2023-2024 and up to £4.7 billion in 2024-25 into the adult social care system in England to improve both the quality of, and access to care services.

Additional Investment Set To Improve Hospital Discharge Statistics?

According to government figures, only 40% of patients are able to be discharged from hospital when ready.

To relieve the pressure on NHS beds by supporting discharges from hospitals into the community where possible, £400 million in 2023-24 and £680 million in 2024-25 is to be ringfenced.

Will the extra money allocated make any discernible difference to the capacity of the social care system to cope with patient demand? Or do other more structural problems need to be addressed as well?

According to government figures, only 40% of patients are able to be discharged from hospital when ready.

'Bed Blocking'

Those patients unable to be discharged because the social care provision is insufficient or unavailable end up stuck in hospital, occupying beds that are sorely needed.

This ‘bed-blocking’ leads to other patients enduring long waits in emergency departments or for ambulances that may not have been able to transfer patients into hospitals in a timely fashion.

Shortages In Social Care

In July 2022, Skills for Care reported a decrease of 50,000 in the number of occupied posts across the whole of adult social care between 2020/21 and 2021/22.

'Discharges can be delayed for a number of reasons… but lack of social care is now the biggest problem of all, due to shortages of care workers and of funding' explained Caroline Abrahams, charity director at Age UK.

Is there an argument for a re-evaluation of the decision to dismiss care workers because of covid vaccine mandates, and if so, should provision have been made in the Autumn Statement for financial enticements to persuade these experienced workers back into the care sector?

In July 2022, Skills for Care reported a decrease of 50,000 in the number of occupied posts across the whole of adult social care between 2020/21 and 2021/22.

In their workforce pressures survey, over a third (36%) of care home providers and 2 of every 5 (41%) homecare providers said that ‘workforce challenges’ had a negative impact on the service they could deliver, with over a quarter of those care homes citing workforce pressures reporting that they were not able to admit any new residents.

The Negative Impact On Care Homes

Severe staff shortages in adult social care are also resulting in homecare providers surrendering care packages back to local authorities.

Workforce shortages have also contributed to a reduction in care home capacity, with a number of providers choosing to hold empty beds because they don’t have the care workers to staff them.

Responding to the government’s latest adult social care workforce survey, which by June 2022 had over 5,500 responses, 87% of the care home providers that reported workforce challenges in the survey admitted they were experiencing difficulties recruiting.

For homecare providers this figure was 88%.

Vacancy rates for both care homes and homecare providers are running higher than 10%, with staff turnover rates in care homes north of 30%.

Identifying The Underlying Issues

Will the government addressing issues around social care pay start filling some of the gaps in the social care system? Or are there other issues that need rectifying as well, and if so, what are they?

The NHS Confederation stated in July 2022 that the pressure on health and care services was for a large part being caused by a chronic lack of capacity within the social care system.

In a survey the Confederation undertook of healthcare leaders, 99% of respondents agreed that there is a social care workforce crisis in their local area.

73% of those healthcare leaders surveyed identified the lack of adequate social care capacity as having a significant or very significant impact on their ability to tackle the elective care backlog.

Over 80% said that capacity shortage is driving the demand for urgent care.

Unmet Care Needs

Analysis from September 2022 by Age UK on behalf of the Care and Support Alliance, estimated that over 2.5 million people aged 50 and above are living with unmet care needs in England.

Are there measures you would like to see that were not in the Autumn Statement?

If so, what are they and how effective do you think they would be in helping to address capacity issues in the social care system?

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