As Autumn begins to force its hand, the weather on the coast, where I live, slowly but surely begins to unravel. Fair skies give way to gunmetal grey ones and balmy breezes are replaced by stiff winds, sheet rain and swells, which crash against ageing piers.
In the UK care sector, where I work as a consultant for QCS, the leading provider of content, guidance and standards for the social care sector, the first storms of the autumn have already made landfall. They are not meteorological squalls, formed by rising warm moist air, however, but man-made storms, which have been fashioned by Brexit, fed by COVID-19 and made more powerful by a government, that has not given the care sector the financial help it so badly needs to flourish.
Health & Social Care Levy
Take the government’s Health & Social Care Levy, which is expected to raise around £36 billion over the next three years. According to the Nuffield Trust, only £5.4 billion will actually go to the care sector in that time and with much of it being spent on capping the £86,000 lifetime cost of care, many strongly doubt whether there will be enough in the pot to provide professional carers with the salary and training they deserve to map out a defining career path. [i]
Many providers, however, are struggling to think that far ahead. Sadly, without government help, some are simply focusing on staying afloat. They desperately need an injection of cash, but according to The Guardian newspaper, they are unable to borrow from banks. The National Care Association, a partner of QCS, confirmed this was the case. Executive Chair, Nadra Ahmed told The Guardian, “We haven’t seen surveys but I know these conversations are beginning to be held across the country with all banks. Some a bit more aggressive than others. Definitely we are hearing that providers are beginning to feel the pressure.” [ii]
Rising energy bills
In the short term, Ahmed is also concerned that the gas crisis, which has seen prices soar, and worried that the Infection Control Fund is due to finish at the end of the month.
Having worked in the sector for over 15 years, it is a view that I agree with. Energy bills are not cheap due to the number of months in the year when the central heating is on, while ending the Infection Control Fund is sure to add to the cost of PPE. With services often operating on wafer-thin margins, even paying the cost of VAT on PPE could present a significant financial burden for providers this winter. On top of this, there are many services in England, who are struggling to renew insurance policies due to a poor rating or because of a substantial hike in premiums brought about by the pandemic.
Recruitment and retention
But, it is two age-old challenges – recruitment and retention – combined with Brexit and COVID-19 – that have combined to give this storm real potency. In a sector where overcoming staff shortages presents a perennial problem for Registered Managers, Brexit has dramatically narrowed the talent pool. Before Brexit, there were around 113,000 EU carers working in the care sector. Now, the Migration Advisory Group says that immigration rules brought in after Brexit, which do not categorise care workers as skilled workers (meaning they are ineligible to work in the UK care sector), will create a “looming shortage” of staff. ([iii] and [iv])
COVID-19, which shows no signs of disappearing, is of course the other major challenge. According to figures published in last week’s Sunday Times, 5,000 professional carers have left the sector in the last two months following the government’s decision to make two COVID-19 jabs a compulsory requirement in all care homes in England – and possibly all settings subject to the results of a consultation – from November 11. [v]
Depending on the results of consultation, as to whether jabs should be compulsory across the entire health and care sector, it may lead care – or parts of it – staring down the barrel of a recruitment ‘cliff edge’. Why? Well, anecdotally at least, it appears that many care staff, who don’t wish to be vaccinated, have chosen to work up until November, 11. This has led some in the sector to suggest that an exodus of unvaccinated workers leaving the sector at the same time, many of them tempted by retail and logistics firms offering higher wages to care staff, could lead to some care providers closing.
The question is, is there anything we can do to stop this gargantuan storm in its tracks, or it is a case of battening down the hatches and trying to ride it out? The good news is that unlike physical storms, man-made ones can be calmed and even quelled if effective and affirmative action is taken.
Put an end to panic culture
The pandemic, has for example, brought it home to us that we live in uncertain times. This has created a culture of panic, which is often sparked by a misplaced quote and accelerated by social media. It has led to a shortage of toilet rolls, petrol and other commodities. We all need to break this cycle. If we don’t care services that need gas, food, PPE and other supplies, will suffer.
But, what can be done to solve the deeper, more intractable issues? I’m not a politician or a legislator, but as it becomes clearer that the compulsory vaccination programme is having a negative effect on social care recruitment, depending on the results of the consultation, the government could choose to level the playing field and make mandatory jabs a condition of work across all health and social care settings. Or, it could temporarily extend the November 11 deadline. Paying a higher hourly rate to staff may also stem the tide of care workers wishing to leave, but, that said, I would expect this to only have a limited effect. Why? Well, those workers who have elected not to be jabbed, have made their decision on principle, and are unlikely to change their minds – even if they are offered a considerable wage hike.
Overcoming funding and recruitment concerns
In terms of government intervention, again I’m not a policymaker but there are a series of short and long term measures that could be introduced to help services overcome funding concerns. The first would be to extend the Infection Control Fund, especially if England suffers a fourth wave of COVID-19, or, as we expect, a new winter flu and respiratory illness to surge.
Recruitment worries could be eased by re-classifying social care work as a skilled job, which of course it is. That would mean immediately widen the recruitment pool. However, legislation always takes time to push through. In the short-term, therefore, the government may have to consider temporarily bringing back freedom of movement for care workers living in the EU.
What Registered Managers can do
Thirdly, Registered Managers can play a significant role too. Leading from the front as many have demonstrated throughout the pandemic, they can ensure that their care and support delivered always strives to be as outstanding as it can be. On this front, QCS provides all the tools that frontline workers need to deliver outstanding care and exceed regulatory requirements.
Registered Managers can also plan for the future by using tools such as QCS’s winter planning document, its risk assessment instrument, recruitment plans and QCS’s recently updated Business Continuity Plan.
The profile of the care sector needs to change
But I want to finish on the profile of the care sector, which is very important too – especially when it comes to attracting new blood to the ranks. Too often the social care sector gets a negative press. Perhaps I’m being too harsh on the media, but every time I pick up a newspaper, I only ever seem to read stories of care homes failing service users, or mercenary staff jumping ship for better opportunities. This paints a wholly inaccurate picture of the care sector and deeply damaging one for a sector which desperately needs new recruits.
The reality is very different. Care settings are inspirational places, where teams of dedicated, responsive and resourceful staff make remarkable breakthroughs with the service users they support on a daily basis. These good news stories are just not reported. Maybe they should be. If they were, more young people from different walks of life might join the ranks.
But for the narrative to really change, good news stories are not enough. The health and care sectors need to forge a closer, more integrated bond to prioritise educational and career opportunities. New entrants need to know that whatever care service or health service they join, they will have access to a progressive career ladder, underpinned by a culture of professional training, which will give them the best opportunity to realise their stellar ambitions.
This exciting vision of the future is the prize which comes from seeing off the super storm, which is currently bearing down on the sector. It’s our collective responsibility to make this vision a reality – for service users, for families and for the legion of brave carers, who sacrificed so much during the pandemic. If we do nothing, their efforts were in vain.
To find out more about the QCS or to purchase a subscription, please contact QCS’s team of advisors on 0333-405-3333 or email: [email protected].
The article was first published in The Carer, Issue #56
[i] Nuffield Trust
Chart of the week: How much of the health and care levy will social care receive and what is this intended to do?
By Camile Oung
Date: 10, September, 2021
[ii] The Guardian
UK care homes face funding crisis as banks refuse loans
By James Tapper and Michael Savage
Date: 25, September, 2021
[iii] The Independent
Thousands of EU care workers in UK face losing immigration status
By May Bulman
Date: 25, January, 2021
[iv] ‘I’ News
Social care sector faces ‘looming shortage’ of workers due to post-Brexit immigration rules
By Jane Merrick
Date: 20, September, 2021
[v] The Sunday Times
Get jabbed, win a car: care bosses on desperate drive to keep hold of staff
By Tom Calver
Date: 25 September, 2021