The report, ‘Adult Social Care 2018: Funding, Staffing and the Winter Crisis’, also presents data gathered from surveys of local authorities and over 200 leading operators across elderly and specialist care in the UK, particularly looking at the use of agency staff, costs and fees, and how the Government’s additional funding has been utilised.
The 2018 report outlines the continued challenges the sector faces in both recruiting and retaining trained staff. Whilst the removal of the cap on Tier 2 visas for overseas nurses is a positive development, we observed a 13% drop in total nurse registrations. Uncertainty over Brexit has had a material impact on EU nurse registrations which fell by 87% compared with 2016/17 figures.
While favourable immigration policies and overseas nurses are key in helping bridge the current gap, the ability to train and retain UK nurses remains a key issue. Our report highlights that 30% of undergraduate students do not complete their nursing degrees.
Our operator survey responses showed that agency staff are becoming more expensive, despite 69% of elderly care operators reporting that they managed to hold or reduce agency staff usage. In specialist care, agency usage has gone up marginally whilst overall agency costs have fallen, indicating that agency staff are being used for lower paid support staff roles in specialist care, as opposed to more expensive, trained nursing staff.
Both our operator and local authority surveys have shown reasonable overall levels of fee increases, albeit for elderly care, these fall below the average fee rate increases shown in our 2017 report. Our surveys show that considerable regional variation continues, with funding remaining a critical issue as we await the anticipated Government Green Paper this autumn.
The need for sustainable funding and a joint approach between the NHS and Adult Social Care to commissioning was reinforced by pressures resulting from the winter of 2017/18. Due to the extreme weather conditions, unprecedented levels of demand were placed on the system with 24 NHS trusts reporting a state of ‘Code Black’ and NHS England issuing a directive to cancel all non urgent operations. Our report found that almost half of those trusts which reported a ‘Code Black’ were in areas with the highest levels of delayed discharges and a high density of people aged 65 years or above. The report highlights the importance of community care services in reducing unnecessary hospital admissions and the crucial role which social care can play in reducing bed blocking to free up much needed hospital capacity.
Michael Hodges, Head of Consultancy – Care at Christie & Co comments, “As we await the Government Green paper, our 2018 research shows that once again the most critical issues revolve around funding and workforce related themes with further complications related to uncertainty connected with Brexit. The pressures placed on the healthcare system by the winter of 2017 and the increasing age of the UK population illustrate the need for additional capacity, which can only be met by a comprehensive suite of policies associated with the key themes identified by our research.”