Editorial

Building back better or papering over the cracks?

The pandemic has made short and longer-term plans for older people's care of vital importance
The pandemic has made short and longer-term plans for older people's care of vital importance

The pandemic has made short and longer-term plans for older people's care of vital importance

As individual practitioners, we are responsible for the quality of the care we provide directly to older people living with frailty, but we have no control over whether there will be enough of us in post, let alone competent, to supply high-quality care in the future. That lies in different hands: the government’s.

Its plan for health and social care,

The pandemic has made short and longer-term plans for older people's care of vital importance

The pandemic has made short and longer-term plans for older people's care of vital importance
Picture: iStock

As individual practitioners, we are responsible for the quality of the care we provide directly to older people living with frailty, but we have no control over whether there will be enough of us in post, let alone competent, to supply high-quality care in the future. That lies in different hands: the government’s.

Its plan for health and social care, Build Back Better, was published in September. In it, a white paper on reforming social care was promised with a pledge to invest at least £500 million over three years to ‘provide support in professionalising and developing the workforce, including hundreds of thousands of training places and certifications for our care workers and professional development for the regulated workforce’.

It further pledged to improve recruitment and support for the social care workforce.

Social care costs are supported by detailed calculations of the impact on people’s savings

These pledges are most welcome, but they contain no spoiler alerts about how they will be realised. This is a sign of unevenness in Build Back Better: elsewhere, it provides detailed responses to the challenges of the pandemic for acute and elective care, and of the costs of future social care.

Unlike workforce issues, social care costs are supported by detailed calculations of the impact on people’s savings and the threshold above which they will be required to contribute, with case studies.

For a deeper understanding of the consequences of the pandemic for the workforce that supports older people’s health and social care needs we must look elsewhere.

In State of Care, the Care Quality Commission’s (CQC) annual assessment of health and social care in England, the regulator says: ‘Health and social care staff are exhausted and the workforce is depleted. People across all professions, and carers and volunteers, have worked tirelessly to help those who needed care. The negative impact of working under this sustained pressure, including anxiety, stress and burnout, cannot be underestimated.’

Careers in health and social care must be made more attractive

The CQC observes that there could be a ‘tsunami of unmet need’ in social care this winter as exhausted staff leave the sector. Vacancies have already risen from 6% to 10% over the past six months. We are on the brink: workforce needs must be addressed in the short and the long term.

Pay review might help, but it is not enough to retain staff. Careers in health and social care must be made more attractive by guaranteeing time and support to complete training, with access to mentorship and coaching in the workplace, and clinical career structures that offer future progression for those who would like it.

Nursing Older People has consistently demonstrated the challenges for care homes in accessing CPD and training compared with the NHS over the years, including in this recent piece, Care homes: could nurses in advanced clinical practitioner roles be key to change?

Now is the time for a comprehensive workforce plan that addresses recruitment incentives, training and careers support for staff caring for older people with frailty and complex needs, in the NHS and social care.


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