Rt Hon Damian Green MP
HOUSE OF COMMONS
LONDON SW1A 0AA
I am writing to make a plea that social care is kept as an issue on which we need to make significant and visible progress before a General Election. The NHS problems have laid bare how integral fixing social care is to solving the wider NHS crises, but even in its own right the state of social care in this country is a rebuke to all of us who have political responsibility. I welcome the recent Next Steps announcements on social care, but we need to be more radical if we are to make a significant improvement in the state of social care.
I would argue for four particular changes:
The social care workforce is understaffed and underpaid. Currently, there are 165,000 vacancies in the social care sector and this is creating a problem, as eventually we will require an extra 100,000 social care workers on top of this to support our ageing population. Mirroring social care sector pay with the NHS Agenda for Change pay scales will improve retention of social care workers, ensuring they are not lost to similar roles in the NHS, but will also support recruitment of more social care workers which we desperately need. It is currently estimated that NHS roles involving similar skills sets and responsibilities to social care workers receive around £8,036 more pay per year. To help encourage more people to choose a career in social care, there should be positive advertising campaigns sending clear messages that highlight the value and rewarding aspects of a career in social care. The adult social care sector should work with young people in schools to promote social care as a skilled and fulfilling career. Finally, the Care Quality Commission should include basic digital training in their Mandatory Training Courses package including basic digital skills, assistive technology and basic data collection. This can ensure that the social care sector is fit for the future.
We are currently not exploiting the full range of technology which is universally available, for example, the use of devices which help people in care settings communicate easily with friends and family, and more data sharing between the NHS and social care providers. By using the opportunities that technology provides we can reduce the need for more expensive professional care and provide a choice to enable people to live as independently as possible. Technology, such as assisted technology, can give those in receipt of care more control over the daily lives. Local authorities should produce a list of technology which can benefit those in receipt of care. Technology can also be used in the sharing of information between different parts of the system to increase the efficiency and effectiveness of providing social care. Ideally, the greater use of technology will allow more people to stay in their own home for longer.
Supported living has the goal of keeping people in their own homes for longer. Currently councils are incentivised to reject planning applications for new care homes and prioritise mainstream housing over retirement housing. We need to build more housing and facilities that are suitable for those who need help. We can do this by creating a new class for older person housing and require councils to meet local need, to help drive up this supply of housing. This proposal worked before in the 1980s when the decision was made to guarantee national funding for those social care patients who could not afford to pay. Private residential care therefore could expand, with operators knowing they would be supported financially as long as costs were not excessive. What resulted was a boom in the number of care homes. Also, elderly people are tending to stay in their own homes which can be larger than they need, and potentially unsuited to their needs. The Government should require every council to have a target of housing for older people in their local area with a strategy on how this will be achieved, and to create a “use class” to help achieve this target. Finally, a more streamlined planning regime for retirement housing would also encourage existing mainstream developers to enter the retirement market.
Integrated Care Boards
The introduction of Integrated Care Boards has provided us with an opportunity for a once in a generation improvement in the quality of social care provision. We need to make sure integrated care boards actually integrate both health and social care. Research should be carried out to highlight the benefits that well-funded social care can have on quality of life, independence and general wellbeing. This should be combined with research into the impacts that properly funded social care can have on the NHS. There should be clear public guidelines on the social care system and how to access social care services in each area. Making it easier to navigate the world of social care will make a huge difference at a potentially stressful time for families and friends of social care patients. Finally, there should be clear guidelines for leadership structures within integrated care boards.
I am copying this letter to Steve Barclay and Helen Whately, but I hope that a personal commitment from you can strengthen the work they are already doing.