Social care: The £600m jobs emergency that isn't going away

With NHS waiting lists at record highs, the last thing ward managers need is medically fit patients stuck in a hospital bed for weeks because there isn’t the care and support available for them to be safely discharged.

Yet because of the crisis in social care – where 10% of vacancies stand empty — that’s exactly what’s happening.

The government has put aside £600m to sort out the problem this year, but will that be enough?

We find out.

Why is everyone talking about social care? Because vulnerable people are waiting longer than ever to be assessed for care and it’s making long NHS waiting times even worse. New figures published by the BBC earlier this week found that almost a quarter of councils now leave patients waiting over a month for a care assessment.

A month is a long time. Yes, but that’s only the average. Researchers found one woman in Wales had spent 11 healthy months in hospital waiting for a care package to be put in place, only able to get out of bed when nurses were available to move her into a chair. These delays cost the NHS almost £400 a night.

Why aren’t councils getting this sorted? After years of cuts to local government funding through the austerity era, councils are cash-strapped and struggling to meet the demands of an ageing population. The Local Government Association said recent wait times were illustrative of a “chronically underfunded system and the pressures councils continue to face”.

But the government has pledged £600m to fix the problem. Why is it still getting worse? The main problem for care providers is finding enough staff. Adult social care is hard work for low pay and often involves undesirable shift patterns and overnight work. The average hourly rate for care workers is £9.50, and many supermarkets including big chains such as Asda and Tesco now pay staff more than £11 an hour, making the job even more unattractive.

So carers are leaving? In their droves. The industry now has 152,000 unfilled vacancies, according to The King’s Fund, which is leading to some care homes blocking new admissions, which means more people are stuck in hospital for long periods worsening the crisis in the NHS.

What about recruiting new staff? Brexit makes this more difficult, so the government has added social care to its list of shortage occupations to help bring in qualified staff from overseas. During 2022, only 11,000 people entered the country to work in care but this rose to 70,000 at the end of 2022/23. However the recruitment crisis isn’t over. and the vacancy rate is still almost 10%.

What will the £600m be spent on? The money — which was reannounced by the government in July — is being given to local areas to spend on new projects to retain existing staff and recruit and train new ones, including boosting salaries to make the job more attractive. Just £30m is being set aside to tackle backlogs in the worst hit areas.

Will it fix the problem? That will require a much bigger drive in recruitment from UK citizens. Despite being listed as a shortage industry, overseas workers must be paid £20,480 or more to qualify to plug those vacancies, which is a hard salary to achieve. Experts are cautious, with former government advisor Andrew Dilnot warning that, despite the investment, the state of social care is a “pretty miserable situation”.

Has the government made any other promises? A white paper published in April pledged £2bn in funding to meet the challenges of care inside and outside the NHS including extra money to help adults with complex needs live at home, better quality housing support and a total of £1.6bn aimed at reducing hospital discharges (which includes the £600m for the social care workforce).

Apart from long NHS waiting lists, what does all this mean for me? If you’re one of the 700,000 people caring for someone with dementia, the lack of social care could be putting you at risk. Dementia UK says its helpline now receives an average of three calls a week from relatives or friends caring for dementia patients who are themselves at physical risk and in immediate danger –- twice as many as last year.