NHS Digital innovation £1m up for grabs for adult social care technology pilots


It was good to hear that Local authority projects that use digital innovation to help benefit people who access adult social care can bid for share of £1 million in funding.

The funding, provided by NHS Digital and managed by the Local Government Association (LGA), with support from the Association of Directors of Adult Social Care (ADASS), will be awarded to local authorities that put forward projects that support forward-thinking uses of digital technology in the design and delivery of adult social care.

Twelve will receive £20,000 to design a digital solution to address a specific issue with their service, with six receiving up to a further £80,000 to support its implementation.

Those bidding will need to focus on one of three themes:

  • efficiency and strengths-based approaches;
  • managing marketing and commission; and
  • sustainable and integrated social care and health systems.

Formerly known as the Local Investment Programme, the Social Care Digital Innovation Programme aims to encourage the adult social care sector to make better use of technology.

This new initiative builds upon support for the strategy advocated by the CQC who for some time have been encouraging providers to make more use of technology in the provision of care services.

James Palmer, programme lead for the social care programme at NHS Digital said: “Last year’s projects delivered inventive, forward thinking and creative solutions to local challenges in social care. They have led to successful outcomes for both services and the people who use them.

“This year, the funding will help to identify and address some key pinch points within local authority services, especially those around the integration of health and social care systems. We are looking forward to seeing the innovative solutions that councils come up with in response to our latest round of funding.”

Previous projects to have received support include home video-conferencing in Essex, voice-activated home support in Hampshire and electronic referrals for home care packages in Hampshire and electronic referrals for home care packages in Sefton and Knowsley.

Sefton and Knowsley Mayor Kate Allsop, deputy chair of the LGA’s Community and Wellbeing Board said: “We are committed to enhancing the role that information and technology can play in the commissioning and delivery of health and social care services.

“As part of this agenda we are pleased to run another funding round in collaboration with NHS Digital, to stimulate digital solutions to social care challenges at a local level.”

The closing date for applications is 4pm on 1 June.

An NHS Digital-commissioned review of the state of IT in social care revealed a myriad of challenges.

This latest initiative by NHS Digital is just one of many such funding approaches with the aim of increasing the use of technology in social care. There is little doubt that the funding crises that is affecting social care, has prevented investment in the use of technology. Many providers ae aware of the benefits that technology can bring to adult social care services but where is the money coming from to pay for it?

Those who work in the social care industry are full aware that the use of technology will play an increasingly important role in the future provision of adult social care services. We can also expect it to be included in the Governments Green Paper on the future of social care services to be published in the summer.

Summary

The offer of more funding from NHS Digital to fund specific technology projects should be welcomed. But this piecemeal approach is only scratching the surface when it comes to the technology needs of adult social care services.  What is needed is a government funded worked-out strategy for the implementation and use of technology that is available to all providers and commissioners.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy

Urgent action required to reverse care work’s poor public image and boost recruitment and retention


Following on from my article of last week on a strategy to improve the recruitment and retention of staff in adult social care services. The Public Accounts Committee have produced a report urging the Government to take urgent action to address the poor public image of care workers and methods for boosting recruitment and prevention of staff.

According to the Committee the adult social care sector is underfunded, with the care workforce suffering from low pay, low esteem and high turnover of staff. The care sector is in a precarious state but the Department of Health and Social Care (the Department) has not yet said how it intends to put in place a long-term, sustainable funding regime to meet the ever-increasing demand for care. The Department does not know whether the ways that local authority’s commission care, and the prices they pay providers, are contributing to the problems within the care workforce.

The Committee is not convinced that the lack of regulation within the care sector workforce and the balance of regulation versus a market-based approach, is supporting the care sector to provide the best care possible. The UK’s departure from the EU is causing uncertainty over how the workforce will be sustained, particularly in areas that are more reliant on non-UK workers. There is an urgent need to reverse the poor public image that care work has to boost recruitment and retention across the care sector.

The Committee is also concerned that the move to supporting people with substantive and critical care needs only is contributing to growing levels of unmet need for people with moderate care needs. These moderate needs may well grow into substantial or critical needs if support is not given. The Department has committed to addressing all these issues through the health and care workforce strategy that it is currently consulting on, and the promised Green Paper on funding of care for older adults. But given the pressures on the sector, the Committee is concerned that the Department sees the Green Paper as a cure all and underestimates the scale of the challenge. The Department must ensure that its delivery partner, Skills for Care, is properly supported and funded to implement the workforce strategy.

The underfunded Adult social care sector

The adult social care sector is underfunded, with the care workforce suffering from low pay, low esteem and high turnover of staff. The care sector is in a precarious state but the Department of Health and Social Care (the Department) has not yet said how it intends to put in place a long-term, sustainable funding regime to meet the ever-increasing demand for care.

The Department does not know whether the ways that local authorities commission care, and the prices they pay providers, are contributing to the problems within the care workforce.

Brexit causing uncertainty over workforce sustainability

The Committee is not convinced that the lack of regulation within the care sector workforce and the balance of regulation versus a market-based approach, is supporting the care sector to provide the best care possible.

The UK’s departure from the EU is causing uncertainty over how the workforce will be sustained, particularly in areas that are more reliant on non-UK workers.

There is an urgent need to reverse the poor public image that care work has to boost recruitment and retention across the care sector.

Concerns that Department sees Green Paper as “cure all”

There is concern that the move to supporting people with substantive and critical care needs only is contributing to growing levels of unmet need for people with moderate care needs. These moderate needs may well grow into substantial or critical needs if support is not given.

The Department has committed to addressing all these issues through the health and care workforce strategy that it is currently consulting on, and the promised Green Paper on funding of care for older adults.

But given the pressures on the sector, we are concerned that the Department sees the Green Paper as a cure all and underestimates the scale of the challenge.

The Department must ensure that its delivery partner, Skills for Care, is properly supported and funded to implement the workforce strategy.

Summary

The Public Accounts Committee Report is attempting to put pressure on the Department of Health and Social Care (the Department) which has not yet said how it intends to put in place a long-term, sustainable funding regime to meet the ever-increasing demand for care.

The ever-increasing demands for care, the poor public image, difficulties in recruiting and retaining staff are well documented challenges facing the social care industry. The Government are placing a great deal of faith in the forthcoming Green Paper and the health and care workforce strategy, it remains to be seen if they are a cure all and underestimates the scale of the challenge.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy

A strategy for improving recruitment and retention of staff in social care services


The difficulties faced by providers in attempting to recruit staff for social care services continues to present significant challenges. Low wages, conditions of service and lack of career opportunities are often cited as major reasons why it has become increasingly more difficult to attract people to work in social care.

In December last year, Health Education England published Facing the Facts, Shaping the Future: A Health and Care Workforce Strategy for England to 2027.

  • The adult social care workforce is larger than the NHS workforce but has lower average pay, fewer qualifications and more part time staff.
  • Turnover is high and there are 88,000 vacancies.
  • Required growth of between 14% and 31% is forecast by 2030.
  • 18% of the workforce is from overseas with regional variation.
  • 20,300 independent organisations provide care in England.
  • The government is consulting on changing aspects of the system.

The report highlights that the majority of the care workforce is likely to earn at or near the National Minimum Wage. The workforce is 82% female with an average age of 43 and nearly half work part time including 54% of care workers. Zero-hour contracts cover 24% of all staff and 33% of care workers. Turnover is high at over 25% with around 347,000 staff leaving roles during 2016/17, 33% of those leaving the sector altogether.

The sector faces recruitment and retention challenges at all levels, in both regulated and unregulated professions. Vacancy rates are higher than the general economy at 6.6% compared to 2.5%, with approximately 88,000 vacancies. Workforce diversity, as with the NHS, means a combination of interventions are needed to support an adult social care workforce for the future. The government has recognised pressures on the social care system with an additional £2bn, however a number of factors such as pay, large numbers of small employers, contract status and retention and recruitment make workforce issues challenging for the sector.

Increasing demand for adult social care

Demand is growing as people live longer with more comorbidities leading to more complex health and care needs. According to “Horizon 2035: health and care workforce futures”, by 2025 unconstrained demand for lower skilled direct care staff is likely to increase by 12%, (around 120,000 more jobs), and an overall workforce demand increase of 14% (190,000 jobs). Skills for Care suggest that need might be as much as a 31% increase or 500,000 jobs by 2030. Factoring in vacancies approaching 90,000 and the challenge of the current staffing model to meet these demand projections is clear. It also has implications for the wider economy, with labour used to meet this increase not being available to other sectors. There are interventions that can alleviate some of this increasing demand whilst meeting peoples’ desire to remain independent and well at home for longer. These include social care staff supporting prevention and public health interventions; better join up between health and care; more support for carers; and new technology.

Maximising recruitment

There are two focus areas for ASC recruitment. The first is training and skills development. Roles tend to have low entry requirements with around half the workforce having no formal social care qualifications. This is especially true of the vast majority of staff providing direct care and support. The regulated professions tend to perform more supervisory roles. There are no standard training requirements across large parts of the sector with too many staff not receiving training or professional development, despite providing direct care for vulnerable adults whose dignity and quality of life is dependent on the quality of their work. The Care Certificate, developed by HEE, Skills for Care and Skills for Health, provides a standard induction framework across social care and health. There is no mandated skills training or development across employers.

The second recruitment challenge is overseas staff. UK nationals make up 83% of the ASC workforce; 7% (around 90,000), are non-UK EEA nationals and 11% (about 140,000) are from the rest of the world. Direct care staff form the biggest group of EEA staff with about 67,000 workers

The majority of roles have low entry requirements and limited career structures. The 20,300 employers separately determine job titles and structures, which makes demonstrating career pathways challenging meaning staff often seek career progression by leaving the sector. Increases in the National Living Wage have driven up pay for those on the lowest wages but also narrowed pay differentials thereby reducing the attractiveness of seeking promotion or progression in some cases.

Summary

The Health and Care Workforce Strategy for England to 2027 has involved consultations with those who have a vested interest across the care industry and was due to be completed last month. Any new strategy will need to take into account that if we are to recruit and retain more staff, we cannot continue to have over 20000 care providers determining staff job titles and career structures. We need a national set of employment conditions that give staff encouragement to seek career progression with available training, that is recognised and financially rewarded.

If staff can be supported to gain satisfaction in their work through training that leads to improvement of skills, career opportunities and financial rewards, then we have the basis for a thriving, consistent and high-quality workforce. We may then begin to see an improvement in recruitment and retention of staff in the social care industry.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy