Mind the Care Gap campaign: A renewed vision for England’s care force

16th January 2018 about a 6 minute read

We urgently need a plan that spans the whole careforce – both paid and unpaid carers – if the care available to our ageing population is to be fit for purpose over the years ahead.

Adult social care is a highly pressured working environment – many people who join the profession do so because they are passionate about helping individuals to maintain their independence and wellbeing in later life. If we are to tackle the care gap, we need to support and nurture the skills of workers right across the sector. According to Skills for Care, dependent on population projections up to 2030, the additional number of social care workers required varies between 300,000 to 700,000.[1] We must also look at the challenges facing unpaid carers – people who, increasingly, put their own lives on hold to look after a loved one. Many unpaid carers find it incredibly difficult to juggle their caring responsibilities – especially when they also have work commitments. We are calling for the Government to take steps to improve the work-life-care balance of millions of people.

The recruitment and retention of the care workforce, the reliance on unpaid carers and the provision of adult social care on offer are all significant issues that need to be factored into any potential solution to close the current gap in provision. Funding challenges are also hampering adult social care workers.

One adult social care worker, who spoke to us as part of our campaign, discussed what impacts the funding challenges are having on individuals waiting for care support:

“It’s down to the funding of services, not necessarily bureaucracy. You want to see the individual and provide a service that you know needs to be actioned quickly – it’s for the prevention of deteriorating conditions and hospital admissions – but unless you’ve got the resources there, that can have a big impact on the length of time waiting.”

On average, local authorities have had their budgets reduced by almost 26% since 2010.[2]

Provision and more people living longer

The population in the UK is getting older.[3] By 2040, almost one in seven people is expected to be aged over 75.[4] In twenty years’ time, it is likely that more people will need care or treatment, for a longer period of time and support to live with increasingly complex needs. The level of unmet need for care and support amongst older people has grown in recent years, and Age UK’s 2017 analysis indicates that there are now almost 1.2 million people with unmet care needs in respect of essential everyday tasks – a 48% increase since 2010.[5] We need a long-term strategy to ensure the careforce is ready to cope with further predicted increases in demand.

Unpaid carers

Growing demand, coupled with declining access to local authority care services, has also placed increased pressure on unpaid carers. The proportion of those who provide unpaid care for a friend or family member has increased in recent years and now stands at over 9 million.[6]

Carers UK estimate that, as a result of reduced public funding and growing demand for care, we will need a 40% increase in the number of unpaid carers over the next 20 years.[7]

We must not forget that many unpaid carers are older people themselves, with around 1 in 5 people aged 65 and over providing care. One of the key issues we have identified in developing our campaign is the issue of ‘carers strain’. Our case studies highlighted examples where the health and wellbeing of an older person, who acts as the main carer to their partner, deteriorated because they were unable to cope with the demands of managing their own wellbeing needs and those of their husband or wife.

Potential solutions

There is scope for a better professional development pathway for adult social care workers. To address workforce and skills gaps in paid and unpaid care, we have said:

  • There needs to be an enhanced role for social care nurses to attract more people into the profession;
  • a greater variety of degree-level qualifications focusing on specialist pathways like end of life care, mental health and leadership to attract more graduates; and
  • better guidance for unpaid carers to learn best practice when supporting a loved one.

Health and care professionals also need time to be able to learn and develop new skills. Dr Adam, a GP in Leicester, spoke to us about the importance of staff being allowed more time to learn:

“There also needs to be more work on education to release staff from their day job to help further educate someone, if you do that they are more likely to stay in that job. That’s a good investment, but if you cannot get staff out of the day job to educate them, things like backfill, so covering peoples’ time so they can go and learn is also needed for care home staff too.”

There are good examples of best practice that could be held up as national exemplars for others to follow suit. We visited the Willowbrook Medical Centre, which operates a holistic approach to health and care needs. The Centre is in an area of Leicester City that has a larger than average proportion of over 65s. The GPs are supported by an adult social care worker and a Mental Health Nurse to support the needs of older patients. All the staff at the Centre use the same computer system to update patient records which helps deliver a joined-up response to their older individuals care needs.

Dr Joshi, a GP at the Centre in Leicester, talks about the approach to integrating health and care:
“…we got a social care worker to work with us. Later we were also able to get a mental health nurse too. So, the key idea was to look at a patient’s health and social care needs, including mental health, a holistic approach.”

We believe that this kind of model has the potential to be adopted nationally. This type of arrangement with a joined-up workforce, not working in silos but as a coordinated team could lead to better patient outcomes and higher staff satisfaction rates amongst health and care professionals.

We are calling on the Government to provide leadership and work with training and skills providers to build the capacity of the careforce. This is to ensure we have sufficient numbers of professionals, as well as unpaid carers, with the appropriate skills to meet future demand and deliver high standards of care. The Government must recognise the economic and societal contribution of unpaid carers too. This means employers should be encouraged to introduce measures designed to improve carers’ ‘work-life-care balance’.

It is important we support the growing number of carers at home and in community settings who play a vital role in our ageing society. We must ensure a new deal for the careforce flows from the Government’s adult social care Green Paper in the summer.