Written evidence submitted by The Disabilities Trust (WBR0083)
Workforce burnout and resilience in the NHS and social care
The Disabilities Trust:
The Disabilities Trust is a nationwide charity offering specialist community-based and residential support for adults with acquired brain injury, complex physical or learning disabilities and for people with autism, including those in education. Working alongside those supported by The Disabilities Trust, their families and friends, local authorities, health authorities, housing associations and other organisation, The Trust provides leading-edge services, meeting the needs of people with complex and challenging disabilities.
The Disabilities Trust employs over 1,000 people, who work across the UK and we welcome the opportunity to respond to this inquiry on workforce burnout and resilience within social care. The last seven months have represented an unprecedented challenge for The Trust, those we support and our colleagues. However, during lockdown and throughout the pandemic our colleagues have worked exceptionally hard to maintain high-quality support to those in our services, whilst managing staff absences and stretched capacity. Before the coronavirus crisis, experts were warning about the fragility of the social care market, with a workforce vacancy rate of around 120,000 and fears this is set to rise as a result of Brexit wherein limitations will be put on workers trying to enter the UK1. Despite this, The Disabilities Trust and many other providers in the sector responded to the unprecedented challenges presented by coronavirus positively.
Workforce burnout and the need for resilience is not unique to the pandemic, with historic difficulties in recruiting, training and retaining NHS and social care staff, which has placed significant strain on the sector2.
As such, The Disabilities Trust are calling for:
Covid-19 and The Disabilities Trust:
During this uncertain period and with a second peak of the virus casting concern, it is vital the physical and mental wellbeing of the approximately 1.6 million people working within social care and 1.4 million people employed by the NHS is a priority3. To protect the wellbeing of our colleagues, The Disabilities Trust introduced several interventions, including:
The Disabilities Trust are also aware of the disproportionate affect of the virus on those of Black and Ethnic Minority (BAME) backgrounds. In their report published in June 2020, Public Health England (PHE) reported that after controlling for age, sex, deprivation and region, those of Bangladeshi ethnicity were twice as likely to die from Covid-19 compared to those of white backgrounds. Moreover, those of Chinese, Indian, Pakistani and other Asian, Caribbean and Black ethnicity were 10-50% at higher risk of death due to Covid-194.
Throughout the pandemic, social care and its workforce has felt less valued than their counterparts in the NHS. For example, policies which promoted rapid discharge from hospitals seemed to prioritise hospital capacity over care providers’ safety. The delayed Social Care Action Plan also contributed to social care providers and our colleagues feeling less valued than NHS staff. This was also evident in the Government’s distribution of PPE, which prioritised the NHS, and led to exacerbated shortages of equipment within social care and in inflated prices, which the social care sector nevertheless had to pay5. Guidance issued at the start of Covid-19 prioritised the NHS and didn’t provide adequate protections or recognition of the needs of social care staff. Even now guidance still does not adequately address the needs of supported living services or their staff.
Out of all the hardship which has stemmed from COVID-19, there needs to be a positive trend towards professionalisation and appropriate reward in the adult social care sector. While the workforce is resilient it is only as resilient as the funding and support behind it; hence the need for adequate long-term support for the sector. Ultimately, this support for the skilled and vital work of our colleagues will also ease demands on the NHS, benefiting both sectors.
The adult social care workforce is the sector’s biggest resource. Prior to coronavirus the sector faced adverse trends, including challenges with recruitment, retention and staff turnover. Maintaining the financial sustainability of social care providers is of critical importance in maintaining the capacity of the integrated health and care system and the resilience of the adult social care workforce.
The wider Social Care Sector:
Workforce burnout within the social care sector is not new to 2020. Difficulty in recruitment, training and retaining staff is a historical issue, resulting in a workforce shortage of 122,000 vacancies6. This is confounded by a high staff turnover of approximately 440,000 leavers per year7, all of which places enormous strain on the social care sector and those employed in it.
Whilst many of our colleagues would not report pay as the only reason they work in social care, comparatively low wages does not appropriately reimburse staff for their skilled work or the societal contribution they make. Whilst The Disabilities Trust pays its frontline staff above the national minimum wage, The Trust feels this does not adequately reward our colleagues and further impacts our ability to attract and retain hardworking and skilled staff. This is an issue which ultimately can only be addressed by Government, through additional funding for the sector, but also a long-term plan which recognises the invaluable contribution of those working within the social care sector.
1 Community Care. (2020). Post-Brexit migration plans ‘would spell disaster’ for social care, warn sector heads. Available at: https://www.communitycare.co.uk/2020/02/19/post-brexit-migration-plans-spell-disaster-social-care-warn-sector-heads/
2 The King’s Fund. (2019). NHS workforce: our position. Available at: https://www.kingsfund.org.uk/projects/positions/nhs-workforce
3 The King’s Fund. (n.d.). Overview of the health and social care workforce. Available at: https://www.kingsfund.org.uk/projects/time-think-differently/trends-workforce-overview
4 Public Health England. (2020). Beyond the data: Understanding the impact of Covid-19 on BAME groups. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892376/COVID_stakeholder_engagement_synthesis_beyond_the_data.pdf
5 BMJ. (2020). Covid-19: social care’s forgotten workers – they matter too. Available at: https://blogs.bmj.com/bmj/2020/07/02/covid-19-social-cares-forgotten-workers-their-lives-matter-too/
6 The Health Foundation. (2020). Health and Social Care Workforce. Available at: https://www.health.org.uk/publications/long-reads/health-and-social-care-workforce
7 Skills for Care. (2019). The State of the Social Care Sector and Workforce in England. Available at: https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/documents/State-of-the-adult-social-care-sector/State-of-Report-2019.pdf