NAO criticises DHSC for lack of workforce strategy
Department of Health and Social Care (DHSC) has not published a workforce strategy for the past nine years and cannot demonstrate that the sector is sustainability funded, according to a National Audit Office (NAO) report published today.
The Adult Social Care Workforce in England also criticises local and regional bodies for not taking the lead on workforce planning in the absence of a national strategy.
This has led to high staff turnover rates (27.6%) and vacancy levels (6.6% rising to 9% for nursing staff), the growth in the number of jobs falling behind demand for care and public perception of care roles as low skilled and offering limited opportunities for career progression.
NAO head Sir Amyas Morse said: ‘Social care cannot continue as a Cinderella service – without a valued and rewarded workforce, adult social care cannot fulfil its crucial role of supporting elderly and vulnerable people in society.
‘Pressures and demands on the health and social care systems are increasing, so the Department needs to respond quickly to this challenge by giving the sector the attention it deserves and needs, instead of falling short and not delivering value for money.’
An investigation by the Government spending watchdog found that the DHSC’s last strategic document (Working to put people first: the strategy for the adult social care workforce in England) was published in 2009, can only be found on the National Archive website, refers to roles and bodies that no longer exist.
Furthermore, Health Education England’s draft workforce strategy for health and care to 2027, published in December, was ‘short and lacking detail’ when it came to adult social care. However, the DHSC is working with Skills for Care on a consultation exercise to inform future strategies. Any future strategy ‘will require the roles of the various bodies involved in delivering care to be more clearly defined and agreed across the sector’, NAO said.
It continued saying uncertainty over sustainable funding was making workforce planning difficult, with council spending on social care falling by 5.3% in real terms between 2010-11 and 2016-17. A further 0.2% drop is expected by 2019-20 despite rising demand for services and the increased cost of the National Living Wage.
The report states: ‘The sector remains concerned that there is no certainty about whether the extra £2bn in government funding for social care between 2017-18 and 2019-20 is a permanent increase. Uncertainty over the sustainability of funding makes it difficult for local authorities to plan how much care, and at what price, they will be able to purchase. This affects providers’ ability to undertake workforce planning.
‘The Department should establish how much funding the sector will need over the long term and make the consequences of any funding gap clear. The Department should consider sharing its modelling of cost and demand pressures on the care sector to help commissioners set appropriate fees for providers; this includes the costs arising from future changes to the National Living Wage.’
In addition, the DHSC should encourage local authorities and CCGs to produce workforce strategies that complement national plans, including liaising with other statutory bodies such as Jobcentre Plus offices.
Current initiatives, both national and local, to support recruitment, retention and development need to have a bigger impact, with successful ones increased in scale, concludes NAO.
Chair of the Housing of Commons Public Accounts Committee Meg Hillier said the report showed the social care workforce is in a precarious state. ‘The Department of Health and Social Care needs to address these issues urgently’, she said. ‘To date it has done little to help councils and providers prevent a looming workforce crisis.
Colin Angel, policy director at the United Kingdom Homecare Association, responded to the findings saying: ‘The National Audit Office rightly calls time on the Department of Health and Social Care’s consistently “hands-off” approach to the social care market and its workforce.
‘The absence of a published strategy for the social care workforce highlighted by NAO should be an embarrassment to Government, but a strategy is only useful if it leads to decisive action.
‘Government has given increasing responsibilities to councils to shape their local care markets, while councils argue that they have insufficient funds to do so. UKHCA continues to urge Government to ensure that social care is properly funded and that there is independent oversight of councils’ commissioning practices and their effects on the social care workforce. Government must finally tackle the growing crisis in social care head-on.’
Chief executive of Care England, Professor Martin Green, said the report showed ‘yet more evidence that the social care system is fit to burst and that the Government is not doing enough to support the social care workforce’. He said: ‘Workforce is the most valuable asset to care providers and they need to be able to support, develop and pay them appropriately’.
‘No more reviews, no more consultations; let Government press ahead with all the necessary partners, to provide some much needed direction to a sector that is struggling.’
Cllr Izzi Seccombe, chairman of the Local Government Association’s Community Wellbeing Board, added: ‘Councils can’t plan for the future due to uncertainty over funding and an annual £2.3bn shortfall that adult social care will face by 2020.’
A Department of Health and Social Care spokesperson told CM: ‘We recognise there are challenges in the social care workforce – that’s why we’ve launched a consultation on the adult social care workforce and committed to publishing a health and care workforce strategy in the summer. At the Spring Budget we provided an extra £2 billion funding to the sector and we have just announced a further £150 million for 2018-19. We will publish plans this summer to reform social care to ensure it is sustainable for the future.’
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