The NHS workforce plan: Bridging the social care gap

The NHS has unveiled its comprehensive long-term workforce plan, outlining a strategic path to strengthen the healthcare workforce through innovative training, retention and transformative reforms

However, a notable omission from this blueprint is an NHS Workforce Plan for social care.

The plan, rooted in the challenges of an ageing population, foresees an impending strain on healthcare. With the elderly population, specifically those aged 85 and above, projected to surge by 55% by 2037, a potential shortage of 260,000 to 360,000 NHS staff members by 2036-37 looms.

This imminent staffing gap underscores the criticality of home care, as a substantial number of the elderly express a preference for care within their own homes.

While the NHS workforce plan embodies a progressive stance towards healthcare transformation, the absence of social care from its long-term vision prompts a serious conversation.

This omission raises compelling questions about the government’s rationale for excluding such a vital component.

It underscores the urgency of adopting a more inclusive and far-reaching strategy, one that resonates with the needs of the population and ensures the creation of a sustainable framework that caters to the holistic well-being of every individual.

The plan is a glass half-empty without any strategy about social care

The NHS is a vast body that oversees many subdivisions. But social care, despite its distinction from the NHS, has to be an inclusive part of this workforce plan. Without a unified vision for health and social care, it will be much harder to meet the “evolving challenges […] that the next 15 years hold”.

The plan itself directly acknowledges the inherent interconnectedness of the two factions in its scope and key considerations. It notes the “pressure in social care, which impacts patient flow through the healthcare system and builds demand by increasing the burden of disease and complexity of conditions over the longer term.”

This makes it more unacceptable that social care isn’t treated as an equal partner in the strategy. As the authors go on to acknowledge, for the plan to succeed it needs to be backed by government support in wider areas. When it comes to social care provision, it expresses that:

“Health and care services are interdependent, and if efforts in this Plan to tackle the current challenges in the NHS are to yield success, then capacity needs to increase across both. This Plan is predicated on access to social care services remaining broadly in line with current levels or improving.”

This exclusion of social care is even more evident when the plan sets out its case for change, highlighting again how “workforce challenges in adult social care mean that meeting people’s physical and mental healthcare needs at home or in the community is challenging, leading to poorer health outcomes and increased likelihood of hospital admissions.”

So, if it was included specifically, how could these needs be met? For this, we have to look at the collaborative role played between government entities and technology providers.

Incentivising tech providers with government support

A growing demand for home care alongside staff recruitment challenges and the aforementioned ageing population are all creating a cocktail of complex challenges for social care.

Technology can be used to mitigate some of these challenges as it provides a means to digitise workflows, effectively allocate resources and increase efficiency. Without it, it will not be possible to tackle these workforce burdens – some say easily, but I believe it will be near impossible.

Consequently, a major part of reducing the workforce shortage is elevating the role of collaborative efforts between government entities and technology providers; and specifically, for the government to incentivise such providers to improve their work.

Steps are being made towards this. In May this year the government released a framework outlining “what good digital working looks like for care providers and local authorities”, including offering guidance on how these organisations can support the objectives of their integrated care system (ICS) (more on that later).

Yet this is advice specifically for care providers and individuals running digital transformation projects rather than for the technology providers themselves.

There is scope for a fund, programme or initiative to incentivise technology providers to improve on their offerings and collaborate with both care and other technology providers. That way, they can then also start to bridge the social care gap.

For example, this could involve using grants to stimulate healthy competition between technology providers offering their services to home care agencies, providing funding to aid research and development and reduce the implementation costs of technology.

And the research itself could be specifically tailored to finding optimum ways of delegating workload and alleviating workforce pressures on a wider scale, for instance. This all works towards creating a more joined up and collaborative social care system.

ICSs: Will they achieve the necessary steps for integrating health and social care?

Without having a comprehensive overview of workforce resources in both the NHS and social care, decision-makers are deprived of the whole healthcare picture. The omission of social care from the NHS Workforce Plan further amplifies this gap, questioning the cohesiveness of the entire healthcare strategy.

Without this crucial information, the challenge of effectively distributing resources at local, regional, and national levels becomes considerably more daunting.

To holistically address the healthcare landscape, it is imperative that the government establish a robust and inclusive social care plan, thereby ensuring an integrated and well-informed approach that benefits the entire population.

Health and Care Act makes considerable changes

Last year, the Health and Care Act made a considerable leap in addressing these issues by facilitating the rollout of ICSs, establishing 42 across England. This followed a framework proposed by NHS England the previous year after the challenges of the pandemic.

Essentially, an ICS comprises partnerships of various organisations who collaborate to deliver health and care services for a specific area. Each ICS has its own statutory Integrated Care Board (ICB)  – responsible for planning, budgeting and arranging the provision of services in the ICS area – and Integrated Care Partnership – a broad alliance of partners responsible for strategy.

One of the keys to integrating health and social care in a constructive and beneficial manner involves creating a level playing field between the NHS, local authorities and wider care providers. As the King’s Fund highlighted before the Act was passed, history shows previous attempts to integrate health and social care have largely been dominated by the NHS. In light of the government review into ICSs earlier this year, this concern is still apparent.

Current divide between health and social care

These are all ambitious plans, but do they specifically address the current divide between health and social care? Will they effectively encourage equal collaboration between all providers, or will they simply create further bureaucracy and allow the bigger players involved to dominate?

Any regulation that seeks to foster collaboration, use of advanced technology and allocate resources more effectively is a positive move. The workforce plan is a bold and impressive undertaking, and ICSs hold much promise. To thrive, these undertakings must be backed by government incentives for care technology providers.

Social care has to be considered in all planning alongside health care. These cannot be treated as two separate entities. So, to circle back to the beginning, where is social care in the plan? It’s mentioned, but it needs to be integrated.

This piece was written and provided by Josh Hough, Managing Director and Founder, CareLineLive