UK government risking Highland care sector over its national insurance and overseas staff policies amid fears of a ‘catastrophic’ loss of provision
The Highlands’ troubled care sector faces the “catastrophic” loss of “swathes of social care provision” due to two UK government policies, according to a new report from Highland Council and NHS Highland.
The council and health board’s joint monitoring committee will be asked this week to add two new items to its risk register – Employers National Insurance Contributions (NIC) and UK government plans to end overseas recruitment of staff.
It is the latest among a flurry of warnings going back months that the sector is in deep trouble and the failure of adult care in the region could have a major impact on allowing the NHS to function.
The additions are suggested by committee member and Highland Home Carers boss Campbell Mair who believes that both NIC and ending overseas recruitment could dramatically undermine the sector.
The risk register tracks projects, initiatives or issues and highlights risks faced in delivering the service graded by likelihood of happening and by their impact or consequences.
At the moment there are three graded ‘Extreme High 25’ which is the second highest or worst type of risk.
The first is workforce amid “challenges in recruiting to vacant posts” which “may result in a failure to deliver all services to at least statutory minimum levels” and that could have a “significant impact on their health, safety and wellbeing”.
Then there is Care Home Viability as many providers struggle to break even so closures result in “a reduction in capacity to provide care services which leads to a risk that service users' health and social care needs are not being met”.
Also, Out of Hours Care at Home delivery foresees “inadequate/no contingency in parts of NHS Highland to adequately provide cover outside normal business hours” means some who need care seven days a week may not get it.
Part of his argument for both NIC and overseas recruitment is that there needs to be a clear understanding of the risks both pose and refute misconceptions.
Mr Mair said: “National data confirms that nearly half (48 per cent) of providers note the very real possibility of service closure as a result of this [NIC] increase. The failure to recognise and account for the impacts of these changes on social care organisations raises further concerns about the lack of value placed on social care and awareness of the perilous sustainability of the sector.
“It is no exaggeration to say that we will lose swathes of social care provision in Highland unless urgent, practical, and resource-based solutions are progressed for the sector.
“If not, the impact on individuals, communities and public services will be catastrophic.”
Then there is the issue of UK government visas and immigration which sparked concerns across when the politicians said overseas recruitment could end.
“As a sector, we have expressed deep concern over the UK government’s consideration of ending overseas recruitment for social care workers entirely,” he said.
“Such a move would be profoundly damaging to Highland’s social care sector and fails to recognise our distinct demographic and workforce challenges. Our social care sector is already under immense strain, and international recruitment is no longer a luxury but a necessity.
“There is a dangerous assumption that the skilled work of care can be undertaken by anyone - this is not true. Care work requires people who want to care and, who have the compassionate skills, and right attitudes to do so.
“The biggest impact of these immigration changes will be felt by people who depend on care and support every day. In effect, these proposed changes are a direct risk and threat to the many hundreds of vulnerable adults who rely on care and support to live their lives.”
Mr Mair told us: “The wider issues here relate to pay and non-pay inflation pressures and realities, all of which are outwith our sector influence or control (eg NIC), and the lack of financial support to meet the rising costs – unlike other sectors, we do not have a ‘price’ that can simply be inflated to react to cost pressures; we live in the world of ‘the funder and the funded’.
“The irony is that it is the public purse, albeit sometimes at UK level, who often are the drivers of pay and non-pay inflation (eg NIC), and yet the same public purse (who fund adult social care in our case wholly) does not then address the need to build these inflation pressures into the funding model.”