26 May 2023

Capacity and workforce survey 2023

Over half of homecare providers are delivering less care than last year despite increasing demand for care   

New research by the Homecare Association has demonstrated the challenges facing the health and social care system, with over half of providers (54%) reporting that they are delivering less care than this time last year. This is despite almost three-quarters (74%) of providers stating that the demand for homecare had increased since the beginning of 2022.

Homecare providers have also seen a significant increase in demand for hospital discharge services – nearly two-thirds (64%) suggested there has been a rise in the quantity of care packages for people who were being discharged from hospital. Furthermore, 71% felt that there is an added time pressure to ensure a care package is arranged.

People leaving hospital need more complex care than before the pandemic, with more than half (56%) of homecare providers agreeing that more complex tasks were now being commissioned by the NHS.

The impact of the pressures on the health and care system is being felt by those who need healthcare, with 85% of providers saying that the people they support were finding it more difficult to access healthcare than this time last year.

Despite the thousands of people stuck in hospital awaiting discharge, 46% of private-pay providers had expressed an interest in providing homecare for discharge services but were not commissioned.

Homecare Association’s CEO, Dr Jane Townson OBE, said:

“Vacancies in homecare services in England are at 13%, more than four times the average for all jobs in the UK. Homecare simply cannot meet the increasing demand for support and providers have no choice but to turn down work as they cannot recruit the staff they need. Sadly, thousands of people are waiting for care in the community or are stuck in hospital when they could be at home if care were available.

“We saw the lack of capacity in homecare impacting on the NHS last winter. Without adequate investment, we are concerned that, this year, there will be even more people waiting for help in the community or whose hospital discharge is delayed, leading to dangerously high ambulance and A&E wait times on top of growing waiting lists for diagnosis and treatment, which are already at over 7 million.

“Some regulated providers have capacity to accept people waiting for discharge from hospital but are not being commissioned. In some cases, this is because councils or the NHS will only work with providers they normally contract with. In other cases, it is because providers are unable to accept council or NHS fee rates that are too low even to cover the direct costs of staff wages at the national minimum wage or the other costs of running a homecare agency. In our view, public bodies should be funded to pay fee rates that enable compliance with NMW, good-quality services and the financial sustainability of providers.

“Without proper investment in homecare, which would improve careworkers’ pay and terms and conditions of employment, we will not be able to meet the growing demand for care, extend healthy life expectancy, reduce inequalities, take pressure off the NHS and reduce costs for the health and social care system.”

The Homecare Association calls on the government to:

  1. Provide adequate funding to local authorities to enable them to pay a fair price for care, so that careworkers can receive wages equivalent to Band 3 healthcare assistants in the NHS with 2+ years’ experience. According to the Homecare Association’s Minimum Price for Homecare 2023-24, this would require an hourly fee rate of at least £28.44.
  2. End the practice of local authorities and the NHS purchasing homecare ‘by-the-minute’, alternatively focusing on achieving the outcomes people want, enhanced by technology solutions.
  3. Work with the sector to develop a credible 10-year workforce strategy for social care, aligned with the NHS People Plan.

Read the full research here.