Today, the Homecare Association welcomed the appointment of the Rt Hon. Stephen Barclay MP as the new Secretary of State for Health and Social Care.
We wrote to urge him to prioritise support for homecare this winter and commit to progressing social care reform, including addressing social care funding.
We pointed out that investment in homecare will allow us to grow and develop the workforce and innovate, so we can enable people to live well at home, extend healthy life expectancy, reduce inequalities, take pressure off the NHS, ensure people remain economically active, and reduce costs for the health and care system.
Demand for homecare is far outstripping supply, with many providers constrained by severe challenges with retention and recruitment of care workers. This is contributing to long waiting lists for care in the community, increased ambulance response times, and NHS waiting lists of over 7 million for diagnosis and treatment.
We explained that at least 70% of homecare hours are purchased by local authorities and NHS Clinical Commissioning Groups (now Integrated Care Boards). Unfortunately, due to years of chronic underfunding of social care by central government, the fee rates many public sector organisations pay for homecare are substantially below the costs of compliance with the legal minimum wage and provision of high quality and sustainable services. This means that the income of many providers is effectively fixed by the government and they have little room for manoeuvre.
With the cost-of-living rising and a tight labour market, homecare providers are simply unable to compete for workers with retail, hospitality and the NHS. Fuel prices have been almost 50% higher than last year and remain high. This is having a particularly negative impact on homecare workers, who collectively drive an estimated 4 million miles per day to support people in their own homes.
The £500m announced to support hospital discharge and workforce; and the £15m announced to support international recruitment in the Plan for Patients is welcome. Whilst we are grateful for any additional funds, without long-term investment in homecare, this short-term funding won’t address underlying problems.
We welcome the reform agenda and the Government’s work towards ensuring a Fair Cost of Care. We hope the cost of care exercises will provide clear official data on the quantum of funding needed to ensure fair pay and terms and conditions of employment for careworkers; improved outcomes for people drawing on services; and market stability. It is imperative that this work is progressed swiftly and published for public scrutiny
We call on the Secretary of State to address the following priorities:
- Invest in homecare to build workforce capacity – ensure that funding is available to meet the true costs of delivery and retain a skilled, competent and compassionate workforce.
- Workforce strategy – develop a credible, funded 10 year workforce strategy.
- Fuel costs and winter pressures – the sector needs an extra £107 million p.a. to cover the 50% rise in fuel costs over the last year. Additional costs are likely to arise due to the circulation of COVID-19 and flu. We ask for grant funding to support these.
- International recruitment – any changes to international recruitment need to address the complexity, cost and speed of the process.
- Digital transformation of homecare – If 80% of care providers are to be using digital care records by 2024, substantial support is required. Providers need reliable, affordable software solutions they can trust. Transition from paper to digital comes at a cost, both in terms of staff time and finances, and many providers lack the expertise or confidence needed.
Home-based support and care play a vital role in enabling us all to live well at home and flourish in our communities. We look forward to working with the new government on enabling everyone to live well at home.
