My Worries About Adult Social Care

Last month the Skills for Care: Workforce Intelligence Group published its report on “The state of the adult social care sector and workforce in England”

A summary of some of the highlights of this report is contained in the infographic below.


Caroline Abrahams, Charity Director, Age UK in their recent Blog about this report shares many of my concerns.

About 130,000 new workers are needed each year just to keep the number of care workers in balance with the number of workers we need already. This figure though masks an even bigger problem that faces us in the future.  The numbers of over 65’s in England will increase by 2035 from the current 10 million to around 14.5 million people (about 44%). If the balance between the numbers of older and disabled people remains the same then around 650,000 extra recruits will be needed in adult social care by 2035.

The situation in Scotland is very similar. In March 2018 Scottish Care released a report into the situation in Scotland called The 4 R’s Report it highlighted that the care sector in Scotland is also experiencing a severe recruitment and retention crisis. Care homes employ almost 5,000 nurses (approximately 10% of the total nursing workforce in Scotland) but data included in Scottish Care’s Independent Sector Nursing Data report suggested that there is a care home nurse vacancy level of 31% – up from 28% in 2016.

Approximately 6% of the care home workforce originate from the European Union and a further 6% from other countries. In relation to nurses, this EU figure increases to nearly 8%. Although not directly comparable the English report gives a real figure for their sector pointing out that 104,000 jobs are filled by people with an EU nationality.

As we stumble towards a Brexit cliff, our departure from the EU is bound to have a  significant impact on the care home sector labour market and area of the economy that we are already struggling to recruit to. So its time for action. Care workers play an absolutely vital role in the lives of many older and disabled people and we know we haven’t got enough of them to meet demand even now.

It’s not too late for the UK Government to look again at how care workers from the EU should be treated now and after Brexit. There are many good reasons to reject the notion that Adult Social care is a low skilled job that merits only low pay. Providing care to people in our communities is an essential occupation, on which increasing numbers of older people and disabled people depend.

Age UK has just written to the Home Secretary to urge the Government to exempt care workers from the rules around so-called low skilled workers from the EU post-Brexit. Let’s hope the government are listening, although there is no sign yet… See Business leaders warn of Brexit impact on social care following policy announcement






Why is it Hard to Talk About Dying?

Last week the Royal College of Physicians (RCP) released a new report that explores the reasons why doctors and other healthcare professionals find it hard to talk to their patients about dying.

The report called “Talking about dying: How to begin honest conversations about what lies ahead” is downloadable RIGHT HERE

The RCP report is based on conversations with doctors at all levels, patients and carers, and medical organisations and reveals the barriers that stand in the way. It offers some solutions and resources to help, including a ‘mythbusting section’ debunking common but erroneous beliefs that we have about these kinds of conversations

Four English hospitals leading the way in supporting end-of-life care (EOLC) have contributed good practice case studies to the report.

One of the major issues identified within this report and the one that much of the UK media is reporting most frequently is the need for healthcare professionals to begin conversations about planning for end-of-life care nearer the time that patients are given a terminal diagnosis. They point out as would I, that there are multiple opportunities in a patient’s healthcare journey to start honest conversations even earlier than this, when discussing future goals and treatments whether that’s at outpatient appointments, hospital admissions, in social care settings or best of all out in the community.

And why are these conversations so important?

Because the sooner we have these early conversations the sooner we are allowing those we care for opportunities for choice and control over the remainder of their lives. Like many others I would call for anyone with a known life limiting illness to consider creating an Anticipatory Care Plan to manage their health and well-being at the earliest opportunity. Why is explained quite nicely in the video.

Scotland’s Anticipatory Care Planning Toolkit is accessible HERE

For more about this topic its also worth taking a look at the Death Cafe site

Maybe this will inspire you to host your own community Death Cafe!

“The Care Home Journey”; a New Resource


Last month the Royal College of Nursing (RCN) launched a new resource for nursing staff based in care homes. With over 30,000 nurses in the UK working in care homes and care homes having a greater number of beds that the NHS then a resource that is designed to bring evidence based information to nurses working in this sector interactively is long overdue.

The resource called “Care Home Journey: An online resource to support nursing care in older peoples care homes” aims to bring together evidence based guidance on on typical clinical and social problems that care residents might experience. It presents this information through the use of 3 characters whose journey’s you can follow.

They are John, Seema and Jane. and the journey’s go all the way from pre-admission to end of Life Care.  Each section of the journey demonstrates the role of nursing staff when supporting the resident, their families and nursing colleagues at each stage in the fictional resident’s journey. Worth an explore if you are working in this sector since the resource is both FREE and Open Access.

To access the resource CLICK HERE


In Advance of Armistice Centenary Day

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St John’s Ambulance Brigade Nurse 1914

This year Remembrance Day on the 11th of November will mark the 100th anniversary since the end of the First World War. As part of the commemorations, Britain and Germany are joining in a call for bells of all kinds to be rung globally (at 12.30 hrs GMT/13.30hrs CET/12.30 local time) to replicate the outpouring of relief when 100 years ago the guns finally fell silent. The US Centennial Commission has already made a similar appeal to Americans.

For other events and activities taking place to mark the Centenary the following website is useful, click here on  Centenary News.

Of particular interest to me is a  Royal College of Nursing (RCN) online exhibition showcasing the lives of nursing staff during the First World War, which won the Women’s Network History Award for 2018. Called “Service Scrapbooks: Nursing and Storytelling in the First World War” this project digitised and transcribed photographs poems diary entries and illustrations ranging for 1909 to 1919. To go to it click here

this new archive contains a collection of digitised slides from Scottish Women’s Hospitals which is a haunting glimpse into life in a field hospital 100 years ago.

A very moving archive full of personal views of the war by nurses who were there.