The dire warning came in a letter to Boris Johnson and is the clearest sign yet that fear of a second Covid wave is growing. It was sent yesterday, more than a year after Mr Johnson stood on the steps of Downing Street and promised to fix social care “once and for all”. Signed by members of the Health for Care coalition, chaired by the NHS Confederation, the letter said: “With the potential of a second wave, localised outbreaks, and the challenges of winter ahead, we are now gravely concerned about the ability of social care services to cope.
“These difficulties will be compounded by the need to simultaneously provide care and rehabilitation to patients suffering from the longterm effects of Covid-19 and those who have not had [Covid] but have experienced a decline in health as a result of shielding during lockdown.”
Frustration at the lack of Government action to fix the crisis comes after 13 documents during the past 17 years have promised social care reform.
The majority of people using social care have dementia and the impact on the NHS is huge.
Niall Dickson, chair of the Health for Care coalition, said: “Covid-19 has highlighted the critical role social care plays in supporting the NHS, but it has also exposed a fractured, understaffed and underfunded system in desperate need of reform.
“Social care services urgently need immediate funding to deal with the aftermath of the pandemic and to prepare for the possibility of further localised outbreaks, as well as a long-term plan.”
Latest figures show more than 50,000 patients had been waiting more than a year for their operations, compared with fewer than 2,000 in February.
Estimates suggest the waiting list for routine procedures could be as high as 10 million by the end of the year.
Meanwhile, the number set to be struck down with dementia is expected to double to two million in just 30 years.
Kate Lee, chief executive at Alzheimer’s Society, said: “Coronavirus has provided a sobering wake-up call for just how poor a relation social care is to the NHS – clearly exposing the deep-rooted cracks in our care system.”
The Department for Health and Social Care said: “We are committed to bringing forward a plan that puts social care on a sustainable footing to ensure the reforms will last long into the future.”
BLUEPRINT FOR A BETTER SYSTEM
The academics made the following demands in their letter to the Prime Minister:
- Eligibility should be based on need and widened to include both older people and those of working age with unmet or under-met need.
- We need a workforce strategy that encompasses health and care, tackles the recruitment and retention crisis in the sector and addresses the serious inadequacies in pay, training and career progression for social care staff.
- We need a set of measures to support unpaid carers which recognises their huge contribution to the economy.
- The Government must seek to build stronger ties between the health and social care sectors and between them and the wide array of community, voluntary and third-sector providers.
Comment by Donal O’Donoghue
The challenges with social care are long-standing ones, but Covid-19 has thrown a spotlight on the problems we face as never before.
It has long been said that we need greater integration between health and social care, but this alone will not mean fewer patients needing to go to hospital, reduced waiting times, nor the end of delays to patients being discharged.
Adequate additional funding is needed to provide enough hospital beds and meet the demand in social care.
Covid-19 has magnified the problems with social care and shown that the Government must place social care on a sustainable footing immediately.
Any new settlement should provide secure funding to enable the social care system to operate effectively and develop in the long term. It must meet the needs of those people who rely upon it and make sure we don’t find ourselves in a similar situation in 10 years’ time.
Social care and NHS workforce planning needs to be joined up and must consider the needs of the whole system.
One aspect that needs to be considered urgently is how the future immigration system supports social care providers to recruit internationally.
The health and social care system is reliant on staff from outside the UK, so we must create a welcoming environment that values the contribution of workers from across the world.
Donal O’Donoghue is the registrar of the Royal College of Physicians
