Leaders of care associations in England, Scotland, Wales, Northern Ireland and the Republic of Ireland met in London on 4 and 5 October 2021, for the first time since the start of the pandemic. http://www.fivenationscareforum.com/

Reflecting on the invaluable role of our care workforce in making a positive difference to the lives of others, and on their vital contribution to economic growth, we renewed our collective commitment to improving their working lives.

Throughout the darkest days of the COVID19 pandemic, care workers kept going, focusing relentlessly on the safety and well-being of others.

Now there is requirement for Governments to engage with this vital healthcare workforce to ensure they are positioned to focus relentlessly on investing in them.

In Scotland and Wales, careworkers have each been given bonuses of £500 or more in recognition of their outstanding commitment during the COVID-19 pandemic. In Northern Ireland there is commitment to do the same. The Governments of England and the Republic of Ireland have declined to acknowledge the exceptional contribution of the care workforce. Whilst the bonuses have been very much appreciated by careworkers, one-off payments of this nature do not solve underlying issues.

Increasing pay, terms and conditions of employment for the workforce, so they are on a par with equivalent roles in State-provided health services is a priority. The pandemic should signal an end to the discrimination applied by Governments towards employees in the independent and voluntary sectors who are fulfilling vital roles in caring for older and disabled people at home or in the community.

News of the Scottish government’s announcement on 5 October 2021 that wages of careworkers in Scotland will rise from £9.50 per hour to £10.02 per hour, equivalent to Band 2 healthcare assistants in the NHS, was warmly welcomed and heralded as a lead other Governments in the UK and Ireland should follow.

A recommendation by the Low Pay Commission to increase the UK’s national legal minimum wage to £9.42 per hour, which will likely be accepted by government, is another step in the right direction for UK healthcare providers. But these are far more than minimum wage jobs and we need to go further to attract, retain and develop a talent pool for the future. Irish representatives emphasised the critical requirement to review pay levels in the sector.

Recent analysis by the Health Foundation suggests we need over 600,000 additional careworkers in the UK in the next decade to meet needs, on top of the 1.5 million we already have. Over 20,000 healthcare assistants alone will be required to meet demand for services in Ireland in the next ten years.

As a society, we must recognise and fairly reward the enhanced skills and experience required by careworkers to support highly dependent older and disabled people with complex health and social needs.

There is urgent requirement to invest in training and upskilling care workers in social care. Careworkers and managers must be trained in numerous areas including medicines management; frailty; reablement; dementia care; end-of-life care; catheter and stoma care; wound care; care of people with specific conditions such as diabetes, Parkinson’s disease, multiple sclerosis, motor neurone disease, epilepsy, autism and learning difficulties. They must understand safeguarding; infection prevention and control; falls prevention; food hygiene; health and safety; and fire regulations. They also require skills in leadership, management, finance, marketing, planning, customer relations, communication, influencing, negotiation, conflict resolution and de-escalation. And increasingly they are also expected to be experts in technology solutions in care. These roles are not just about helping people get out of bed or cooking.

If the United Kingdom and Ireland are going to shift towards higher wage, higher productivity economies, and reduce inequalities, it is essential to focus on the social determinants of health, rather than just healthcare per se. Social care plays a pivotal role in improving the way we all live our lives.

International evidence shows there is a direct relationship between healthy life expectancy and GDP per capita. And that the tradable economy cannot function effectively without a strong foundational economy.

Investing in our care workforce is a key part of investing in our health and wealth as nations.

The Five Nations Care Forum calls on the Governments of the UK and Ireland to:

  1. Fund social care adequately so that careworkers are paid fairly for the skilled roles they perform, and at least on a par with equivalent public sector roles.
  2. Support development of an expert-led workforce strategy for social care and a 10-year workforce plan, aligned with the NHS People Plan in the UK. In Ireland, the Government’s Health Service Capacity Review and ESRI projections emphasise the urgent need for stakeholders to bring together a workforce strategy, with shortages in homecare workers already manifesting across the country. The Government must also publish the terms of reference for the Social Care Workforce Advisory Group announced by Minister Butler at the HCCI conference last week.
  3. Recognise current national needs and regional variation in demography and workforce and explore placing social care on the Shortage Occupation List.
  4. Create a professional register for careworkers in England, in line with Scotland, Wales and Northern Ireland. Registration of careworkers needs to be adequately funded and carefully implemented. In Ireland, regulation of homecare must remain a Government priority and bring better State resourcing for homecare workers.