On adult social care – praise for Scottish Government but ‘bewildered by the lack of urgency’ in Westminster!

It’s worth sharing findings from a Nuffield Trust article (16 February 2023) on severe challenges facing the adult social care sector and how these are being addressed – or not – by governments across the nations of the UK.

See https://www.nuffieldtrust.org.uk/news-item/addressing-social-care-workforce-challenges-what-can-england-learn-from-wales-scotland-and-northern-ireland

We learn ’All four UK countries are struggling with workforce pressures and it’s clear that none have successfully tackled the issue. But it is striking that the Migration Advisory Committee has singled out England for its inaction, warning that “the conditions now faced by the social care sector are unsustainable”. In contrast, the committee has commended Scottish and Welsh governments for their “clear action” to address pay and professional status of staff working in social care.’ (my emphasis)

This is what the Migration Advisory Service (MAC) stated in the Foreword to its Annual Report (December 2022):

‘We completed our enquiry into the impact of the ending of Freedom of Movement on the Adult Social Care Sector in April and submitted the report to Government and Parliament. … our main recommendation was that a minimum rate of pay should be established for care workers at a premium to the statutory minimum wage where care is being provided with public funds. We suggested that this should initially be set at £1 per hour above the National Living Wage but expected a more substantial premium to be needed to properly address the crisis in social care recruitment and retention. It is deeply disappointing that the (UK) Government have still not responded to our report.

‘We note that the Governments of Scotland and Wales are taking clear action to address low pay in the sector and are bewildered by the lack of urgency exhibited by the Department of Health and Social Care.’

Source: ‘Migration Advisory Committee (December 2022) MAC Annual Report (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1133466/MAC_Annual_Report_2022.pdf )

The Nuffield Trust researchers highlight that: ‘the most striking difference between England and its neighbours is the absence of a national workforce regulator to introduce qualifications and a mandatory register for a majority of people working in social care. Workforce regulators in Scotland, Wales and Northern Ireland have driven a number of improvements in the terms and conditions for social care staff, with Scotland and Wales taking steps to address poor pay by increasing minimum hourly wages for people working in the sector.’

The article provides useful insights into the different approaches taken by governments to pay: ‘All three of England’s UK neighbours have also nationally awarded one-off bonuses to staff in recognition of their contribution throughout the Covid-19 pandemic. Despite recommendations to the DHSC by the independent Social Care Covid-19 Support Taskforce, in England one-off Covid bonuses were instead provided at the discretion of local authorities and providers, leading some to question the absence of a nationwide bonus for all staff.’

Presumably this ‘discretion’ allows the Westminster government to avoid providing additional financial support to local authorities and providers in England. And as this relates to a devolved matter, it means that governments in Edinburgh and Cardiff are denied any consequential financial benefit. 

The article compares and contrasts minimum pay levels across the UK (based on April 2022 data):

• the Westminster government sets the pay for staff working in adult social at the level of the ‘National Minimum Wage’ viz. £9.50 per hour – a similar rate pertains in NI
• the Labour Welsh Government sets this at the level of the ‘Real Living Wage’ viz. £9.90 per hour
• in Scotland the minimum pay is £10.50 per hour.

Again in contrast to the Westminster government’s stance in England: ‘While none of the UK countries have it sorted (as indeed do few others around the globe), Scotland, Wales and Northern Ireland have at least laid the foundations for long-term workforce reform. The creation of a national register for staff working in social care in the other UK countries feels like a first step to giving social care work the visibility, status and identity it so often lacks.’

‘… England appears to be several steps behind its neighbours in grasping the scale of the problem, as it continues to inject short-term pots of cash that do not offer the longevity the system needs to durably solve the workforce crisis.’

In another Nuffield Trust report (September 2022) on the subject of the adult social care sector we read this: ‘The day-to-day working terms and conditions of care workers in England need urgent attention. Countries around the world have sought to address precarious employment and improve conditions in a variety of ways. New Zealand funds home care workers’ travel time and travel costs, while Germany has introduced childcare grants and additional days of annual leave. Scotland is distinct in the UK for requiring providers to take staff wellbeing into account in their staffing decisions.‘

Source: https://www.nuffieldtrust.org.uk/research/new-horizons-what-can-england-learn-from-the-professionalisation-of-care-workers-in-other-countries