The NHS will not have any hope of clearing the backlog of routine operations unless there is a comprehensive and funded plan to support social care services through the winter months.
That is the stark message from leading health organisations who are warning that patients will end up stranded in hospital because arrangements are not in place in the community or in care homes to support them. Also, they fear more patients will end up in emergency departments because they have not been able to access the personal care they need to keep them safe and independent in their own homes.
In a letter to Boris Johnson, the health leaders call on the Prime Minister to honour his pledge to fix social care ‘once and for all’ and to set out a timetable for reform which addresses both the immediate crisis and the need to put these services on a sustainable footing.
The letter, signed by members of the Health for Care coalition, which is chaired by the NHS Confederation, asks for immediate action.
“With the potential of a second wave of COVID-19, 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 long-term effects of COVID-19 and those who have not had COVID-19 but have experienced a decline in health as a result of shielding during lockdown.”
This move comes as the NHS has been set very stretching targets for resuming services which had to be paused during the first stage of the coronavirus pandemic.
Health service leaders were already concerned that the targets looked unrealistic, given workforce vacancies, exhausted and burnt out staff and the fact that many services are having to operate at reduced capacity because of the need for social distancing and infection control.
The scale of the challenge is enormous. In June, more than 50,000 patients had been waiting more than a year for their operations, compared to fewer than 2,000 in February.
Independent analysis estimates that the waiting list for routine procedures could be as high as 10 million by the end of the year.
Niall Dickson, chief executive of the NHS Confederation and chair of the Health for Care coalition, said:
“COVID-19 has highlighted the critical role that 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, which successive governments have failed to deliver.
“Without this, the NHS will be fighting with one hand tied behinds its back.
“The Prime Minister has promised to ‘fix social care’, we now need that promise fulfilled.”
In a report out today (Wednesday 19 August), the NHS Confederation has also set out what will be needed to make sure social care can support the health service effectively. The report calls for:
- Immediate additional funding for social care to help it deal with the aftermath of COVID-19 and prepare for winter;
- A long-term funding settlement that secures the future of the sector;
- A long-term plan for social care including help to develop a better trained workforce to deliver care;
- A decisive shift to person-focused outcomes-based commissioning.
Last month, the Public Accounts Committee reported that the pandemic had demonstrated the “tragic impact” on social care of “years of inattention, funding cuts and delayed reforms”.