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33% of adult social care providers consider exiting the market amid financial pressures

ADULT social care providers have urged the Government to work with them to put the sector on a sustainable footing in the face of unfunded rising costs and deepening workforce challenges.   This comes as a new report, launched at the Care England conference in London, revealed that of adult social care providers, including half of smaller organisations, have considered exiting the market in the past 12 months.

The Sector Pulse Check report, a piece of independent research commissioned by national learning disability charity Hft and Care England, the largest and most diverse representative body for independent providers of adult social care in England, illustrates the unique challenges facing the sector following the Pandemic, cost of living crisis and decades of under investment by central Government.

Based on a representative survey of care providers in England, the report describes how cost pressures, including:- sky high utility bills, rising by as much as 500% for some providers; and increasing, unfunded workforce pay resulted in 82% of providers being in deficit or facing a decrease in their surplus in 2022.

Financial and workforce pressures have also seen 42% of providers forced to close parts of their organisation or hand back care contracts to Local Authorities.

1 survey respondent described the current climate as:- "genuinely the most perilous period in the organisation's 50 year history," going onto say that their "ability to provide residential care and supported living is seriously compromised."

The Sector Pulse Check report illustrates that workforce related cost pressures, driven by increases in the National Living Wage, were a standout concern for providers, with 92% citing workforce pay as a key pressure on their organisation. Concerningly, 81% said that Local Authority fee increases did not cover the increasing costs of workforce pay in 2022.

Low wages relative to other sectors, as well as a perception that better opportunities exist elsewhere, were identified as key drivers of difficulties in recruitment and retention, with 95% of respondents saying that increasing pay would have the most impact on boosting staff numbers. 

Cumulatively, the impact of financial and workforce challenges faced by the adult social care sector leave some of the most vulnerable in society at risk of not being able to access the support they need, and has a knock on impact for wider society, families, communities and the NHS.

The foundations for a sustainable and new found future have been set out by Hft and Care England in the report's recommendations. Despite the difficulties facing many care providers, the organisations describe an unwavering desire to work with Government to harness the sector's innovation, energy and commitment to ensure those who draw on care and support are empowered to live the lives they choose with dignity and independence.  

Kirsty Matthews, Chief Executive of Hft, says:- "The crisis of the Pandemic was swiftly met by another; a cost of living crisis, characterised by spiralling inflation and catastrophic increases in utility bills. Political and financial efforts have been focused on tackling the broader impact of these national challenges, but we are still at risk of forgetting about the mostly hidden social care sector and workforce which has determinedly continued to support our society as the country lurches from one crisis to the next. As a provider, I empathise with my peers across the sector having to close services and turn away referrals because of financial constraints and staff shortages. This is made more critical at a time when we need to further support our partners in the NHS by preventing admissions to Hospital or enabling the discharge of people to social care. We can no longer afford to ignore the fact that our sector is being driven out of the market without acknowledging the devastating impact this is having on the lives of the people who draw on our support, the National Health Service and the wider economy. We hope our research illustrates key issues that Government could work to address in the short term to provide a longer term solution to ensure the sustainability of this very important part of society."

Professor Martin Green OBE, Chief Executive of Care England, says:- "The Sector Pulse Check report corroborates many of the concerns I; and others in the sector; have been raising with Government for many years. We want to craft a vision that enables people to live well, through a system of support in which health and social care systems act in a coordinated fashion focused on those who draw on care and support and are financed adequately and appropriately to allow for innovation and investment. Now is the time to shift the needle. This needle needs to point to a new future, one which sees social care as part of the solution in terms of how we look after our nation. We require a new vision where success is measured in outcomes, and in terms of the benefit delivered to people and communities more widely. The whole system needs to work together with a shared vision and purpose to ensure this becomes a reality for all. Organisations, staff and the people we support are all suffering as a result of the current roadmap. This landmark report must be the last which reaffirms the current reality and it is incumbent upon Government to respond if the sector is to continue to provide quality care and support. There is an opportunity to lay the foundation for meaningful reform, within the current funding envelope, and it is 1 that should be grasped with both hands."   

Among the recommendations made by Hft and Care England are that the Government develop a pay framework to establish a minimum care wage, align benefits, terms and conditions with NHS staff and establish a professional register for care workers in England.   

In addition, they recommend that the Government continues to offer enhanced support for energy costs equivalent to that offered through the initial Energy Bill Relief Scheme expiring on:- 31 March 2023, and remove the 5% VAT surcharge currently applied to energy bills until energy prices stabilise closer to 2021 levels. 

The full report can be found here.

New data reveals that 78% of people in Liverpool want Government to do more to promote good oral health

RESPONDENTS in Liverpool overwhelmingly want more support for the dental profession, with 78% of adults agreeing that the Government could do more to promote good oral health; and only 3% disagreeing. Experts are calling for the Government to prioritise putting prevention at the heart of dental care.

The Wrigley Oral Healthcare Programme's Oral Health Index has uncovered the real life impact of the lack of access to NHS dentistry across England. The North West has the joint lowest percentage of dental practices, along with the South West, currently taking on new adult NHS patients, with only 1% of practices taking on adults and 4% taking on children.

The new research finds that over a 34% of 16 to 24 year olds, from across the country agree they would resort to 'DIY' dentistry measures, including self tooth extraction, due to a lack of access to dental care. Shockingly, young adults are feeling the most pressure to resort to such extreme measures, compared to just 12% of respondents over the age of 55.

The Index also found that 73% of respondents from Liverpool agreed that there is a crisis in the provision of dental services and well over half (57%) agreed that there is a postcode lottery when it comes to accessing dental care, highlighting the extent of the challenge in accessing dental care in the City.

With the Health and Social Care Committee launching an inquiry into NHS dentistry, it is vital that prevention in oral healthcare is recognised as a priority by the Government to support the dental industry and protect the nation's oral health.

The Wrigley Oral Healthcare Programme is proud to work with dental professionals to promote the role of at home oral health tools in preventative oral healthcare. Measures like brushing twice a day and flossing are key, whilst tools like sugarfree gum can play a vital part in protecting people's oral health when they're on the go.

Mick Whitley, the MP for Birkenhead, said:- "Access to dental care is severely restricted by the shortage of NHS dentists and the increasing costs of private dental treatment. It is no surprise to me that 73% of people in the Liverpool City Region are fed up, to what is left of their back teeth, with the appalling state of our dental services. The Index published by Wrigley's Oral Healthcare programme has highlighted that the crisis in the North West is now acute. As well as promoting good practice in oral health, I believe the Government needs to take urgent action to guarantee access to people across the country. Getting relief from a toothache should not depend on where you live."

British Dental Association Chair Eddie Crouch said:- "In a civilised society no one with toothache should be reaching for pliers and a bottle of gin. Underfunded and overstretched, COVID has pushed already struggling services to breaking point, leaving millions with no options. This access crisis was made in Westminster. Government has a moral responsibility to consign 'DIY dentistry' back to the Victorian era."

Dr Nigel Carter, Chief Executive of the Oral Health Foundation said:- "DIY dentistry is often seen a last resort and is sadly becoming more common as the UK faces growing problems accessing NHS dentistry. By performing their own dental treatment, a person can cause severe and long term damage to their mouth. This should be avoided at all costs. By adopting a few simple habits, people can prevent oral diseases like tooth decay and gum disease, that sadly remain far too common."

Michael Dodds, Senior Principal Scientist for Oral Health, at Mars Wrigley, said:- "Our survey has revealed some critical statistics about the lengths people would go to rectify their oral health challenges, even going so far as considering extracting their own teeth. While we know that dentists have done; and continue to do; all they can to support patients through the impact that COVID-19 has had, ongoing challenges like the cost of living mean we need to look for low cost, impactful ways to protect your oral health. Brushing your teeth twice a day and flossing are important steps, but in addition sugarfree gum is an effective, accessible and inexpensive way to protect your teeth on the go."


Vision for future of General Practice specialty training unveiled by Health Education England

A vision for the future of general practice specialty training has today been revealed by Health Education England (HEE). It outlines ways to reform the delivery of education to GP trainees, better preparing them for future practice in different models of care; addressing:- health inequalities, improving technology and enhancing areas of clinical care such as mental health.

The report details opportunities to move to a more flexible model of training that meets the needs, skills and experiences of the trainee, as well as the demands and nuances of local populations.

Key priorities include:- equipping GP Trainees to deal with the growing number of primary care patients with mental health concerns; working closer with:- Nursing Students and NHS Talking Therapies professionals, while also exploring the potential for innovative placements with charities, third sector organisations and services such as CAMHS.

The report also puts forward technological advancements such as:- live streaming, simulations and a virtual training academy offering a range of digital resources.

There is a focus on ensuring patients in deprived areas are able to access care, with actions including developing specific training offers on these issues and prioritising training capacity expansion to areas in need.

Other important proposals involve offering more leadership opportunities during training to help develop leaders of the future; a range of measures to help improve cancer diagnosis; and exposing trainee GPs to placements, learning and educational events about improving health of entire populations.

It comes after more than 4,000 Doctors accepted training places to become GPs in 2022, meaning that, as the organisation responsible for managing the specialist training process, HEE hit the Government's target for the fifth year running. The total has increased from:- 2,671 in 2014.

The report:- 'Training the Future GP; Enhancing Delivery of GP Specialty Training,' is based on extensive engagement with key national stakeholders, patients, Doctors in training and educators, along with the results of a number of Regional pilot programmes.

Professor Simon Gregory, Medical Director, Primary and Integrated Care at HEE, said:- "Primary care remains the foundation of universal healthcare and our NHS. The world is changing at unprecedented rates and our future GPs must be equipped with the right skills and resources to meet the evershifting needs of their patients. At this challenging time for the profession it has also never been more important for them to see the potential for a fulfilling and rewarding career in general practice. This report seeks to revitalise GP training by outlining a vision for a future of sustainable general practice careers, ready to best deliver the established curriculum through quality GP training programmes and placements, delivered within available capacity."

Health Minister Neil O'Brien said:- "It is important doctors entering general practice have the necessary skills to treat both people's physical and mental health needs. We also need a workforce which can make the best use of technology to help speed up diagnosis and treatment. We have record numbers of GPs in training who require the best possible programmes of training and I welcome the work done by Health Education England who listened to patients, doctors and educators to develop these innovative proposals."

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