That’s the main message from a UNISON Scotland survey of workers in health and social care who will have to deliver the planned integration of health and care services in Scotland. The report shows that while many staff believe care integration provides an opportunity to improve services, but the impact of budget cuts mean services will get worse.
Only 6% of workers involved expect conditions to improve in the next year. 68% believe the situation will get worse. 63% felt that their professionalism is or has been compromised by budget and resource limitations.
The report also includes many verbatim quotes from the workers in the front line. These paint a picture of services which are struggling to deliver.
“Clients are being restricted in activities because of funding as many other services are being withdrawn and a lot have been closed due to local government funding cut backs. This has an effect on family carers a lot of whom are elderly and can receive no respite from their home caring role.”
Staff are generally supportive of integration as an idea and can see advantages in closer working, but fear that a top down managerial model of change will make improvements more difficult.
“I’m positive about working with practitioners, negative about being subject to another layer of managerial agendas.”
The report builds on UNISON Scotland’s ‘It's Time to Care’ report which also outlined how tight resources are in Scotland’s residential and home care services.
A further indication of the pressures on staff comes in the latest SSSC workforce data. One in thirteen people in paid employment in Scotland now work in social work. However, the size of the workforce appears to have fallen for the third year in a row, from 192,360 in 2012, a drop of 1.4%, to 189,670 in 2013.
The private sector continues to increase its share of the labour market, employing 41% of people working in social services in Scotland. The public sector employs 32% and the voluntary sector employs 27%. This chart gives a breakdown by local authority area:
The largest types of social services are housing support/care at home, care homes for adults and day care of children; together, these account for almost 76% of the workforce. Housing support/care at home services saw the largest drop in the actual number of staff employed, from 64,290 to 61,350.
Around 79% of the workforce is employed on permanent contracts, which is the same as in 2013. Most are also full-time positions, though at least 10% of the employment appears to be on zero hours contracts or equivalent. As we know from the ‘Time to Care’ report this can have serious consequences for care standards.
I’ll leave the last word to the staff who deliver care.
“Lack of local authority care is resulting in delayed discharges within hospital wards which is placing greater strain on the NHS system. Sometimes packages of care are agreed and discharge is arranged but then there is physically not anyone to actually deliver the care”