The government has dropped a pledge to invest in new social work training routes as part of a halving of committed spending on developing the adult social care workforce.
The Department of Health and Social Care (DHSC) revealed last week that it was reducing planned additional spending on workforce development in adults’ services from £500m from 2022-25 to £250m from 2023-25. This came in a policy paper setting out next steps on taking forward its 2021 adult social care white paper, People at the heart of care.
It later confirmed to Community Care that two specific initiatives that it would no longer be implementing were investing in new routes into social work and wellbeing, mental health support and improved occupational health provision for the wider workforce.
The planned £500m was part of a £1.7bn package on reforming social care, including funding for supported housing, carers’ support and greater use of technology. In its next steps document, the DHSC said that, while it was still committed to spending all of the £1.7bn on adult care by 2025, up to £600m of this was, as yet, unallocated.
However, this fact, plus the halving of committed workforce spending sparked widespread sector condemnation. The British Association of Social Workers described it as “a failure by government to grasp the workforce crisis in adult social care and the challenges for adult citizens and carers getting access to social work support and care”.
New routes into social work pledge
In the 2021 white paper, the DHSC pledged to “invest in new training routes for people who want to become social workers”, listing it as one of the ways it would use the £500m it had previously announced would be spent on developing the wider workforce, from 2022-25.
Chief social worker for adults Lyn Romeo had previously confirmed that part of the £500m would be used on ensuring there were sufficient social workers to help implement the proposed adult social care charging reforms, then slated for implementation in October 2023.
These – an £86,000 cap on care costs and an increase, from £23,250 to £100,000 in the assets threshold below which a person can receive council-funded care – would necessitate local authorities carrying out hundreds of thousands of more assessments a year.
However, in November last year, the government announced a two-year delay to the reforms, recycling £3.2bn to help councils meet current pressures. This has put their implementation beyond the next election – which the Conservatives are tipped to lose – raising the prospect of them not being implemented at all.
Despite the reforms not going ahead on schedule, the need for more social workers in adults’ services has been highlighted by a rise in vacancy rates, from 9.5% to 11.6% in the year to September 2022, and waiting lists for assessments, revies or care hitting 490,000 as of August last year.
However, in this week’s next steps document, there was no reference to investing in new routes into social work. Instead, the DHSC restated its existing funding for social work education, through the fast-track Think Ahead programme to train mental health practitioners, the education support grant, which funds practice placements, and the social work bursary.
“Our investment will ensure we lay the right foundations to meet future demand for social workers, and for the continued success of the social worker profession in the long term,” it said.
In explaining its decision, the DHSC referred Community Care to the £130m it and the Department for Education already spent each year on social work training, through undergraduate and postgraduate degrees, fast-track programmes and apprenticeships.
‘Risk of diluting social work role’
The news comes with the DHSC emphasising how councils can make use of alternatives to social workers in carrying out Care Act assessments, including through greater self-assessment, outsourcing the function or employing social work assistants or trainees to do it instead.
The plans, set out in a new £27m grant from the department to local authorities to “streamline” assessment processes, sparked concerns from the British Association of Social Workers that practitioners’ role risked being diluted by DHSC plans for non-social work qualified staff to carry out more needs assessments.
The DHSC provided more guidance last week on how councils should use the grant, with a strong emphasis on the use of technology to reduce the time staff spent on assessments, for example, by automatically prepopulating forms with basic information.
However, it also included a case study of how Gateshead council had used social work apprenticeships to both boost assessment capacity – at a lower cost than equivalent qualified social worker roles – and grow its future workforce.
Investment in counselling and occupational health dropped
In the 2021 white paper, the DHSC pledged a “wellbeing and occupational health offer”
that would “provide immediate relief from burnout, trauma and mental illness” and “a more positive experience” for staff, in recognition of the “immense sacrifice” they had made during the pandemic.
It promised to invest in one-to-one counselling, group-based mental health and wellbeing sessions, a helpline, coaching to support wellbeing, a workforce wellbeing fund for employers to draw upon for their own initiatives and a pilot scheme to test the collective purchasing of occupational health provision for small and medium-sized providers.
However, DHSC confirmed last week that it had ditched this too, on the grounds that many care providers and councils already offered comprehensive wellbeing packages and that stakeholders had told it that a national offer might not be the best focus for its reforms.
The department has, broadly, retained its other white paper commitments on the workforce.
Plan for career pathway and funded training retained
It remains committed to introducing a “care workforce pathway” – referred to in the white paper as a knowledge and skills framework – setting out the knowledge, skills and behaviours needed to perform specified adult care roles and a career structure setting out how staff can progress.
As set out in the white paper, the DHSC will also fund “hundreds of thousands” of training places help staff progress along the pathway, starting this autumn.
In a separate call for evidence on developing the pathway, the DHSC said it would consist of four broad categories of role:
- Care and support practitioner – for people in their first 12-18 months in social care, who would be expected to complete induction and mandatory training to build their knowledge and skills.
- Advanced care and support practitioner – for those with more experience, who have completed introductory learning and development and would then be receiving further training to further progress.
- Senior care and support practitioner – for staff supervising those on the previous two levels who are developing, or have developed, leadership skills.
- Practice leader or specialist practitioner – for those who are working towards, or hold, a specialist qualification, showing expertise in a particular area of care.
For each category, the pathway will set out expected behaviours, knowledge and skills, responsibilities and relevant experience, and opportunities to progress.
New Care Certificate and CPD for nurses
As part of the pathway, the DHSC said it would develop a new Care Certificate qualification, that would “become the baseline standard for all new care workers to work towards when they join the profession” and should be held by advanced practitioners under the proposed pathway. This would likely replace the existing certificate, and the DHSC said it would fund staff to complete it from next year.
Another white paper commitment that has been retained is the introduction of “continuous professional development budgets for registered nurses, nursing associates, occupational therapists and other allied health professionals”.
However, the next steps paper has pledged CPD funding for “registered nurses and other eligible regulated professionals”, making it unclear who would be covered by the latter group.
In her foreword to the next steps document, care minister Helen Whately said she the workforce was “front and centre” of the government’s social care reforms, and that she wanted to “support care workers to develop their skills and their careers, and to be recognised for those skills”.
However, while the DHSC has not ruled out using some of the unallocated £600m in sector funding on the workforce, a string of bodies lambasted the cut in committed workforce funding, in the context of vacancies having risen by 52% in 2021-22.
Skills framework ‘will fall flat’ without extra cash
Association of Directors of Adult Social Services president Sarah McClinton said the reduction would “make it harder to turn around the social care staffing crisis, where vacancies are at a record high, pay and conditions poor and morale very low”.
Carers UK chief executive Helen Walker described it “a massive missed opportunity to improve the lives of so many people”, given the importance of paid-for care in giving unpaid carers a break. The County Councils Network’s social care spokesperson Martin Tett said it welcomed “many of the measures on workforce qualifications and career progression”, but warned that “a reduction in funding coupled with a lack of focus on pay and conditions” would undermine the government’s wider care reforms.
“Halving the money to support the stretched social care workforce is a particularly low blow amid a cost of living and recruitment and retention crisis affecting social care,” said Nuffield Trust deputy director of policy Natasha Curry. “It’s all very well to create a skills framework but if employers don’t have the cash to recognise improved skills with better wages, it will fall flat.
On behalf of healthcare trusts, NHS Providers deputy chief executive Saffron Cordery described the halving of committed workforce spend as “hugely disappointing” with capacity in the sector is at its lowest with 165,000 staff vacancies due to recruitment and retention challenges”.