NCF Member Briefing 15.3.24
Questions for Member Call
The next member call will be on Tuesday 19th March at 1pm. Email me if you haven't got the calendar invite. Ahead of the call please consider the following questions and topics we will discuss:
Migration Policy Changes
Changes to the Health and Care Visa went live last Monday (details below). We're aware of the challenges members are facing and want to understand if anything has changed in terms of delays to visa renewals, or recruiting people already in the UK who need an employer with a certificate of sponsorship.
PPE and Testing Policy
We want to hear from members about any concerns they might have about changes to PPE and Testing policy - more details below.
Local and General Election
We want to hear if any members are planning to make their voices heard ahead of the local elections in May, and during the general election (whenever that will be). We're keen to encourage members to engage their staff and those drawing on their services ahead of the local elections in particular.
Unfair To Care
NCF was delighted to be at the launch of Community Integrated Care's latest Unfair to Care report in parliament earlier this week. You can see my Twitter thread for more details of the event.
Community Integrated Care carried out a benchmarking exercise with Korn Ferry to show that a support worker in adult social care is equivalent to someone in the middle of Band 3 in the NHS. The report incorporates NCF data to show that there is at least a 35.6% pay gap between the average take home pay between the two. This rises to over 50% if we include pension and other terms and conditions.
Perhaps one of the most interesting elements of the report was exclusive YouGov polling which showed that the majority of MPs recognised the current rate of pay for social care workers is unfair, that there should be parity with the NHS and that the next government has a responsibility to act to improve pay, terms and conditions! There is no excuse any longer for inaction.
The social care vote could influence the direction of the general election and new government. 2.6 million people with direct experience of providing or drawing on social care constitute the social care vote and make up 10% of the average voter turnout in each constituency. This presents a great opportunity to speak up for care.
COVID Testing and PPE
At the end of March, free PPE will come to an end and DHSC is currently considering what to do with the portal.
Likewise, conversations are happening between DHSC and UKHSA about the adult social care testing regime and we expect some form of public announcement next week.
You may have spotted that a series of pieces of guidance have had a placeholder piece of text inserted which states something along the lines of:
'The ordering portal for accessing tests kits for [insert service here] has now closed. Guidance will be updated before 1 April 2024 to reflect changes to COVID-19 testing. Until then, settings should continue to follow the current guidance'
Essentially, UKHSA has stopped supplying LFDs to social care settings.
We have already pointed out to DHSC and UKHSA that this temporary guidance is contradictory when talking about outbreaks in care homes as the main guidance still points to a testing portal which has closed. We have been assured that this will be rectified when new guidance is issued.
We will communicate further changes and information when we know them.
Changes to Health and Care Visa
Last Monday the changes to the Health and Care visa came into force banning care workers from bringing their dependants to the UK. The relevant regulations can be found here. The House of Commons Library has a useful briefing.
The regulations laid prevent overseas care workers and senior care workers from bringing their dependants to the UK and require care providers in England who wish to sponsor migrant workers to be registered by the CQC.
Care workers and senior care workers who are already in the route will be able to extend their permission with the same sponsor, and settle, without the CQC regulation requirement applying to them. They will also be able to bring dependants, including in cases where they change jobs to another sponsor who meets the CQC regulation requirement.
However, individuals who are in the UK on any other route, including where that route permits dependants, who switch into the care visa as a care worker or senior care worker will not be able to stay with (or bring over) dependants.
We are very aware of all the issues the changes have caused, including the delays from UKVI to renew visas. NCF has been working with ADASS to push for a solution and will be holding a roundtable with UKVI to try and resolve the continued issues.
Webinars
DHSC and the Home Office will be holding webinars about the changes to the visa system on the following dates:
Friday 22nd March 2024 at 11amWednesday 27th March 2024 at 10:30am
We're also anticipating a toolkit to be published by DHSC/Home Office for providers.
Other Resources
Justice & Care, part of the Gangmaster and Labour Abuse Authority (GLAA), has produced information and guidance for international workers on sponsorship in social care. The guidance covers: your rights as a care worker in the UK; joining a trade union; sponsorship in the UK; finding alternative sponsorship; additional work; labour exploitation; what is the NRM?; how to raise concerns and get advice; and food/clothing banks.
Accelerating Reform Fund
You may remember that the government announced a £42.6m Accelerating Reform Fund last year designed to support innovation and new initiatives in adult social care and support for unpaid carers.
Today, DHSC has announced that the first tranche of £20m will be allocated to lead local authorities, with a particular focus on expanding community-based care models such as Shared Lives, a service that matches people aged 16 and above with approved carers.
The funding will also be used to develop innovations and digital tools focusing on identifying and support unpaid carers:
Local authorities in Coventry and Warwickshire will expand a digital carers self-help tool to equip carers with the ability to identify local support and access bespoke information to support their own well-being.Local authorities in West Yorkshire will use the funding to connect hospitality, tourism and leisure businesses with unpaid carers so they can donate holidays and experiences to carers to recognise their invaluable contribution to society.In Southwest London, the funding will scale up approaches for identifying unpaid carers, such as through hospital discharge programmes and referring them to carers networks.
While the money is welcome, this is yet another example of a short-term approach by the government towards investment in adult social care - this is not a long-term strategic approach to the develop of and investment in new innovations and models of care.
A full list of the lead LAs that have received money on behalf of their ICS areas, along with their allocations, can be found here.
ARC England Fee Rate Maps
ARC England has produced a very useful set of fee rates maps to visualise the 2023-2024 fee rates for external learning disability and autism services. They have found that a minimum uplift of 12% is necessary for providers to meet the national living wage increases that will be implemented from 2nd April . But even with this minimum, it does not begin to address the cumulative funding shortfall that year upon year of below inflation uplifts has created.
Preventing people with a learning disability from dying too young
The Nuffield Trust has published a report highlighting the fact that people with learning disabilities face barriers to accessing healthcare and preventative services, resulting in higher risk of obesity, cancer going untreated for longer, and poor access to mental health services and treatments.
The report recommends that:
NHS England should conduct a national review of the quality of annual health checks for people with a learning disability.
Integrated care boards should use local data to review the number of people on GP learning disability registers and organise targeted information campaigns to encourage people to join the register.
The number of health and social care staff working in care coordination roles should be increased to improve care coordination for people with a learning disability.
All providers of NHS and publicly funded social care should deliver training to staff in the use of the ‘Reasonable Adjustment Digital Flag’.
All local authorities should provide weight management programmes specifically designed for people with a learning disability.
DNACPR Report
Earlier this week the Parliamentary and Health Service Ombudsman published a report on improving 'Do Not Attempt CPR' decisions.
The report is very focused on the health service but many of the issues will have been experienced in adult social care too. Some of the findings include individuals not being informed about DNACPR decisions and ageist and ableist attitudes by medical colleagues recommending the decisions.
Update to Dysphagia learning
NHSE has updated their Dysphagia elearning to help healthcare and other staff better manage the condition with people in care settings and hospitals.
The programme has been updated to align with Level 2 of the Eating, Drinking and Swallowing Competency Framework.
Energy Bills Discount Scheme
The Department of Net Zero and Energy Security has asked us to remind relevant providers that the deadline for heat suppliers to apply for the Energy Bills Discount Scheme is at the end of March.
All heat suppliers with domestic end consumers are required by law to apply for the scheme and pass on the benefit they receive to their end consumers. The heat supplier is defined as the body responsible for supplying and charging for the supply of heating and/or hot water supplied by the heat network.
Flu Immunisation Programme 2024 to 2025
NHSE and DHSC have issued a letter outlining guidance for the 2024 to 2025 flu season.
The letter contains information on the next steps for regions and providers to take, including which flu vaccines to order. It also confirms there are no changes to the eligible cohorts for the coming year, although providers should read the section on the timing of the programme carefully. If you have any questions, contact nhs.stakeholderengagement@nhs.net and copy myself in.