First published in the Sunday National, September 26
Around one in five beds in Scotland’s major hospitals are occupied by elderly people who could be discharged – except there is nowhere for them to go. One in six beds in Scotland’s care homes is currently empty – but the homes can’t take in more patients because of staff shortages due to a combination of Brexit and Covid.
The shortage of staff is even worse in the social care sector which supports people in their own homes – and that means vulnerable people may be more likely to end up needing emergency help. Private care providers are passing patients back to councils because they can’t fulfill the need – but councils too are struggling with shortages.
“There is a gender dimension to this. The impact of staff shortages in the care sector will be even more devastating than the HGV drivers shortage this winter. But we don’t hear nearly so much about that. I suspect this is because it is a largely female workforce. They are “invisible women’ and we don’t appreciate them until they are not there,” said Karen Hedge, National Director of Scottish Care.
Hedge said the capacity of care homes across Scotland is around 86% – but although rooms are empty, homes can’t accept new residents. “There is a waiting list for places in care homes – but homes can’t accept people when they don’t have the staff to provide an acceptable level of care.”
“The system is out of balance. The first plank is social care – that keeps people active and in their own homes for longer. If that doesn’t happen, there is a rise in emergency treatment – both for these vulnerable people and for unpaid carers whose health is impacted. Before Brexit, she said, between 6 and 9% of care home nurses, assistants, and an unknown number of support workers were EU citizens. Many have now left.
“These occupations should have been given protected status. They were highly skilled and experienced staff we could not afford to lose. In many cases we had two or three members of one family working in the same care home. It has proved impossible to replace them in most cases. ”
Hedge said the added burden on those who remained in the sector throughout Covid was taking its toll. A report published earlier this month shows 90% of providers are struggling to recruit and retain staff. Almost half say they can’t go on providing care at the current level.
A nurse who didn’t want to be named said “Staff shortages in the care sector are impacting us massively. Between one fifth and a quarter of beds in our hospital are now occupied by elderly people who should be discharged. They can’t be – because there is nowhere for them to go. “We are very short staffed. We miss our European nurses. We had Spanish, Italian and Polish nurses. They added to the diversity and resilience of our workforce. We can’t replace them.”
She said many of the nurses who had worked all through the pandemic were also suffering stress and burn out. “At the beginning of this, there were people coming out of the woodwork to help us – but we don’t have them this time round. Every shift is short by several nurses. I don’t know what will happen. People talk about opening field hospitals – but where will we find staff? I don’t know where this will end. It’s very frightening.” She also added that one reason for the ambulance crisis is paramedics having to queue at A&E to unload patients.
John Mooney, Unison’s head of social care in Scotland said: “All the employers are fishing in the same pond for staff. But the other side of the picture is that life for our members is very difficult. “The rates of pay are a disgrace. But there is more to it than that – they don’t have any say at work, they don’t have a voice. They are just being told that they have to do more. They are constantly firefighting. Government has not been taking the problems in the sector seriously – it has been out of sight out of mind. This crisis has been building for years. The ongoing staff problems were compounded by the pandemic and Brexit.”
MSP GIllian McKay, spokesperson on health and social care for the Green Party said: “The impact of staff shortages in the health care sector is devastating. Pushing through a hard-Brexit in the midst of a pandemic was reckless and cynical. Once again we are seeing the people of Scotland suffer due to decisions made by a Tory Government we didn’t vote for.”
A Scottish Government spokesperson said: “We are continuing to work with Health and Social Care Partnerships to provide support around the current challenges facing the sector. We have allocated an additional £380 million to Health Boards to help with costs arising from the pandemic. This comes on top of the £1.7 billion already provided to Health Boards and Health and Social Care Partnerships last year.”