COSLA S Response to the National Health and Social Care Workforce Planning: Discussion Document

COSLA S Response to the National Health and Social Care Workforce Planning: Discussion Document

COSLA’s Response to the National Health and Social Care Workforce Planning: Discussion Document

Introduction

  1. Political governance for the success of integration is shared between the Scottish Government and COSLA.The workforce is critical to the success of integration, to the overall sustainability of health and social care systems, to the design and delivery of transformational changeandto people’s experiences of health and social care. Councils are autonomous and democratically accountable to their communities, and have the authority and responsibility to produce local workforce plans.
  1. COSLA welcomes this opportunity to contribute to the National Health and Social Care Workforce Planning: Discussion Document (Discussion Document), and to consider, in partnership with the Scottish Government, how to take forward national health and social care workforce planning. Local government welcomes this opportunity topromote the value and strategic importance of thesocial care sector.In order for a National Workforce Plan (NWP) to meaningfully apply to local government, it would need to recognise and respect local government’s role, responsibilities and accountability for its workforce. It is COSLA’s expectation that if a NWP seeks to cover health and social care, it should be jointly produced and agreed with COSLA. Failing to develop the NWP without the full buy-in from local government would risk creating an unhelpful disconnect between Integration Authority(IA) and council workforce planning. It would also run counter to COSLA and the Scottish Government’s mutual integration policy aims.
  1. Within this context, COSLA supports the development of an overarching joint arrangement for a NWP across the health and social care sector. A NWP that is sensitive to the diversity of the social care and social work workforce.

Timescale

  1. The Discussion Document presents an opportunity to harness leadership across the wholesector. However, the Programme for Government 2016 – 17 set out an unrealistic timescale to delivera meaningful NWP for health and social care. The imperative to meet such a deadline should not be to the detriment of producing an effective NWP, and nor should it limit the opportunities for discussions and engagement with the social work and social care sector. COSLA notes the production of a NWP is an iterative process and recognises there are ongoing opportunities for collaboration with partners and supported people.COSLA recommends that time is given to collaborating with allpartnersonsocial care workforce planning.The delivery of a NWP should be with the full agreement of local government Leaders.

Engagement with the Social Care Sector

  1. COSLA views the Discussion Document as a starter paper. Significant groundwork is needed to agree what would constitute a NWP for social care. It presents a welcome opportunity to initiate these discussionsacross the social care sector.Discussions are essential to agree on how theNWP could promote collaboration and cooperation within the social care sector, and how the social care sector can develop to support transformational change.
  1. However, the challenges, barriers and opportunities need to be clearly determined – and agreed with local government, IAsand the third and independent sectors before progressing with a NWP. There needs to be a greater shared understanding and articulation of the complexities of delivering social work and social care. There needs to be recognition of the pivotal role of local government and its partners in delivering social care services.Undertaking a review of workforce planning will require leadership and resources.Engagement and dialogue with the key providers and supported people will be key.Without engagement, it will be difficult to implement a meaningful and helpful NWP that is owned by the whole sector. Given that this level of development and engagement has not been done, it would be untimely for a NWPto guide how social care workforce planning should be undertaken. It is recommended that the NWP sets out broad workforce planning principles and/or outcomes.

Scope of a National Workforce Plan and Governance

  1. The social services sector comprises of a wide range of services. Over 200,000 social services staff are employed across approximately 2,600 voluntary, private and public sector employers. These service providers run just over 8,000 separate registered care services. Differing governance structures and responsibilities are in place across these different sectors. Within this complex array of social care provision, councils are the largest single employer of the social care workforce.
  1. Councils and NHS boards areIAs parent bodies.IAs have an accountability to both the councillors and NHS representatives that sit on the Integration Joint Board (IJB). Where parent bodies have opted for the lead agency model, Integration Joint Monitoring Committees are in place instead of IJBs. Separate consideration of these issues within the lead agency context will be required. The delegated functions within scope of the IAs will vary from council to council, but they will all include adult social care. Local workforce planning takes place within council areas and IA boundaries and at NHS board level. IAs, though not employers, are accountable for planning staffing needs for the services delegated to them by councils and NHS boards. Councils have a strategic responsibility to ensure that a council’s workforce plan supports and responds to the needs of the IA, and interfaces appropriately with other non-delegated services, such as children’s services and education. Councils continue to commission some social care services and procure other services on behalf of IAs. In both instances, councils hold a corporate duty for Best Value and the use of public funds.
  1. It is not clear from the Discussion Document what the scope of the NWP will be for the social care sector.A NWP could cover a variety of services including: mental health officers, criminal justice social work, home care, care in the early years, child minders, housing support, child protection and personal assistants. We need to be careful that in producing a NFP, we do not adversely affect locally appropriate workforce planning. To consider whether only those services that are within the scope of the IA should be included within the NWP, orwhether to include all social care services.This must be decided and agreed with local government and cannot be imposed upon it.
  1. Further discussions are needed about legal and operational social care workforce planning responsibilities at national/regional/local level.There are several sound workforce planning methodologies, but these vary across job description, responsibilities and education frameworks. We need to consider workforce planning methodologies that are flexible, intelligent, predictive and sustainable. We need to support workforce planning that enables bespoke local solutions to workforce issues. The drive for consistency should not hamperinnovation at a local level.
  1. It is clear within the Discussion Document that the Scottish Government has a developed vision for NHS workforce planning. There is a significant focus on health andthe NHS approach to workforce planning. If a NWPis to encompass social care, it needs to speak to a wide spectrum of employers, commissioners and employees.

Policy Landscape

  1. National policy directly impacts on workforce planning in several specific and significant ways. The wider policy context for workforce planning needs to be adequately reflected in the NWPs. It is likely that the increase in early years’ provision, growth in demand for adult social care, an increase in the complexity of need and the shift in the balance of care will impact on the availability of staff at a local level to fill all social care posts. This will exacerbate an already difficult recruitment and retention environment for social care. There is likely to be competition between employers for the same staff. There is a shared concern about the impact on service sustainability and the ability to meet public expectations.
  1. At the same time, we have jointly and rightly committed to the Living Wage within the social care sector. This should have a positive impact on recruitment and retention,but unless we reform models of care this may add pressure to our ability to afford the size and scale of the workforce we may need. Shifting the balance of care will require growing the social care workforce.Successful remodelling of adult social care for example, will bring with it different workforce challenges, particularly in respect of training and skills.
  1. Some of the other policy areas that will require further consideration and impact on the health and social care workforce include the Carers (Scotland) Act 2016, Self-Directed Support (SDS) and the Social Services Strategy. SDS empowers people to have more control and choice over their support and services, and includes the direct employment of personal assistants. SDS will have a direct impact on commissioning and procurement, and how future supply and demand is predicted.

Recruitment, Retention and Career Pathways

  1. There is a need to develop a more rounded view of the social care workforce needs and demands. Retention of social care staff is an issue, as highlighted in the report Recruitment and Retention in Social Service Workforce in Scotland (Why Research, 2016). Joint strategic commissioning provides a mechanism for a more shared approach to workforce planning and retention. An overview of the challenges councils, IAs, NHS boards and the independent and third sector face would be useful. It would be helpful if national conversations were facilitated about what could be done to address these challenges.
  1. Several issues influence the retention of social care staff. Some of these are structural issues e.g. the prevalence of meaningful and valued career pathways for social care workers. A NWP could helpfully consider more generic/flexible care posts and qualifications to support workers moving between health and social care. To promote and encourage people to make positive choices about a career in health and social care.
  1. To be factored into future workforce planning,alongside doctors, nurses and other professionals,it takes a considerable number of years to qualify and specialise as a social worker. To stimulate new enthusiasm for caring professions, those already employed within health and social care need to have the opportunities to consider career changes and progression. The Scottish Government could add value by facilitatingnationwide discussions with further and higher education bodies and other relevant bodies in the recruitment, supply and engagement of the health and social care workforce. Greater collaboration and sharing information on skills and recruitment gaps could help find solutions and stop competition between employers for the same staff.
  1. As workforce planning discussions progress a NWP could consider practical solutions like a shared site for recruitment e.g. the better use of the myjobscotland recruitment - www.myjobscotland.gov.uk .

Workforce Planning Data

  1. Issues relating to workforce data need to be explored further. Integration means data collection will need to consider a whole systems approach. We need toestablish if there are any data gaps, if there are data comparability issues and how to appropriately reduce the volume of data that is collected. Discussion, clarity and agreement is needed on which bodies should receive, collate, check and challenge the data. It is recommended the Scottish Government and COSLA jointly undertake further discussions with councils, the Improvement Service, Scottish Social Services Council and the Care Inspectorate on workforce planning data.

Resources

  1. There are costs and resources required to undertake and implement workforce planning. Workforce planning is hindered by diminishing short-term budgets. There is a need to identify longer-term funding to develop a sustainable workforce. Staff training and development opportunities can also be limited due to financial restraints. This in turn impacts on recruitment and retention. Integration and a NWP should offer the opportunity to share workforce planning resources across the NHS and local government.

National Monitoring and Scrutiny

  1. COSLA would welcome further information on any proposed monitoring and scrutiny, and consideration of national blockages e.g. to recruitment, training and development. COSLA would not support further monitoring burdens being placed on local government. Local performance reporting should be community driven and support localities in their improvement journey. Any move to encroach on local flexibility to deliver bespoke local services would risk hindering local innovation and solutions.

Caroline Johnston

COSLA

March 2017

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