Love InC is an exciting and dynamic partnership consisting of Aberlour, Includum, CELCIS and the Care Inspectorate. The name was suggested by a care experienced young person and sums up just what the partnership is about – love in the care system for children and young people.
The final report outlines the project’s work, findings and key messages over the past three years. It narrates the journey of the partnership, reflects learning and has some important messages for corporate parents in Scotland. The project has explored how can we ensure that loving relationships are able to flourish for children and young people who experience care.
The thinking and approach of Love InC chimes with the findings and messages of the Promise. The five foundations of voice, family, care, people, and scaffolding are integrated throughout the work and the findings.
Our involvement in this partnership has contributed to this work and enabled there to be a focus on exploring the complexities of regulating love.
The Health and Social Care Standard 3.10 states “As a child or young person I feel valued, loved and secure”. We know this is not an easy thing to regulate but we are committed to children and young people feeling loved in the care system. This needs to be the norm, not something that is controversial or ambitious.
Our methodology is evolving in line with this and as part of our organisational commitment to Keep the Promise. Our focus of inspection in services for children and young people this year has children feeling safe and loved at the core.
The learning from the project about recruiting and supporting care experienced people into the workforce is important. It can help us shape and develop our approaches to participation in line with our work to keep the Promise and being a corporate parent.
Scottish health boards have recruited more than 1,000 additional healthcare support staff and almost 200 registered nurses from overseas to help address the unprecedented challenges facing the NHS.
The support staff recruitment drive, backed by £15 million, was launched by Health Secretary Humza Yousaf last October. The new employees will be working in a variety of roles, both in acute hospitals and in community health teams.
Under a separate £4.5 million initiative, offers of employment have been signed with 191 nurses from countries including India and the Philippines, with some already arrived and in posts in hospitals across the country, while agreements are in place with recruitment agencies for a further 203. The figure is likely to increase significantly over the coming months as boards take advantage of new infrastructure for employing qualified international staff.
All international recruitment is in line with the Scottish Code of Practice for health and social care personnel, which demonstrates Scotland’s commitment to ethical recruitment to protect the healthcare systems of developing countries.
Health and Social Care Secretary Humza Yousaf said: “The pandemic has been the biggest shock our NHS has faced in its 73 year existence. To help deal with Winter pressures and pressure brought on by the current Covid wave we are expanding and investing in our NHS workforce.
“Our hardworking and compassionate health and social care staff have been on the frontline of patient care throughout the pandemic and I am incredibly grateful to them all.
“In October, we set ambitious targets to boost the number of health care support staff and step up international nurse recruitment. I am delighted with the success of the recruitment campaigns and seeing the new staff already providing frontline patient care.
“Scotland has the best paid NHS staff in the UK and record workforce levels, with more than 155,000 whole time equivalent (WTE) staff now working in the service. We are determined to continue this progress as we recover from the pandemic.
“Our National Workforce Strategy for Health and Social Care commits to understanding how we can achieve a more sustainable, skilled workforce which makes careers in health and social care – at all levels – more attractive.”
The Scottish Ambulance Service is actively engaged with NHS Boards, Health & Social Care Partnerships, GP practices and other key stakeholders to support the effective delivery of high-quality care.
As a result, we believe we have enormous potential to play a significantly enhanced role in the future of health and social care provision, by working collaboratively with the public and stakeholders around how we plan and provide safe, effective and person-centred health and care for the people of Scotland.
In 2019, we actively consulted with staff and the public to get input into the development of our 2030 Strategy. However, soon afterwards, we had to pause the development of the strategy to allow us to focus on our response to the COVID-19 pandemic.
Now, taking account of the new post-pandemic landscape, we must consider how we develop our strategy to respond to Scotland’s Health & Social Care priorities to help address the root cause of the challenges we face on a day-to-day basis.
The leading Scottish care home group is undertaking a full review of culture across the organisation after two years of care staff fighting at the front line against the pandemic
Leading Scottish care home group, Renaissance Care, has implemented a full review with its staff across each of its 16 homes to overhaul the traditional operations across the care home sector.
Following interviews with staff across all levels, the group, which employs 1,200 people across the country, is reviewing the culture, working practice, and its health and wellbeing offering across the board, as it responds to rising resignations of care staff across the industry on the back of the pandemic.
Staff across the homes will now be offered a range of new benefits including flexible working, a pay review across all roles, and a health and wellbeing package.
In response to feedback around long shifts within the care sector, which have historically been 12 hour shifts as industry standard, Renaissance Care will now offer staff a flexible working pattern based on their individual requirements.
The move means that those who want to change shifts around childcare commitments, or want to cut down on long shift times can do so, while office staff will have the option to move to a four-day working week.
The group will also implement a minimum 5% pay increase for all staff and has committed to becoming a Scottish Living Wage Employer.
In line with the review, the care group is also undergoing a project to promote inclusivity and security among its workforce.
It has committed to supplying sanitary items for female staff in all of its facilities, as well as becoming a menopause-friendly workplace with plans to roll out training for staff later this year, and is ensuring an inclusive environment for LGBTQ+ staff and residents with an understanding that identities can be complex.
The home will also introduce a health and wellbeing package which includes free access to danceSing for all staff members – encouraging health and wellbeing through fitness classes with a saving of £400 per year for each individual. It is also to invest in upgrades to the staff rooms in each home to ensure its care teams have a space that promotes a positive culture throughout shifts.
In addition, the care home operator is currently investing £500k on its operational management and accounting systems to improve administrative processing for all staff as it responds to feedback about time spent on paperwork throughout shifts.
Louise Barnett, managing director at Renaissance Care, said:“It is absolutely clear that staff retention and recruitment across the care industry is a massive issue on the back of the pandemic. It comes as no shock that staff, who have had an incredibly difficult two years looking after our most vulnerable in society, would consider changing careers.
“For most organisations, people are at the heart of the business, but within the care sector it is no exaggeration that staff play the most crucial role in ensuring that elderly residents receive care that goes above and beyond, and we see time and time again the difference that our teams make to peoples’ lives.
“Operationally, the care sector has always functioned in a certain way but now, as we begin to recover from the pandemic, it is time to turn it on its head and set a high benchmark for what the industry will look like for years to come. We need to modernise the offering for care staff and ensure that they can remain dedicated to delivering the best quality care while having a work life balance that allows a career around family and personal life.”
Robert Kilgour, executive chairman of Renaissance Care, has been a consistent industry voice throughout the pandemic, calling for more support for care homes across the country.
Last year, he spearheaded a group of the country’s leading care home operators who joined forces to help uncover answers to the many questions around the handling of the coronavirus pandemic in Scotland.
Robert Kilgour, executive chairman of Renaissance Care, said:“The last two years have been an incredibly tough time for residents, families and hard-working team members in care homes across the country and it is important to us that we provide the best possible care and facilities for our people.
“Despite all that we have been through since the start of the pandemic, we remain very positive about the direction of the business and at the heart of our plans for recovery is our people.
“We are investing, developing and working alongside our team, ensuring that we can attract and retain the very best of talent to perpetuate a person-centred approach across each of our homes for staff, as well as residents.”
Renaissance Care has a strong people service strategy which focuses on learning and development for individual staff members, as well as onus on creating a person-centred culture of inclusivity and care.
Edinburgh health and wellbeing charity, Thistle, has launched a pilot ten-week training course for those looking to start or return to work in social care at a time when many are questioning their career choice as we recover from the pandemic.
The Thistle Academy is a first in Scotland and has been launched in response to the growing need for long-term social care support and will provide vital training and guidance for those looking for a career in social care.
Successful applicants will benefit from an intensive training course, as well as a £500 welcome payment and full pay from day one.
Thistle, which employs just under 500 people and supports over a hundred people with disabilities or long term health conditions to live independently across Edinburgh, the Lothians and Fife, has seen a significant demand for services throughout the pandemic. Many of its employees have come from different sectors looking to move into a role supporting others.
A national Aviva survey* found that three in five UK workers wanted to make changes to their careers because of the pandemic, with those aged between 25 and 34 most likely to want to retrain or pursue a completely different career.
The launch comes as part of the charity’s ongoing recruitment drive and commitment to employee training and development. The in-depth, people-focused course will allow successful applicants to fully develop their confidence before embarking on their social care career.
Heather Simmons, Thistle Academy Lead, said:“We want to ensure the highest standard of support is available for people living with disabilities and long-term health conditions, which is why we are so pleased to be launching our Thistle Academy for the first time and to be helping those looking to take an important next step in their career.
“Our trainees will work alongside a supportive cohort of like-minded people who have a passion to make a difference to the lives of others, encouraging those with disabilities or long-term health conditions to live life to the fullest.”
Mark Hoolahan, Chief Executive of Thistle, commented:“The social care industry is full of highly skilled people who draw on their own experience and natural empathy with others to deliver the best support possible.
“I hope the programme will help attract people who might be looking to make a significant career change and give them the support and confidence they need to progress.
“The last two years have demonstrated the vital role of social care in so many people’s lives. The Thistle Academy is our way of showing how much we value our employees and believe in the real difference they can make.
“I hope we will be able to offer further courses later in the year and that the academy will become a permanent part of our recruitment process going forward.”
Applicants should send in a personal statement and a ‘best selfie’ that demonstrates their values, strengths, interests, and why they would be the best fit for the academy. The closing date for applications is Friday 8 April and the course starts on Monday 25th April.
Finalists will go through to the recruitment day at the Thistle site in Craigmillar, giving them the chance to meet and chat to those supported by the charity, as well as the chance to talk to existing employees.
Case study – Tracey and Emma’s story
Tracey is a mum, runs her own travel consultancy business, and lives some distance away from Emma, who she supports on a one-to-one basis.
Tracey works part-time supporting Emma, including sleepovers in case Emma needs support during the night, which fits well into Tracey’s routine.
Tracey acknowledges being a mum to three boys as being good preparation for her role at Thistle. She said: “You’re always having to listen, think ahead, adapt plans and deal with the unexpected. That gave me confidence.
“I still work as a travel agent and learned from my Thistle experience. One specialism I have added is that I now can offer accessible holidays for people with disabilities.
“The most rewarding aspect of my role at Thistle is helping Emma live the life that she wants. We really do have lots of fun and laughs together.”
Case study – Garry’s story
For more than 30 years, Garry was an engineer and enjoyed the variety he found in this role. He started in Naval defence, working on the design of ships and travelled regularly for work, and then moved to the oil and gas sector where he was able to work locally in Fife.
Garry had begun to feel the motivation he once had for his job disappear, and when the pandemic hit and the option for voluntary redundancy came about, he took it, and started to reflect on what he wanted his working legacy to be.
Garry’s personal experience led him to consider support work as the next step in his career. After losing his aunty, his uncle moved into sheltered housing, and Garry became aware of how isolated his uncle was during the pandemic and the many challenges he was faced. Garry soon realised that there were many people like his uncle in the same situation and started looking for job adverts in social care.
Garry said: “The number of jobs advertised for social work made me realise how much of a need there is, but I felt my chance of getting my foot in the door, given my background, was slim.
“Christine, a coach at Thistle, was great, explaining that Thistle would provide training and that the right person was more important than previous experience.”
Garry has now been working with Thistle for nearly a year and works closely with a visually impaired man to help him make the most out of life, taking him on day trips all over Scotland and supporting his passion for music.
Garry continued:“Since I’ve started working at Thistle, I’ve realised the amount of people from every walk of life who need support.
“It’s an important role, and it’s rewarding knowing you are making a difference.”
The latest weekly update of Emergency Department activity and waiting time statistics show:
There were 24,920 attendances, the highest since week ending 10 October 2021 70.5% of attendances were seen and resulted in subsequent admission, transfer or discharge within four hours
7,347 patients were delayed by four hours or more, this is the third highest on record 1,825 patients were delayed by eight hours or more
643 patients were delayed by 12 hours or more, this is the second highest on record
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The data show the stark picture of the health system in Scotland right now and the serious crisis Urgent and Emergency Care is facing.
“There are extremely high numbers of patients being delayed for long periods of time, and we know that these long waits are associated with a high risk of harm or even death.
“This is a critical time. The pandemic is not over. Covid is ever present in the community, with increasing numbers of covid patients in hospital and a high level of covid related staff absences. The workforce is burnt out and overwhelmed, every shift is extremely demanding with staff covering for absent colleagues and managing high numbers of patients, doing their best to keep them safe and minimise harm. The moral injury to our colleagues working in our Emergency Departments cannot be underestimated.
“We welcome The Health and social care: national workforce strategy published last week by the Scottish Government. It is a positive strategy for the next five years. We especially welcome the commitment to grow the NHS workforce by 1,800 WTE staff and increase the number of medical school places by 500.
“However, we are disappointed both not to have been consulted on this strategy and by the limited mentions of Urgent and Emergency Care. We look forward to the Cabinet Secretary for Health and Social Care consulting with The Royal College on the meaningful details for Emergency Medicine including staffing and capacity needs.”
A new framework to shape Scotland’s health and social care workforce over the next decade places training, wellbeing, job satisfaction and the principles of Fair Work at its heart.
The National Workforce Strategy for Health and Social Care in Scotland, co-produced with COSLA, identifies the five key areas which will support the creation of a sustainable, skilled workforce as the sector rebuilds from the pandemic.
The publication, the first of its kind, stresses the need to plan, attract, train, employ and nurture staff.
Over the next five years, the Strategy commits to increasing the NHS workforce by 1,800 full time posts – these posts are in addition to projected required workforce growth. Later this year the Scottish Government will publish, for the first time, projections of required workforce growth across health and social care, which will be reviewed annually.
Other key actions include:
Investing £11 million over this parliament to establish the Centre for Workforce Supply and fund recruitment campaigns to grow the health and social care workforce
Increasing the number of undergraduate medical school places over the course of this parliament by 500
Supporting up to 1,800 training places through the National Transition Training Fund for those interested in roles in adult social care
Recruiting 800 additional GPs by 2028
Further improving staff wellbeing measures, which have already been supported by record financial investment this year
Increasing frontline health spending by at least 20% over this parliament and increasing adult social care investment by at least by 25%
Health boards, local authorities and health and social care partnerships will play a central role in delivering the Strategy through their three year workforce plans, the first of which will be developed this year.
Health and Social Care Secretary Humza Yousaf said: “Our hardworking and compassionate health and social care staff have been on the frontline of patient care through the unprecedented challenges of the pandemic, and I am incredibly grateful to them all.
“While we have seen continued growth in our NHS and social care workforce over the past decade, we need more than sheer numbers alone as we continue to care for patients and plan for the future.
“This strategy is designed to embed a new long term approach. It commits to understanding the change in demand for services as we recover, rebuild and transform our health service, and how we can achieve a more sustainable, skilled workforce which makes careers in health and social care – at all levels – more attractive.
“The health and social care system continues to undergo rapid change, with exciting opportunities created by new technology, data and analytical services. Working with key partners, this strategy will help ensure that services are delivered by a sustainable, well trained and supported workforce.”
Councillor Stuart Currie, COSLA’s Health and Social Care spokesperson, said: “Scotland’s health and social care workforce has been at the forefront of the pandemic response. Working in extremely challenging environments, they have faced unprecedented pressures and made many individual sacrifices.
“Partners working across health and social care must now adopt a strategic approach to the recovery, growth and transformation of the workforce that supports the wellbeing of workers, a continued shift to prevention and the provision of high quality support and care for citizens.
“The values, outcomes and actions outlined in this Strategy provide a foundation for excellence in planning, attracting, developing and nurturing the Health and Social Care workforce, at national and local levels.”
Mental Health Foundation calls for Scottish Government commitment to cost-effective prevention of poor mental health
Cost to UK economy is at least £117.9 billion, around 5 per cent of GDP
Mental health problems cost the Scottish economy at least £8.8 billion annually according to a new report published today by the Mental Health Foundation and London School of Economics and Political Science with support from the University of Strathclyde.
Almost three-quarters of the cost (72%) is due to the lost productivity of people living with mental health conditions and costs incurred by unpaid informal carers who take on a great deal of responsibility in providing mental health support in our communities.
To put the economic cost of mental ill-health in Scotland into context, the NHS Scotland operating budget for 2020/21 was around £15.3 billion.
The UK cost is at least £117.9 billion – equivalent to around 5 per cent of the GDP. Across the UK there were 10.3 million recorded instances of mental ill-health over a one-year period, and the third most common cause of disability was depression.
The report, ‘The economic case for investing in the prevention of mental health conditions in the UK’, makes the case for a prevention-based approach to mental health which would both improve mental wellbeing while reducing the economic costs of poor mental health.
Lee Knifton, Director of Mental Health Foundation in Scotland,said: “Our report reveals the opportunity we have to revolutionise our approach to mental health in Scotland.
“It’s time to increase investment in population-level prevention of mental health problems. We can’t only treat our way out of the mental health crisis, which is worsening due to the pandemic, and we cannot afford the spiralling costs to both people’s wellbeing and our economy.
“We urge the Scottish Government to pay attention to what the evidence is telling us and commit to prioritising prevention in mental health. A prevention-first approach will not only help break down the barriers to good mental health but empower people to thrive at every stage of their lives and boost our economy in the long run.”
Research gathered from the UK and internationally shows the potential public health and economic benefit of programmes that target and prevent mental health problems and empower more people to live well, for example, by addressing issues such as perinatal depression, bullying, and social isolation in older people.
Other well-evidenced initiatives include promoting positive parenting, rapid access to psychological and psychosocial supports for people with identified needs and building supportive and inclusive workplaces.
A growing number of studies report on the significant return on investment from parenting programmes. Methods and costs vary, but those assessed in this way cover a long-time frame and report positive returns of up to £15.80 in long-term savings for every £1 spent on delivering the programme.
Similarly, a review of workplace interventions found savings of £5 for every £1 invested in supporting mental health.
Lead author of the report, David McDaid, Associate Professional Research Fellow in Health Policy and Health Economics at London School of Economics, said: “Our estimate of the economic impacts of mental health conditions, much of which is felt well beyond the health and social care sector, is a conservative estimate.
“What is clear is that there is a sound economic case for investing in effective preventive measures, particularly at a time when population mental health may be especially vulnerable because of the COVID-19 pandemic.
“This requires further sustained and coordinated actions not only within the health and social care sector, but across the whole of government.”
The £8.8 billion costs to the Scottish economy is likely to be a significant underestimate of the true costs – based on the lack of data available around some key areas.
For example, health service costs are based on the number of people receiving treatment and do not consider the many people who would benefit from treatment but either does not receive it because of pressure on services or do not seek help.
Additionally, no costs are included for reduced performance at work due to mental health problems, costs to criminal justice and housing systems linked to poor mental health, costs associated with addiction issues, or the costs associated with self-harm and suicide.
The Scottish Government must focus on transforming health and social care services to address the growing cost of the NHS and its recovery from Covid-19.
Improving the NHS will be very difficult against the competing demands of the pandemic and an increasing number of other policy initiatives, including plans for a National Care Service.
The health service in Scotland is on an emergency footing and remains under severe pressure. There is a growing backlog of patients waiting much longer for treatment because of the response needed to Covid-19. That has made workforce planning and delivering on ambitious recruitment plans all the more important. But the Scottish Government has historically struggled to recruit enough people with the right skills.
The NHS’s ability to plan remains hindered by a lack of robust and reliable data, including workforce, primary care, community, social care, and health inequalities data.
Meanwhile the pandemic has increased the fiscal pressures on the NHS, which remains financially unsustainable. This is despite the Scottish Government allocating £2.9 billion for pandemic-related costs in 2020/21 and committing more funding in 2021/22 and beyond.
Stephen Boyle, Auditor General for Scotland, said: “Reforming the NHS is key to the Scottish Government’s pandemic recovery plan and needs to remain a priority. Putting Covid costs to one side, health spending is rising every year, meaning less money for other public services.
“There’s now a clear opportunity to do things differently by building on the innovation and collaboration we’ve seen across the NHS in the last few years.
“For that to happen, our leaders must take the public with them and involve them in the shift from care being delivered in hospitals to much closer to people’s homes. But better-informed policy decisions and services won’t be possible without better collection and use of data.”
A consultation has revealed strong support for proposals to establish a National Care Service accountable to Scottish ministers.
More than three-quarters (77%) of people who responded to the official consultation thought the main benefit of the proposed change would be more consistent outcomes for people accessing care and support across Scotland.
Meanwhile more than two-thirds (72%) of those responding agreed that the Scottish Government should be accountable for the delivery of social care through a National Care Service.
There were over 1200 responses to the consultation.
An analysis of responses from individuals and organisations on plans was published yesterday, following publication of the individual responses last week. The responses also highlight the risks which could emerge from such significant reform, but the need for change in the immediate and longer term is a key theme.
The consultation process represents the first phase of engagement for the National Care Service programme.
Social Care Minister Kevin Stewart said: “We will consider all views expressed in the consultation very carefully and I would like to thank all those who took part. It is clear that there is a real appetite for change.
“We will continue to engage with people with lived experience of the service whether they are people accessing care and support, their families, care workers or providers.
“The final scope of the National Care Service has not yet been concluded. Over the coming weeks, we will have the opportunity to reflect on these views of the public. We will then be in a position to bring forward the detailed plans for improvement to be undertaken over the course of this Parliament.
“However we are not waiting to act to enhance Scotland’s social care services that’s why we invested £300 million to help deal with winter pressures, and we’re determined to go further.
“We are committed to acting now to improve things for people. I am therefore delighted to announce today that we will develop and publish a standalone Carer’s Strategy with a focus on Covid recovery and improving carer support in a meaningful and sustainable way. We will engage with unpaid carers about its scope and purpose in the coming months to inform its development.
“Our aim will be to draw on the knowledge and lived experience of unpaid carers so that the strategy is shaped by those who best understand the many challenges faced.
“We will seek to publish the strategy by late spring to provide a clear vision for how we will respond to the challenges faced by so many carers.”
The public consultation attracted nearly 1,300 responses, from around 703 individuals and just over 575 organisations. A significant proportion of the responses came from individuals with lived experience, or bodies that represent them.
The social care workforce are also well represented in the responses, along with providers
Actions taken to support immediate improvements on social care include:
Investing £300 million of winter pressures funding in October, to maximise the capacity of the NHS and social care system this winter and in particular to bolster the caring workforce by increasing their numbers, providing them with additional support
Making additional funding of up to £48 million available to enable employers to provide an uplift to the hourly rate of pay for staff offering direct care within Adult Social Care to a minimum £10.02 per hour from the 1 December 2021
An additional £4 million to expand support for unpaid carers this winter, including to enable them to take breaks from caring
Developing options to remove non-residential charging as soon as possible
