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NHS and Social Care: Staffing

Volume 801: debated on Wednesday 15 January 2020


Asked by

To ask Her Majesty’s Government how they intend to ensure safe staffing in social care and the National Health Service in this Parliament.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In so doing, I declare my interests as a nurse, as set out in the register.

My Lords, patient safety is paramount. We expect health and social care providers to deploy sufficient numbers of suitably qualified, skilled and experienced staff at all times. The NHS People Plan aims to ensure a sustainable overall balance between supply and demand across all staff groups. This Parliament will see the people plan deliver 50,000 more nurses by 2025, a further 6,000 doctors in general practice and 6,000 more primary care professionals, all of which will support safe staffing and better care.

I thank the Minister for her reply and particularly commend the NHS People Plan, yet evidence suggests that urgent action is needed to address the shortages in social care as well as healthcare. Many older people with dementia are failed by our social care system, in part due to costs and the availability of suitable staff. It is vital that the Government resolve the future of social care funding. Without certainty on funding, employers cannot invest in and plan for the future workforce. Dignity in care will be achieved only with rapid, proactive planning. Can the Minister explain the potential delay to the cross-party talks about funding for social care and what approach will be taken to ensure that proper staffing in social care is available during this Parliament?

I thank the noble Baroness for her question and pay credit to the work she has done in this area. She is absolutely right that we have to make urgent progress in delivering a sustainable social care solution. In the first instance, we have given councils up to £3.9 billion of additional funding in 2019-20, and the Prime Minister has been clear that he wants to see cross-party consensus on a sustainable way forward this year. I look forward to seeing progress made as swiftly as possible and hope that we will see work across this House on it, as I know this place takes the issue very seriously. In addition, we have run a national adult social care recruitment campaign to raise the profile of adult social care and encourage applicants. This has been successful; we have seen a 23% increase in the number of vacancies advertised on the DWP’s “Findajob” platform, which is improving the situation in the short term.

My Lords, there are particular shortages of nurses in certain specialties such as children’s palliative care, children’s mental health and learning difficulties. What will the Government do to improve the situation in those very important and sensitive areas?

The noble Baroness is quite right that we want to target recruitment towards the areas with the greatest shortages. That is one of the reasons why, when we announced the new non-repayable funding, we also announced a top-up for targeted specialties struggling to recruit. It is also why we have announced the availability of placements which can enable nurses to develop experience in specific specialties, which make it easier to recruit and retain those nurses in very rewarding and sometimes hard to recruit specialties.

I am sure the Minister will understand why the House might be slightly sceptical of “as soon as possible” promises, given that we are still waiting for a Green Paper that was promised almost two years ago. A date would be a good idea here.

Do the Government intend to follow the example of the Welsh and Scottish Parliaments and introduce safe nursing staffing legislation? Does the Minister agree with me—and with UNISON, which has 450,000 health workers in its membership—about the ever increasing importance to the NHS of recruiting nurses from overseas? How can the Government justify increasing the health tax, which applies to overseas nationals and will surely make it harder to recruit and retain nurses? Will the Minister suggest to the Treasury that the Government should in fact drop that planned surcharge?

The noble Baroness will know that appropriate staffing levels are already a core part of the CQC’s registration regime and that the law already requires hospitals to employ sufficient numbers of suitably qualified, skilled and experienced staff at all times. It is also mandatory for staff to provide monthly reports on the average number of care hours per patient per day, which is considered a better measure than staff numbers. However, we recognise the proposals that have come forward regarding staff safety and legislation; they are being considered at the moment.

The NHS surcharge is being considered to make sure that it is at an appropriate level to ensure that we continue to recruit at an appropriate level. At the moment, the rate of recruitment from non-EU countries has increased significantly by more than 150%.

My Lords, I am sure the Minister knows that safety is about not just numbers but the continuing development and supervision of nurses and midwives. Can she comment on what the Government are doing to ensure that both nurses and midwives are funded properly for clinical supervision and professional development?

The right reverend Prelate is quite right. Ever since the tragic events in Mid Staffordshire, the NHS and our nation have been on a journey to make sure that the NHS is one of the safest healthcare systems in the world. This is based broadly on three policy strands: better regulation; greater transparency; and a culture of learning. HSIB is part of that. We hope to move forward in putting legislation in place to ensure that there can be learning without blame, and we hope to ensure that the appropriate training is in place. The people plan, which the noble Baroness, Lady Harding, is in the process of finalising, will ensure that specific proposals on how that will be delivered come forward imminently.

My Lords, the Government are to be commended for wanting to raise the number of staff in the NHS and social care. In the near term, it is equally important that we make sure that we use the staff we have as efficiently as possible, and that we give them the tools and skills to be as productive as they can, including through the use of technology. To what extent will the digital tools that already exist and are on the market feature in the people plan?

My noble friend is a great advocate of investment in innovation and technology—and for good reason. One of the health infrastructure plan’s key priorities is ensuring that we bring forward the data and digital transformation solutions that will enable staff to spend more time on caring and less time on administrative and repetitive tasks that could be much better undertaken by some of the digital solutions that are now available. Some of those solutions would manage rotas more effectively and others, such as those being delivered by the £200 million AI hub, will enable, for example, AI solutions in radiology and pathology, which could lead to much earlier and more effective diagnoses in areas such as cancer.