Northern Ireland Association of Social Workers response to
Northern Health and Social Care Trust 2017/18 Financial Planning
Savings Plan Consultation Document
Introduction
The Northern Ireland Association of Social Workers (NIASW) is part of the British
Association of Social Workers which is the largest professional body for social workers
across the UK. The Association has 22,000 members employed in frontline,
management, academic and research positions in all care settings.
NIASW is opposed to the planned cuts to the Northern Health and Social Care (HSC)
Trust budget of £13m, as part of the proposed Northern Ireland HSC budget savings
of £70m.
Agency and locum staff
NIASW recognises the need for the HSC Trusts to more effectively manage agency
workforces and notes the Northern HSC Trust intends to save £2.42m by ending its
reliance on the use of non-contract Agency Nursing staffing and reducing its use of
Locum staff.
Employing staff on agency contracts does not represent value for money. The Bengoa
report Systems not Structures highlights that in 2014/15 almost £76.5 million was
spent on employing locum and agency staff across the HSC workforce, a 78%
increase on the £43 million spent in 2010/11.
Social work spend on HSC agency staff amounted to £2.9 million in 2014/15, this
increased to £4.6 million in 2015/16.
While NIASW recognises the need to address spend on agency staff to ensure the
long-term sustainability of the HSC workforce, it is deeply concerned at the impact the
proposed measures will have in terms of reducing access to beds in Rehabilitation
services, reducing the number of beds available in acute hospital services and limiting
routine elective work. NIASW is also concerned that the reduction in access to
Rehabilitation services, a result of reducing agency / locum spend and reducing the
number of rehabilitation beds commissioned from the independent sector, will lead to
an increase in bed blocking in acute services and will add pressure to demand for
community rehabilitation services.
This highlights the importance of developing a long-term solution to address the
current reliance on agency and locum staff while ensuring patient / service user care
is not negatively affected. NIASW encourages each HSC Trust to work closely with
the Department of Health to ensure the Department’s forthcoming Workforce Strategy
adequately addresses the staffing needs of the HSC.
Containment of growth in community care home placements and domiciliary
care packages
NIASW is particularly concerned at the Northern HSC Trust’s proposal to contain
growth in nursing and residential home placements and packages of domiciliary care.
The Bengoa report recognises our aging population will require significant additional
social care resources to adequately provide for people in need of care and support.
For example, by 2020 there will be a 15% increase in the number of care packages
required compared to 2016.
Bengoa also highlights the need to increase investment in early intervention and
prevention to reduce the cost of admission to acute hospital services. When short term
savings are required to social service budgets it is often early intervention and
prevention work which is cut back. However, making cuts to these areas of work only
serves to increase the scope of social problems, resulting in greater costs in the longer
term.
The Trust’s consultation paper appears to recognise the impact of cutting access to
domiciliary care stating the restriction of care packages will result in increased bed
blocking, which will impact delivery of acute services.
The above impacts will also result from the Trust’s proposal to contain access to
nursing and residential home placements for new patients and service users for the
remainder of the year.
Individuals who cannot access placements will be required to remain in the community
and as consequence their care needs may not be adequately met. This in turn may
result in degeneration of medical conditions, necessitating the provision of expensive
hospital care in future.
In light of the impacts, NIASW considers it careless to reduce access to domiciliary
care and nursing and residential home placements in order to deliver financial savings
of £1.475m.
HSC Transformation
The former Health Minister’s 10-year vision for HSC transformation proposed the
introduction of a multidisciplinary primary care team (MDT) model embedded around
General Practice. These teams will include GPs, Pharmacists, District Nurses, Health
Visitors, Allied Health Professionals and Social Workers.
