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Nurse shortages helping create ‘care deserts’ across England

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More than 1.3 million people over age 65 live across England in so-called “care deserts”, where residential care or care at home services are lacking due to a lack of beds or nursing staff, according to researchers.

Their study of adult social care provision, which was commissioned by charity Age UK, found that nearly 1,800 of the approximately 7,500 postcode districts in England have no care beds.

“They are desperately short of money to purchase care home places for older people”

Caroline Abrahams

Those districts are home to more than 1.3 million older people who have no access to care without travelling potentially long distances, said the analysts from consultancy Incisive Health.

They defined “care deserts” as areas where sufficient social care services were unavailable, no matter the individual or local authority’s ability to pay, meaning the needs of the local population went unmet.

“Care deserts develop because the market for social care becomes so dysfunctional, that either providers decide that it is financially unsustainable to operate and deliver the capacity required or because there are insufficient staff to deliver care,” they said in a report on their findings.

The Incisive Health researchers focused on four key market indicators: the availability of workforce, care homes beds, care home beds with nursing and the domiciliary care market.

Caroline Abrahams, charity director at Age UK said: “The report shows what an impossible position local authorities are in. They are supposed to ‘manage’ their local care market, but they lack the levers to do so and the big drivers of the problems in the care industry are way beyond their control.

“Meanwhile, they are desperately short of money to purchase care home places for older people in need, so more and more of the financial burden is being shifted onto those older people who fund their own care, who are paying through the nose to keep the system afloat,” she said. “This is deeply unfair.”

Incisive Health also found that there were significant regional variations in care availability. To analyse these differences, they singled out five areas to compare — Hull, Norfolk, Totnes, Guildford and Leicester— and found that the status of the care market differed dramatically from place to place.

One example outlined in the study was that, despite a slight rise in the total number of beds nationally over the last five years, some local areas like Hull had lost more than a third in the last three years.

“The social care system is broken. Despite the best efforts of the dedicated social care workforce”

Kieran Lucia

The study also found that, in some areas of the country, the care available was largely limited by a lack of staff, especially nurses. For example, some care homes in Devon had reduced bed capacity because of a lack of available staff.

It flagged what it described as the “particularly alarming” situation regarding the lack of availability of nursing home capacity, which it said was being driven by a decline in registered nurses working in social care settings. 

It highlighted that Skills for Care, which gathers data on the social care workforce in England, estimated that the vacancy rate for nurses in the social care sector in 2018 was 12.3%, higher than the 8% of vacancies across all social care jobs.

Kieran Lucia, Account Director at Incisive Health, said: “The social care system is broken. Despite the best efforts of the dedicated social care workforce, years of political inaction and budget cuts to local authorities have resulted in a system that is no longer capable of delivering care to everyone who needs it.

“Urgent action is needed to stabilise the system and set it on the course to delivering sustainable care in the long-term,” she added.

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