NHS Providers response to Liberal Democrat health and social care consultation paper 139
We welcome the opportunity to submit to the Liberal Democrat health and social care consultation paper 139. We have not responded to all questions in the document and instead have focused our response on the most pressing concerns for the provider sector including: workforce, prevention, integrated care, funding for social care and mental health services.
- Workforce is the number one concern for trusts, with over 100,000 vacancies across the sector. The interim NHS People Plan is welcome and is the first, clear, public recognition from our national system leaders of the severity of the workforce challenges the NHS faces. As we look ahead to the spending review and the publication of the final NHS People Plan in the autumn, we would like to see appropriate funding for education and training and issues around domestic supply addressed in more detail. We would also like to see additional funding for continued professional development; clarity over financial support and targets for international recruitment; and revisions to the apprenticeship levy.
- The funding shortfall for public health services needs to be addressed urgently. Local authorities have been forced to reduce spending and cut public health services, as well as other services that promote health and wellbeing – such as leisure facilities, libraries and access to green spaces – in order to fund other statutory duties, including adult social care. This means much has already been lost in the way of local authorities’ financial capability to support a holistic and tailored approach to population health management.
- We welcome the move towards local system working and integrated health and care services. In developing approaches to system working – such as sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) – it will remain important to take into account the continuing accountabilities of their constituent organisations, notably, trusts, clinical commissioning groups (CCGs) and local authorities.
- The NHS and social care are two sides of the same coin and we must invest appropriately in both if people are to access the support they need. Social care eligibility needs to be based on need and widened to make sure that those with unmet or under-met need have access to appropriate care and support. However, adult social care services are facing a funding gap of £3.6bn by 2025. There is a growing workforce gap due to low pay, working conditions and lack of job security. Addressing this situation means a new settlement is needed in order to provide secure, long-term, funding at a level to enable the social care system to operate effectively and deliver the care that people need.
- Mental health services continue to face significant challenges, including rising demand, enduring shortages in the workforce, constrained mental health funding and the impact of cuts to wider public services. Consequently there is a substantial care deficit in mental health that must be addressed, with unmet need for a number of conditions – particularly relating to community services for adults and children, gender identity services and crisis home treatment teams – and NHS commissioning decisions have often resulted in services being cut or reduced.