Health and Social Care Committee, 10 Chwefror 2022 | Open Senedd

Open SeneddEnglish

Health and Social Care Committee, 10 Chwefror 2022 | Open Senedd

Allison Hulmes

Diolch, Rhun. In terms of the size of the shortage, at the moment, in terms of sickness rates, the most recent estimate that we've got is that we've got 2,333 absences, so that's about 10.5 per cent of the workforce. I think if I go back a little bit to your earlier questions around some of the barriers to entering the profession, we have to talk about—. We talk about parity of esteem all the time, but it's not a noun, it's a verb; you have to do something. So, we have to address the student bursary question. We're not getting that pipeline into the profession and we're seeing attrition rates at the highest that we've ever seen them across all of the programmes, including the Master's, and that used to have the lowest attrition rates.

We know that student social workers in Wales do not have parity of bursary with nurses and with allied health professionals. One easy way of trying to increase the number of social workers that we have is addressing the bursary question. Student social workers in Wales have been running an absolutely fantastic campaign to increase the student bursaries, but that has to be addressed as a matter of priority. In terms of real-life impact, I spent two hours last Friday speaking to a second-year Master's student who has lost his home, he's sofa-surfing and any savings he had are completely used up. I spent two hours on a Friday evening, until half past seven, with a Master's student who is at the point of qualification but is so desperate because of his financial situation, seeing no light at the end of the tunnel, that he was at the point of leaving his studies. This is the real-life impact of not having those parity of bursaries.

The other perverse situation that we have is that we have these perverse market supplements that local authorities apply to try and address some of the shortages of staff. We have 22 local authorities, so lots of opportunities for social workers to move easily if a local authority is offering—. You know, there are all sorts of reasons why social workers might want to change local authorities, but at the moment, although initially they start on a good salary, we know that social workers are living in families where family members have lost jobs, so social worker salaries, now, are supporting adult children, but also partners who've been furloughed, but also lost their jobs. So, market supplements become an attractive reason for—. But of course, that just leaves problems and vacancy gaps behind. We've talked for decades about a national pay structure for social work, and again, in terms of solutions, that could be quite a straightforward solution to close some of these perverse incentives. You know, we have one local authority at the moment that is offering £8,000 to social workers in children's services to address some of these issues.

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Nicola Stubbins

I think it's fair to say that waiting for assessments isn't just waiting for social care assessments; it actually includes different specialised medical assessments as well. So, that picture is quite a complicated picture. It may require a specialist physiotherapy assessment, occupational therapists, it might be a psychiatrist assessment, a mental health nurse assessment, or it could be a social work assessment. So, there are a multitude of assessments captured within that figure.

What I would say is, though, that we have had a programme called discharge to recover and assess that is really about ensuring that individuals are discharged timely and then assessed in the community, either in their own home or in a residential care setting. But, again, in order for us to be able to do that assessment, we need that social work, we need that therapy, assessment, and we have a shortage of workforce not just within the social care workforce, but also within those crucial therapy posts as well. So, what we can't do is discharge somebody and then leave them without an assessment, because that is just as bad, if not worse, for the individual and likely to end up with the individual then being admitted back into hospital unnecessarily.

So, the whole system really needs to be considered, those community resources, those hospital resources, and we need to be able to work together. I still, unfortunately, hear some of my social workers say that they've gone on to a ward, having been let on—as Allison said, that was not always easy—but, having gone on to a ward, having been told somebody was ready for an assessment, to find that individual is not ready or is still waiting for certain procedures to be completed. So, that then is a waste within the system that we absolutely have to avoid. Unfortunately, sometimes, though, the pressures on trying to move people through the system quickly mean that, sometimes, we push the responsibility for that individual to another organisation rather than actually looking at that individual as a whole to see how we can all work collectively together to support that individual, and take time with them as well to understand what matters to that individual. I do think we rush people out of hospital without actually spending sufficient time talking to the individual, understanding what their needs are, what they want to achieve in terms of outcomes, and, as Allison said, that ethics of how we treat people is absolutely crucial. Individuals deserve dignity.

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