How will the adult social care workforce of the future be affected by public health changes in England? Vic Citarella, Director of health and social care consultancy CPEA, talks to the CfWI.
Vic Citarella is cautiously optimistic about the transfer of public health to local authorities in April 2013. But he believes it will take time before more integrated services and commissioning have an impact. To start with, the majority of people working in social care are unlikely to notice any difference. But with directors of public health championing the need for preventive investment, the benefits of integration and more long-term thinking, there should be positive outcomes for both people who use services and the social care workforce.
“The changes in public health are part of a wider picture of change, which includes personalised care, more emphasis on prevention and adult safeguarding,” he said. “In future, we will expect people in the social care workforce to work across health and social care and to be trained in new areas. This will include making the most of people’s strengths through self care and taking into account components related to their particular conditions, including medication and assisted living technology. A shared approach to training, support and supervision will have to be part of a more integrated approach.”
Inequalities in education and training will need to be addressed, said Mr Citarella. The healthcare and social care workforces are of a similar size, at around 1.35 and 1.56 million, but there has been comparatively little investment in training for social care. If people working in social care are to be trained in areas such as dementia and end-of-life care, the cost will be significant, but will lead to savings and benefits in the longer term.
New organisations such as consumer champions Healthwatch may also help to develop the skills, competence and confidence of the social care workforce.
“Greater integration may be an opportunity for people working in social care to be more innovative and challenging. Sometimes they can see ways of doing things better, but are not in a climate where they can raise issues. If they are all part of the same infrastructure there will be a place for this type of discussion. We may see a more confident social care workforce which is less deferential to medical professionals.”
More personalised services might also mean a more personalised workforce. If social care workers are employed directly by service users or their families, they may take more individual responsibility for their own training, development and practice. With greater choice in the system, they may follow the service user across commissioning boundaries, making workforce planning a challenge.
With many volunteers, community groups and individual carers working alongside paid social care staff, there is a shift towards a more enabling role.
“There is move towards refocusing the paid social care workforce on supporting carers and developing community capacity and networks of volunteers. Investment in self care and assisted living technology also makes the resources go further. There’s an emphasis on ‘doing with’ rather than ‘doing to’.”
There is a huge opportunity for the public health sector to help improve the health and wellbeing of the social care workforce, said Mr Citarella. Directors of public health could play a central role.
“There are high levels of stress and ill health in this workforce. Public health could be more sensitive to the welfare needs of an individualised and isolated social care workforce of over a million people. Occupational health ought to be high up the agenda.”
Planning for the future social care workforce will not be easy, however. “Many people don’t yet understand the complexity, fragmentation and diversity of the social care workforce. Thanks to organisations such as Skills for Care we now know a lot more about this sector than before, but workforce planning will still be a challenge.”
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