Page 0029

and the individual.94 The Alzheimer's Society has criticised the 'Continuing

Healthcare' programme for not ending the postcode lottery of care funding-

claiming that: "statistics show a variation in the number of people receiving

NHS continuing healthcare across different areas even when there is not a vast

difference in the demographics of their population.95

But the trend in hospitals is moving away from extensive nursing care, with

healthcare assistants now spending more time at a patient's bedside than nurses

(and making up around a third of the hospital workforce).96

Not only is nursing care more expensive than basic care needs - £347 per

care home resident per week for nursing care compared to £197 for residential

care97 - but critically it effectively operates without a spending limit, as it is

classified Annually Managed Expenditure (AME).98 This stands in stark contrast

to local authority commissioned care which is under significant financial

pressure. Considering whether nursing care can be provided in a more efficient

way - particularly given the close links with wider care services - is of significant

importance.

At the same time, the Government-commissioned Cavendish Review found

the high levels of staffing turnover in care homes 'worrying', with nearly one

in five staff changing every year. The review also concluded that social care

employers found it "burdensome to navigate the sea of vocational qualifications

and training courses which has developed in response to changing fashions in

government funding."99

Care workers face a number of challenges in the workforce. They are typically

low paid and a report by the International Longevity Centre found that 93

per cent of care workers have faced verbal abuse and 53 per cent physical

abuse at work.100 The report also revealed that the prevalence of training and

qualifications across the care sector was low-adding to a perception of a

sector where there are few learning and development opportunities.101

Despite these challenges the adult social care sector will need to add one million

workers by 2025 in response to population ageing and increasing numbers of

people with disability associated with an older population.102 Clearly, more

could be done to support a better trained and motivated workforce.

94 NHS Choices, What is NHS

continuing healthcare (accessed

December 2014)

95 Alzheimer's Society, NHS

continuing healthcare (accessed

December 2014)

96 The Cavendish Review, An

independent review into

healthcare assistants and support

workers in the NHS and social

care settings (July 2013)

97 LaingBuisson, "Councils rely on

a 'hidden tax' on older care

home residents" (15 January

2013)

98 Department of Health, Annual

report and accounts 2012-2013

(July 2013) p22

99 The Cavendish Review, An

independent review into

healthcare assistants and support

workers in the NHS and social

care settings (July 2013)

100 International Longevity Centre,

The future care workforce (25

February 2014)

101 International Longevity Centre,

The future care workforce (25

February 2014)

102 International Longevity Centre,

The future care workforce (25

February 2014)

Chapter 3 - What Is The Diagnosis? Or Why Are We Failing Our Elderly?

29

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