Debate contribution: Domiciliary Care Packages: Northern Health and Social Care Trust
Debate contribution by Mr Robin Swann on .
- MLA
- Mr Robin Swann
- Party at the time
- Ulster Unionist Party
- Date
- 13 February 2024
- Type
- Debate contribution
- Business
- Adjournment
- Heading
- Domiciliary Care Packages: Northern Health and Social Care Trust
- Assembly identifier
- Official Report component 4206591
Read the official Assembly record
Text
Thank you for the opportunity to respond to the important points that have been raised this afternoon. I thank the Member for securing the Adjournment debate, which is the first of this parliamentary session. I also thank everybody who attended and contributed to it. I have attended many Adjournment debates as Minister of Health, usually with three or four MLAs from a specific constituency, but the topic today has engendered wider contributions, not just from Members whose constituency is in the Northern Trust area but from a number of Members whose constituency is in another trust area. In common with all our health and social care trusts, I am aware that the challenges that the Northern Trust has experienced in securing the capacity to meet the increased demand for domiciliary care are shared across the piece. The trust has reviewed the systems of its in-house home care service in order to improve efficiency and to deliver higher levels of face-to-face time with service users. As was referenced — Mrs Cameron mentioned it in her closing comments — he Northern Trust covers a quarter of the population of Northern Ireland, but it also includes over 27% of the region's people who are over 75, so it covers a wider proportion of the group requiring domiciliary care. It is that population base that generates the majority of demand for unscheduled care and community services. As Dr Aiken said in his contribution, demographics are also an important consideration, and that cohort of the population has grown by 17% over the past five years. As a result, the Northern Trust has experienced unprecedented levels of demand across a range of services. Unfortunately — this point was raised —I am advised that the trust is seeing an increasing trend of external providers handing back services due to their inability, as many Members mentioned, to recruit and retain staff. The mid-Ulster locality has been particularly impacted by issues concerning the recruitment and retention of staff, and I am aware that a number of Members have engaged directly with the Northern Trust on behalf of their constituents. Ms Sheerin's passion in her opening comments was telling, but it was not just about her passion; it was her understanding of the needs of the people who come forward to domiciliary care and of the people who work in it. Mr Deputy Speaker, I do not do this job without thinking about it. As an MLA whose constituency is in the Northern Trust area, I think that the engagement and support that we get from the top down in that trust— starting with the chief executive — in dealing with cases make it an exemplar to other trusts, and we heard about the challenges that they are facing. However, it is not a solution to everything that they need or that we want. I advise Members — as Mr Buchanan said, I have already responded to him in writing — that the Northern Trust has commenced a contract with a new independent sector provider for the mid-Ulster area, and the trust anticipates that that will increase capacity in that locality. As has been said, the trust has contracts with 22 independent sector providers, including three new providers who signed contracts in the past year. That is a positive step, but I accept that more needs to be done. It is important to note that the pressures and challenges faced by the Northern Trust in the provision of domiciliary care packages are, as I said, a regional issue that all five health and social care trusts are experiencing, and all are experiencing the same factors.
I understand fully the many challenges that result from the demand, which outstrips the available supply, for care packages. That has a knock-on effect, as many Members referenced. It delays discharges from hospitals and affects the availability of our hospital beds. Accessing domiciliary care packages for patients at the point of a hospital discharge remains a challenge for our health and social care trusts. As Members referenced, our health service in Northern Ireland is a circular system, so when pressure comes at one point, it has such knock-on effects. It has also been mentioned that there is no easy solution. Our staffing levels continue to be a significant challenge across Health and Social Care, particularly in the allocation and delivery of care packages. Clearly, any increase in the number of care packages that are provided must also have appropriate staffing levels that are commensurate with that additional provision.
I thank the Member for his comment. Shortly, I will come on to talk about that with regard to the forum, which l initiated and which is now running in the Department to look at eight workstreams. My officials continue to work to maximise capacity in social care and to engage with service providers in order to address those ongoing issues of not only recruitment but retention. That is possible only, as, I think, Ms Eastwood mentioned, with that skilled and dedicated domiciliary care workforce. I understand the importance of reward and recognition in the recruitment and retention of staff in the sector. I am also cognisant of the ongoing challenges that relate to the increased costs in providers' day-to-day expenditure. Over 75% of home care is provided by the independent sector. I place on record my sincere appreciation to those staff for the integral role that they play in Health and Social Care. The system would simply not operate without their dedication and commitment. Indeed, I recognise the need for action to support the sector and those who work in it. I have stated that my immediate priority is to see pay negotiations taken forward and concluded without undue delay for our healthcare workers in the statutory sector.
Certainly. I thank the Member for his contribution. I referred to the interest that has been shown in the Adjournment debate. It shows the passion and commitment that we all, as elected representatives, have in the topic. In 2023-24, the regional domiciliary care rate that is paid to independent care sector providers actually increased to £18·54 per hour. Work is ongoing to consider what the regional rate for 2024-25 will look like. Although my Department cannot actually mandate the rate of pay or the terms and conditions that the independent sector providers offer to their employees, any uplift to the rate would be expected — I would expect this — to be reflected in the pay or terms and conditions of their staff. It came across in Members' contributions that now really is the time to move forward and look at how we can meaningfully affect that positive change and improvements in the social care sector in Northern Ireland. I am pleased to advise that the good work that is already under way will, I believe, help to achieve those aims. To that end, as I mentioned in response to the previous intervention and as Members may be aware, in 2023, my Department established a social care collaborative forum, the purpose of which is to provide a formal mechanism for the Department and representatives of social care across the statutory, voluntary and community and private sectors to work together as partners in order to build shared values and deliver improvements in social care. A number of workstreams have been established across a range of issues that have come from the forum. So that Members are aware, I will go through those eight workstreams. One looks at maximising capacity. Another looks at workforce development, which many Members referred to. There is a workstream on enhancing care in care homes, because it all is part of an integral system. There is a workstream on data research and evidence, so that anything that comes forward comes with that experience as well. There is one on communications because all of us, as constituency representatives, see that communication between health trusts, families and carers is vital to ensuring that people are content that the support that they need is there. There is also a workstream that looks at commissioning and contracting, because we are cognisant of the mix between independent providers and our statutory care system. Workstream 7 looks at the role of carers, which was mentioned in the House today. The last one is on supported living, which goes back to Mr Frew's point about the move to support people in their houses.
While a range of factors can impact on the delivery of care, the key objective, which we should all look to, is to meet the assessed needs of the service user, whether care is provided by the statutory sector or the independent sector. I recognise the importance of ensuring that patients receive the right care, at the right time and in the right place. I assure all Members that my Department will continue to work in partnership with all relevant stakeholders to progress plans for those vital services.
1,489 words. Text as published by the Northern Ireland Assembly.
Assessment
Awaiting analysis
This record has not been analysed yet. It is not counted in any total until it has been assessed.
Disagree with this assessment?
Classifications can be challenged. A person reviews every challenge, and any change is recorded publicly above with its reason.