For years the health & social care sector has felt somewhat unloved – lack of investment, lack of staff & potentially costly for an individual. Unlike the NHS, which despite issues of its own is at least fairly well understood, social care has felt the poor relation.
As we approach the winter, whilst COVID is still very much an issue, what’s often forgotten is that its not the only one.
COVID
Over the past 18 months, there’s no getting away from the fact that COVID has had a huge impact on the care industry, as well as individual care homes and the staff that work there, both permanent and agency. Like their counterparts in the NHS, Its also fair to say that staff are tired, have had to work very hard to make up shortfalls as others go sick and have generally had an awful lot to contend with.
Today in the UK, the situation has at least improved – partly because of the vaccine programme, partly because of the improved understanding of the virus, partly because people in general are more cautious than they used to be – and party because we’ve just got used to living with it.
But its important to remember that COVID itself hasn’t gone away, the vulnerable are still vulnerable and as the colder months approach, extra care is going to be needed. Given that many of those vulnerable live with us in our care & nursing homes, its fair to assume the pressure will likely fall there again this time round as well.
Vaccination programme
Many would argue of course that the UK’s vaccination programme has been one if its better efforts in our fight with COVID. However, some would question the need and others simply refuse to to be vaccinated. Whether you agree with it or not, the law dictates that by November, if you haven’t been double-vaccinated, you can’t work in a CQC registered nursing or care homer.
Interesting, and some might say oddly, those visiting care homes don’t have to be vaccinated, nor currently do healthcare staff in the NHS. For some this may mean leaving the profession, a role they’ve probably had for many years, or transferring from the care home sector into the NHS. For them its not negotiable, but it will certainly add pressure on the already understaffed care home sector.
Isn’t that better for agencies?
Cynically one might argue it is, but in fact we face the same pressures for agency staff – and indeed some of own will likely leave for the same reasons unfortunately.
IR35
Possibly less well known than the others, the changes made this year to IR35 – part of HMRCs tax rules have had a large impact on staffing, more especially in the agency world.
Put simply, many agency staff work for multiple clients (homes) and often multiple agencies. To date, they have done this by working through their own limited company – as so-called Personal Service Company (PSC). By doing this, their company is paid directly – and not subject to the normal PAYE deductions, allowing them to claim back certain expenses and paying corporation tax etc. through the PSC.
Prior to April this year, the choice of doing this was down to the staff member. If they broke HMRCs rules, it was their risk. However with the exception of smaller independent homes, from April this decision was moved to the end-client (the care or nursing home itself).
Despite HMRCs earlier promises, many homes – as with other sectors such as banking, simply ruled that everyone must be paid through PAYE. For agency staff, this significantly limits their ability to claim back expenses and in effect means they are paid less.
The result? Staff choose the smaller homes that continue to (be able to) allow direct payments, or they simply no longer provide agency cover with the result that we are unable to cover less shifts for our clients.
BREXIT
Although admittedly not a huge problem for us, its fair to say that many from the European Union work in the healthcare sector, as well as the NHS, in various roles.
With the advent of Brexit and the need to either gain UK settlement status or navigate the new points-based immigration status, the lack of available staff in ours, as well as other sectors is already starting to bite.
Summary
The problem is real but there’s no easy answer. In way its a shame all the above arrived on the scene at the same time.
The biggest issues today revolve around the vaccine and IR35, both of which limit who can/will work – and from an agency perspective, for those that continue, where they choose to work.
Unfortunately without some targeted intervention, its not easy to say how this will improve any time soon.
Join us
There’s plenty of opportunity for those who wish to work in the healthcare – and for those with experience wishing to supplement their income through agency work, we are always looking for RGNs, RMNs and HCAs, in & around the North Surrey & SW London area
To find out more or ask a question, give us a call at 01372 23007 or email message@Care101.uk.