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Ymchwiliad i gynaliadwyedd y gweithlu iechyd a gofal cymdeithasol

Inquiry into the sustainability of the health and social care workforce

Ymateb gan: Comisiynydd Pobl Hŷn Cymru

Response from: Older People’s Commissioner for Wales





Dai Lloyd AM


Health, Social Care and Sport Committee

National Assembly for Wales


CF99 1NA


26 August 2016




Dear Chair,

Inquiry into the sustainability of the health and social care workforce

1.   An appropriately trained and valued health and social care workforce is vital to ensuring high quality services in Wales. I therefore welcome this opportunity to comment on the sustainability of the health and social care workforce as part of the Health, Social Care and Sport Committee’s inquiry.

2.   I welcome the areas of focus identified by the Committee as part of this inquiry, which much of my work to date has addressed.   My evidence below summarises many of the concerns that I have raised through my on-going work:

Care Home Review:[1]

3.   Care staff play an essential role in whether or not older people living in care homes enjoy a good quality of life.   My Review highlighted the current pressures on the social care workforce in care homes in Wales, which included:

·        Lack of staff capacity, thus creating a task-based approach to care;

·        Lack of training, including appropriate training for staff working closely with people living with dementia and/or sensory loss;

·        Insufficient leadership and support for care home managers, which is essential to creating the right culture within a care home;

·        Availability of the workforce (including nursing staff shortages)

·        Staff terms and conditions

4.   My Review included a number of Requirements for Action in relation to the care home workforce which can be viewed here.  I am currently mapping work underway to achieve the outcomes that older people want to see and I intend to share this work with the Committee shortly.

Social Care Wales:

5.   The Committee rightly identifies the need to measure the extent to which Wales has a well-equipped workforce to meet future health and care needs, which will be taken forward through a number of avenues. 

6.   The future regulation of the domically care and adult residential care workforce through the Regulation and Inspection of Social Care (Wales) Act will ensure mandatory training for the social care workforce.  Drawing on the findings of my Care Home Review, I recently set out my expectations for ensuring an appropriately trained, care home workforce in response to the recent consultation on the priorities for the new Social Care Wales, which can be viewed here.

Domiciliary Care:

7.   The recruitment and retention of health and social care staff across Wales, and the factors that influence this, was an area again highlighted in my Care Home Review.  Most recently, I responded to the Welsh Government’s consultation on improving the recruitment and retention of domiciliary care workers in Wales, which outlined the need for the workforce to be seen as a profession of key strategic importance.  My response to this consultation can be found here

Primary Care:

8.   Welsh Government & NHS Wales’ primary care plan[1] clearly signals a shift towards more care and support being provided within the community and close to people’s homes, where this is possible.

9.   It is essential that appropriately trained health staff are available to make this intent a reality. For example, while commitments to nurse staffing levels in hospital wards, found in the Nurse Staffing Levels (Wales) Act 2016, are to be welcomed, sufficient workforce planning and training must take place to ensure that this is not met at the detriment of nurse staffing levels within primary care and the community.

10.               I am currently undertaking work to understand older people’s access to and experiences of GP services, gathering evidence through group discussion sessions and a questionnaire, and I will publish my findings in early 2017.

11.               While I do not wish to prejudice the findings and conclusions of this work, the evidence that I already have demonstrates that older people are aware of current workforce challenges in primary care, and in particular recruitment of GPs, and can currently find it difficult to make an appointment within a reasonable timeframe.

12.               I am able to brief you further on this work should you wish to receive further information.

Nurse Staffing Levels (Wales) Act:

13.               My Care Home Review included significant evidence regarding the key role that the Welsh NHS and its nurses play in the quality of care and safety of older people in residential and nursing care homes.  In addition to nursing care homes, there is a large number of nurse staff working across Wales in community settings.

14.               With the planned policy shift away from treatment and long stays within acute wards and towards care and treatment within the community, and also the need to better integrate health and social care services, responsive workforce planning and safe nurse staffing levels need to apply in those settings to ensure that potentially frail and vulnerable older people are receiving safe and appropriate care in all situations. My pre-legislative scrutiny of the Act can be found here

15.               I will be undertaking my Care Home Review follow up over the next year and I look forward to working with the Committee and its members in our respective scrutiny roles.     

If you require any further information, please do not hesitate to contact me.  

Yours sincerely,

Description: Z:\My Documents\digi sig for Sarah R.jpg  

Sarah Rochira

Older People’s Commissioner for Wales


[1] A Place to Call Home?

[1] Welsh Government & NHS Wales, Our plan for a primary care service for Wales up to March 2018, February 2015