A workforce the size of the population of Newcastle needs to be recruited urgently to ease the “gridlocked” health and care system and to prevent serious harm to patients, the country’s care regulator has warned.
The Care Quality Commission (CQC) says it is getting “tougher and tougher” to access care because of a massive shortage in the workforce.
There are around 132,000 vacancies in the NHS and 165,000 across social care, about the same size as the population of the north east city.
And this shortfall in the care sector is having a huge impact on NHS waiting lists, hospital bed availability and accident and emergency response times.
The CQC described the entire health and care system as “gridlocked” and “unable to operate effectively”.
The CQC echoes the warnings raised by health leaders about the need to address the crisis in social care to ease the pressure on the rest of the health system.
Chief Executive Ian Trenholm said the recruitment challenge faced by health and care leaders “is going to translate into real difficulty” this winter and in the years ahead.
Mr Trenholm said the impact of the gridlock is that people are struggling to see their GP or dentist, wait for longer to get to hospital, and once there can become stuck due to a lack of social care to help them once they are ready to leave.
He said: “And this is not just a care consequence. There’s an economic consequence to all of this as well.
“People who are ill can’t go back to work because they’re in a backlog, in some kind of queue waiting for care.”
Amanda Pritchard, NHS England chief executive, said there are around 10,000 patients in hospitals who are medically fit to be discharged but must stay because there is no care provision for them in the community.
The CQC said only two in five people are able to leave hospital when they are ready, contributing to record-breaking waits in emergency departments following a decision to admit, and dangerous ambulance handover delays.
It found in some cases almost half a hospital is full of people who are medically fit to be discharged but are waiting for social care support, it said.
Beds are available but some care homes are closing their doors to new arrivals because they cannot provide safe staffing levels.
And some nursing homes are having to re-register as care homes because nursing staff are leaving and they are struggling to recruit replacements.
Figures from the Association of Directors of Adult Social Services show that more than half a million people (542,002) were estimated to be waiting for assessments, reviews or care to start as of 30 April this year.
Separate data from the workforce body Skills for Care show that the number of filled posts fell – by about 50,000 – between 2020-21 and 2021-22 for the first time on record.
The CQC’s annual report on the state of health and social care in England also warned that the rising cost of living could result in more care staff leaving for better-paid work.
The regulator also pointed to an unprecedented number of care workers in the South East resigning in May and June because of fuel costs.
The CQC said that, without action, more health and care staff will quit, services will be further stretched, and people will be at greater risk of harm.
This will be especially pronounced in more deprived areas, where access to care outside hospitals is under the most pressure.
Analysis: For too long the focus has been on acute care while the crisis in social care has been allowed to grow.
All health and care leaders are saying the same thing.
Health and social care must be seen as the same integrated system.
For too long the focus has been on acute care while the crisis in social care has been allowed to grow.
Years of chronic underfunding has left social care in the state it is now.
But the impact on hospitals and the rest of the health service is now being felt.
The pandemic has swelled the waiting lists and to make any headway on the numbers, patients need to go into hospital and get out as soon as it is safe for them to be discharged.
But patients are going into hospital and staying there because there is nobody left to care for them in the community.
The pandemic helped to change the way we look at social care.
We saw just how vulnerable many people were, and we saw just how undervalued and underpaid social care staff were feeling.
That is why so many have left the sector. Unless pay and rewards are addressed care staff will keep leaving and new recruits will not take their place.
The NHS recognises the importance of social care in preventing patients from coming to hospital in the first place.
Among other measures it is setting up rapid response units to attend to people who have suffered falls.
The vast majority of these patients will not need hospital admittance.
Every time an ambulance crew attends a fall it cannot attend to another emergency.
I spent a day with the London Ambulance Service last week.
Our third emergency that morning was to attend to a 78 year woman who had fallen from her bed.
Elizabeth was thoroughly examined and no serious injury was found.
Records showed that Elizabeth had more than 200 ambulance visits for falls the year before.
If she had a good care package in place then those ambulance visits would not all have been necessary and the paramedics could have been responding more quickly to another emergency.