Care Assessments; from rhetoric to reality

Professor Martin Green OBE, Chief Executive, Care England

One of the things that happened during the early stages of the Covid-19 pandemic was that the NHS took the decision to enable care providers to assess people after they had been transferred from hospital. This marked a significant change in the way in which assessments were usually done, and we often had to wait a significant amount of time before social work assessments were completed, and people could move either back home with a care package or into residential care setting.

Undoubtedly this new approach to assessment has significantly reduced hospital stays and as we look towards the next crisis in the NHS – the elective surgery back-log, I believe that an expansion and development of discharge to assess can be a powerful tool in getting people out of hospital.

It is interesting to note that for many years, social care staff were not considered able to assess people, and we had to rely on expensive social workers, who are either in local authorities, or the NHS system. Now that social care staff have taken on this significant extra responsibility there is a need to acknowledge this in both their status and pay.

At the start of the Covid-19 pandemic, many primary care services completely withdrew from social care, and this meant that our hard-working, skilled and dedicated colleagues were now being asked to do things they were always told they could not do because it needed primary care staff. I hope that as we move to something more like normal the fact that social care staff have stepped up and been able to do many more important roles this will now be acknowledged by the system and we do not necessarily need to return to the pre-pandemic realities.

That said the extra work needs to be acknowledged in the training and development of social care staff and it also needs to be acknowledged in their remuneration and reward packages. The Covid-19 pandemic has changed so many things in health and social care and we must build on this and create a new approach to delivering services which is less fragmented and less focused on professions and more targeted on who can deliver the best outcomes for the people in our care.

Already we have seen many of the people who withdrew at the start of the Covid-19 emergency trying to regain their position and not acknowledging the amazing work of the social care workforce. The CQC have now begun their new approach to inspection which relies heavily on desk-based and risk-based approaches. This was not the service the care providers expected, nor indeed, it is the service that we are paying for. I believe we need to go back to the CQC and ask them why if this new system is so much less connected to physical inspection, we are still paying the same amount of money. I also note that one of the things CQC has said is they don’t have the capacity to run services in the way they used to. There would be absolutely no question of CQC accepting this as an excuse if it was delivered by a care provider as a reason for a drop in standards.

Covid-19 has been a game changer and we need to take some clear and strategic decisions about what has improved because of the pandemic and never let ourselves slip back to where we were.



Edel Harris





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