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Christie & Co’s social care report shows continued pressure on recruitment and fees

Specialist business property adviser, Christie & Co has published its fourth annual report on adult social care.

The report highlights the sector’s continued funding and staffing challenges, as well as the causes and impacts of winter 2017/18 which saw unprecedented levels of pressure on NHS hospital trusts, with 24 trusts reporting a ‘Code Black’ state across the UK.

The report, ‘Adult Social Care 2018: Funding, Staffing and the Winter Crisis’, also presents data gathered from surveys of local authorities and more than 200 leading operators across elderly and specialist care in the UK, particularly looking at the use of agency staff, costs and fees, and how the Government’s additional funding has been used.


The 2018 report outlines the continued challenges the sector faces in both recruiting and retaining trained staff. Whilst the removal of the cap on Tier 2 visas for overseas nurses is a positive development, the reports’s authors point to a 13% drop in total nurse registrations.

Uncertainty over Brexit has had a material impact on EU nurse registrations which fell by 87% compared with 2016/17 figures. While favourable immigration policies and overseas nurses are key in helping bridge the current gap, the ability to train and retain UK nurses remains a key issue. The report highlights that 30% of undergraduate students do not complete their nursing degrees.

Agency staff

Christie & Co’s operator survey responses showed that agency staff are becoming more expensive, despite 69% of elderly care operators reporting that they managed to hold or reduce agency staff usage

In specialist care, agency usage has gone up marginally whilst overall agency costs have fallen, indicating that agency staff are being used for lower paid support staff roles in specialist care, as opposed to more expensive, trained nursing staff.


Both operator and local authority surveys had shown reasonable overall levels of fee increases, albeit for elderly care, these fell below the average fee rate increases shown in Christie & Co’s 2017 report.

The surveys show that considerable regional variation continues, with funding remaining a critical issue as the sector awaits the anticipated Government green paper this autumn.

The need for sustainable funding and a joint approach between the NHS and Adult Social Care to commissioning was reinforced by pressures resulting from the winter of 2017/18. Due to the extreme weather conditions, unprecedented levels of demand were placed on the system with 24 NHS trusts reporting a state of ‘Code Black’ and NHS England issuing a directive to cancel all non urgent operations.

Christie & Co’s report found that almost half of those trusts which reported a ‘Code Black’ were in areas with the highest levels of delayed discharges and a high density of people aged 65 years or above.

The report highlights the importance of community care services in reducing unnecessary hospital admissions and the crucial role which social care can play in reducing bed blocking to free up much needed hospital capacity. Michael Hodges, head of consultancy – care at Christie & Co, said the 2018 research showed that once again, the most critical issues revolve around funding and workforce related themes with further complications related to uncertainty connected with Brexit.

“The pressures placed on the healthcare system by the winter of 2017 and the increasing age of the UK population illustrate the need for additional capacity, which can only be met by a comprehensive suite of policies associated with the key themes identified by our research,” he said.

The full report will be available to access from 5.30pm on the Christie & Co website: https://bit.ly/2QnVlXU

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