It seems we have been talking about Brexit forever. In the last three years we have heard of nothing else from our politicians and the media. For all the propaganda in the lead up to, and during the referendum campaign of 2016 we remain totally clueless as to where we stand as citizens, businesses and as a society, irrespective of a ‘deal’ or ‘no deal’ position.
More importantly, the ever-changing goal posts of Brexit were hard enough to interpret when a potential deal was on the table. Now it seems the deal is potentially off the table and we have a new Prime Minister who is determined on taking the country out of the EU on the 31 October come what may! The comments coming from Boris Johnson and the Government are well documented, yet it still seems to be the same old rhetoric we have been hearing for the last three years with no clear direction or leadership which enables the public to understand just exactly what ‘no deal’ will mean in real terms, nor its potential impact in the short, medium and long term. What is more disturbing is that as we hurtle towards the 31 October deadline little has been said about just exactly how ‘no deal’ will impact on the adult health and social care sector. Publications pertaining to adult social care on this subject are limited and many written when the expectation was, we would leave on the 29 March and before ‘no deal’ was a real and looming threat.
It is hard to understand that with something as important as adult social care in this country why the government has not worked more closely with the sector to help it prepare for Brexit. Clearly the NHS hasn’t been left stumble alone into the Brexit wilderness! To put into context why I think that more attention to the sector is needed to help them navigate the Brexit minefield, let me highlight the following. In 2017/18 the costs of providing adult social care in England was 17.9 billion (NHS). This highlights the cost of provision but not the scale of the sector. When you consider the scale of workforce 1.62 million and the number of service users accessing services the adult social care sector is a massive provision across the country and one which needs to understand just how Brexit will affect its market. Indeed, demand for services rose by 1.8 million in 2015/16 and we understand that local authorities are planning to increase their budgets to meet demand in the next couple of years. Add the ageing population, a growing demand for more complex care needs and persistent delays and lack of leadership across all political parties to deliver on the Social Care Green Paper and the sector have a real challenge on its hands. With more pressures on services and the unknown impact of a ‘no deal’ Brexit how can we ensure the same quality and standards of service are delivered under such circumstances when we don’t yet fully understand all the implications. With such little information out there can we assume how Brexit will impact on the adult social care market and is it too late to try an mitigate the impact when resources are so limited in every sense?
A major implication for the sector in the event of ‘no deal’ is the impact on EU workers. The sector has over several years grown to be dependent on EU workers in social care. It is estimated that the workforce derived of EU National is 8% in England and by the same token 5.2% of the NHS workforce. Whilst the EU Settlement programme has been open for some months, it is anticipated that in the event of a ‘no deal’ the deadline for submissions to stay in the UK will need to be submitted December 2020, some twelve months earlier than the original deadline of a deal being struck with the EU.
Furthermore, we are told that delays to the supply chain are an almost certainty. This means that many of the goods and services we depend on to conduct our daily lives will most likely be affected. Not only will delays in the supply chain affect us as citizens the impact will reach our workforce and service users. The United Kingdom Home Care Association (UKHCA) is recommending that providers start to try an mitigate what they see as some of the potential issues associated with a ‘no deal’ Brexit which includes the availability of:
- Medicines
- Personal Protective Equipment (PPE)
- Continence Pads
- Food shortages
- Homes without utilities
- Traffic Congestion
- Care workers access to fuel
- Mobile phone and telephone disruption
- Non-British workers leaving
- Civil unrest / aggression towards non-British nationals
How can providers effectively mitigate for things they have no control over or have no real confirmation of whether they will face a set of circumstances. No one really knows just what will happen because this is a ‘first’ in terms of a country leaving the EU. We surely must hope that common sense prevails and both sides of the negotiating table get their act together. I do hope that the powers that be realise that whilst I might cope with some level of disruption to my daily life in a ‘no deal’ scenario there are millions of UK citizens who could not cope, and who depend on adult social care services. How does Brexit sit with their human rights and how will commissioners respond if the above predictions come to fruition and service delivery across the country is affected?
So how is the Government planning to protect those individuals that depend on social care services, in the event of ‘no deal’? the answer is I am afraid we simply don’t know. So my challenge to the Government is to ‘step up ‘ be honest with us about how ‘no deal’ will impact adult social care and advise us in detail about what preparations you have made to protect vulnerable people in this country that depend on the 60,000 plus providers out there. We know the social care sector is in crisis now. Imagine the ramifications of ‘no deal’ increased demand, failing standards, a workforce in crisis, and a whole new level of risks to service users. Social care doesn’t stop just because we leave the EU it’s a human supply chain to the vulnerable which needs to be protected at all costs.
Rosie Turner
Health and Social Care Associate
Further reading: https://www.kingsfund.org.uk/publications/articles/brexit-implications-health-social-care
