Somerset Playbook

For many years, the health and social care workforce faced challenges and barriers around fragmented services, administrative hurdles, complex lines of communication and data and information sharing issues that constrained health and social care integration, but in a matter of weeks Covid-19 has shown that change is possible.  Health initiatives have been rolled out at speed to support the Covid-19 response, such as ‘Hospital at Home’, which aims to protect the elderly and vulnerable members of the community[3].  The sheer pace of transformation has been immense and there are positive examples of joined-up working across the NHS and local government that have supported the workforce by removing obstacles, such as information sharing.

The impact of Covid-19 on the health and social care sector may take many months and even years to fully understand as the pandemic still appears to have some way to go.  However, there is increasing pressure for local areas to start planning for what happens after the pandemic.

While this Somerset Playbook Programme for Place commenced in 2019 under a very different set of conditions, its objective of developing an action plan for an integrated health and social care workforce is now more vital than ever.  There is no doubt that the pandemic will leave a difficult legacy, but it may also be possible to use this crisis as a catalyst for positive change to ensure that the health and social care workforce emerges out of the other side of the pandemic transformed for the better.

In Somerset, prior to Covid-19, a place-based approach was deemed to be essential to address the following health and social care workforce challenges:

• Ageing workforce – in terms of the health sector, 28% of the current hospital and community-based workforce are over 55; and 46% of GPs will be over 55 in the next 5 years, and 24% are currently over 55. In terms of the social care sector, the average age of a social care worker is 42.3 years old. 74% of the workforce is below 55 years of age, and 4% is over 65 years old. The estimated turnover for the sector is 36.8%.
• Health and social care staff shortages – it is estimated that in Somerset there are over 300 nursing post vacancies and there is a 35% turnover in social care, with 39.3 % turnover in direct care. There are staff shortages in the following areas for which there is a supply issue through to at least 2021: GPs,  Nursing – Learning Disability, Paediatric, Mental Health, District, Neonatal, and Radiography.
• Primary care – high turnover rates, the age profile of current staff, growing demand for services and competing sources of employment all contribute to instability within the workforce.

Following the initial steering group meeting held in Somerset (see Annex A – steering group members), the BBI team carried out a series of interviews and a review of key documents, information and data.  The emerging common themes focused on the issues facing young people in Somerset – e.g. limited job prospects, lower paid jobs, poor internet access, poor and at times non-existent public transport, cultural Isolation and geographical isolation – and the impact of Somerset’s aging population and the growing workforce needs of the health and social care sector.

Therefore, it was agreed that the focus of this work programme should be on young people and the health and social care workforce, particularly around development and retention of local talent in order to achieve a better inter-generational balance.

The overall aim was to explore the development of an integrated health and social care workforce plan for young people in Somerset focusing on:

• Creating a sustainable trainee pipeline at all levels of competency.
• Developing a consistent approach and career pathway to health and social care apprenticeships.
• Exploring the possibilities of making greater use of Further Education (FE) colleges.
• Developing Somerset as a ‘brand’ to attract recruits to entry level roles and to come to Somerset after professional training.

There are, of course, specific workforce plans and priorities within and across sectors, organisations and services in Somerset and it is not the intention of this document to attempt to replace organisational or specific workforce strategies/plans but rather to support these by building on the good work and activity already taking place across the county.

The programme and action plan in this report concentrate on the need for collaboration with health, social care, voluntary services, the independent sector and with education and training providers in order to address workforce challenges.  The goal is to address gaps, ensure the delivery of the key priority areas and to maximise efficiencies by bringing people and expertise together, and to create synergies where they do not currently exist in order to support the development of an integrated health and social care workforce that is fit for the future and increases the supply of talent.