As nurses prepare to go on strike in their fight for higher wages, the cost of living crisis is biting, and no one, will escape the inexorable rise in our day-to-day expenses.
Yet in all the furore around nurses demanding inflation relief and going on strike, everyone – including our government – has overlooked how such a pay rise will impact an already strained social care system.
Some 32,000 nurses work in social care, roughly 10% of all nurses – and the overwhelming majority of them work in nursing homes. If the pay disparity between NHS nurses and nurses working in social care gets even bigger, more nurses will be tempted to decamp, leaving the social care sector to work in the NHS.
This issue arose during the pandemic after vaccination against Covid became a compulsory condition of employment across care homes but not the NHS. As a result, those nurses who did not want to get vaccinated simply left care homes to work in hospitals. This exodus added further pressure to an already understaffed industry. To make matters worse, many nurses who migrate to the UK from abroad have traditionally seen social care as a stepping-stone. These nurses typically work in care homes for a year or two before joining the NHS, which has better remuneration and benefits than social care.
Fewer nurses in social care will inevitably lead to more nursing homes being forced to close or deregister. In turn, this will lead to more patients getting stuck in hospital, ambulance delays will get longer, and elective surgeries will be cancelled. This is because nursing homes – which are already struggling to take people ready to be discharged from hospital – will have even less capacity. This is already occurring due to staff shortages in social care, with dire and sometimes fatal consequences.
If care homes are forced to rely on agency nurses, their cost pressures – already strained due to energy prices and inflation – will increase further, and the quality of care will suffer.
Putting pay aside, nursing homes offer nurses a great opportunity to work holistically with people and their families. Furthermore, a nurse working in a nursing home may well find themselves in charge, leading a team and having much more autonomy than they would traditionally enjoy in a hospital. Many nurses retiring from the NHS go and work in nursing homes for this very reason.
Everyone, not just NHS nurses, needs relief from the cost of living crisis, but for every action, there is an equal and opposite reaction. We already face a social care crisis. Unless the pay disparity is matched by an equal level of relief for the social care sector, the potential consequences would be disastrous.
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