Audit Scotland report finds £667 million a year shortfall and charities already struggling to recruit skilled nursing and mental health staff
Charities providing social work services are not paid enough by councils, putting the future of some services at risk.
A major new Audit Scotland report into social worker services in Scotland claimed third sector social care providers are already struggling to recruit and retain skilled staff due to tight finances but warned things are only going to get worse.
The report, commissioned by government spending watchdog the Accounts Commission, says that overall Scotland’s social work and social care services are unsustainable.
It estimates that up to an extra £667 million a year will be needed by 2020 to help some of the most vulnerable in society.
Unless changes are made some providers could be put at risk due to the financial pressure from a mix of growing demand on services, the national commitment to pay staff the living wage and the impact of the new integrated health and social care joint boards.
Councils have been looking at ways to reduce spending by outsourcing much of their services over the last few years by means of competitive tendering, however despite their overall spending falling by 11% since 2011/12 spending on social work has increased by 3%.
In 2014/15 charities were paid just over £569m from Scotland's 32 councils' £3.1billion net expenditure on social work, and employed around 56,000 staff.
Charities however, claim the funding just isn’t enough to cover costs though, as they struggle to pay staff much above minimum wage level and are even having to look abroad to plug gaps. There is a particular shortage of nurses in care homes and mental health officers.
They say they now have to pay to constantly recruit to fill posts due to rapid turnover of staff who can get higher wages at some councils or larger companies which is causing a significant threat to maintaining service standards.
The report clearly signals that efficiency savings and price competition are not effective in addressing the problem
Dee Fraser, deputy director of the Coalition of Care and Support Providers in Scotland (CCPS), the membership association for providers in the third sector said the report gives much-needed detail on the scale of the financial gap faced by all social care partners.
“The report clearly signals that efficiency savings and price competition are not effective in addressing the problem and we need to start thinking and acting differently about how support is planned, commissioned and purchased,” she said.
“CCPS has a significant body of evidence documenting the negative effects price competition has on social care. Low hourly rates drive low pay and consequent problems with recruitment and retention and ultimately this has an impact on service continuity.
“While we recognise the financial pressures faced by statutory partners it is crucial that our focus is on establishing fair work practices that deliver fair hourly rates for fair hourly pay to ensure people get the best support possible.”
Ellen Hudson, associate director of the Royal College of Nursing (RCN) Scotland said the organisation is aware that there is an issue in recruiting and retaining qualified nursing staff.
“We are interested in seeing how the new care home contract supports registered nursing staff to provide quality health care for people with complex care needs, within the care home environment," she said.
"Beyond this, a coherent approach across all sectors is needed.”
Audit Scotland called for local authorities to thrash out a new coordinated approach with charities, the private sector and Scottish Government which sets the overall strategy for social work across Scotland to resolve workforce issues and look at how services are provided in the future.
The report further highlights the range and complexity of care provided for 300,000 Scots - from young children to increasing numbers of frail elderly people.
The public, voluntary and private sectors employ just over 200,000 social work and care staff.
Douglas Sinclair, chair of the Accounts Commission said: "A critical test for any civilised society is how it provides for the needs of its most vulnerable people. Councils have coped well in recent years but Scotland is now facing a watershed.
"Increasing pressure on social work and rising expectations of what it should deliver can only intensify.
"Now is the time for some frank discussions and hard choices. It is vital that people who use and provide services – and the wider public – are actively involved in that debate on future provision."