02/07/2015 07:51 BST | Updated 30/06/2016 06:59 BST

Are Hybrid Care Worker-Nurses the Solution to Nurse Shortages in Care Homes?

Care England's recent report into the state of social care should be a serious concern for us all. The report starkly highlights that an inability to recruit nurses into the independent sector risks placing inordinate strain on social care across the board.


For those of us involved in the industry, the report is a confirmation of long-standing issues which have not been acted upon. There is at last genuine momentum behind the essential integration of the NHS and social care.

However this monolithic idea still needs serious development to be brought to realisation - in a way which ensures the continuity and quality of care services. In particular, persuading enough nurses both to join and to stay in social care will be fundamental to the health not only of the industry but our society.

Social care has seen many changes in recent years, and some have given significant cause for optimism. The publication of the NHS Five Year Forward View, the establishment of the Better Care Fund and the passage of the Care Act 2014 have been flagship moments representing a real desire to bring through some of the changes that the industry needs.

However, the sector is being asked to do more and more and the resources are not keeping up. Over the course of the last Parliament there was a cut in local authority adult social care budgets of 16 per cent. Yet in 2010 the Personal Social Services Research Unit projected that demand for social care services would increase by 17 per cent over the decade from that year.

These trends will only be exacerbated by an ageing population. Around 300,000 people already live in care homes throughout the UK, and the number is on the rise.

Social care has often faced neglect as the NHS dominates not only headlines but funding - indeed there is a link between those two things.

However as the report by Care England which represents independent care providers makes clear, the NHS also dominates staffing, as it is frequently able to offer better terms and conditions than many private providers and as such recruits heavily both from the private sector and from the pool of nurses available to both.

The upshot of this is that most vacancies in the care sector go unfilled for at least six months, with some being empty for around two years. If immigration rules are tightened without special dispensation for our industry, this shortage will become ever more acute.

One of the proposals being put forward by Care England to cope with this situation is the creation of a new hybrid role in the independent sector. This position would fall between a care worker and nurse, but would enable registered nurses to become supervisors whilst those performing the hybrid function - who would be known as assisted care practitioners (ACPs) - would fulfil the practical duties of nursing care.

Whilst ACPs would require training and CQC approved qualification, they would be easier to recruit than fully qualified nurses and would mean that fewer nurses would be required by private providers. Crucially it would also allow nurses a greater level of responsibility and career progression which encourages retention. Currently, staff turnover in the care sector is notoriously high.

Though silver in the care industry is more closely associated with hair than bullets, we at would welcome these changes as a practical solution to the acute staff shortages that the industry faces.

As the Government considers what is required to integrate health with social care, such pragmatism should be encouraged as a means of alleviating the pressure on care services whilst ensuring that the quality of provision lives up to the standard that all of us would expect for ourselves and our families.