Union calls on NHS Highland to cease phased outsourcing of home care

The GMB union has claimed that a shortage of staff providing home care for some of the most vulnerable people in the Highlands has left the services at breaking point.

The union also says that privatisation had left profit-making private care providers competing for clients in more affluent areas at the expense of remote areas where provision is more costly.

The GMB has now written to head of NHS Highland (NHSH) objecting to plans to outsource 1,200 hours per week of home care to private contractors which is to be completed by end of March 2016. The outsourcing is to be phased in across the region with private firms working alongside NHS direct workers until the outsourcing is completed.

The union claims in house staff will transfer to private providers under TUPE legislation but that will not be the case for 26 carers who now walk from house to house. They will be required to learn to drive or face redeployment or redundancy.

In the letter to NHSH chief executive Elaine Mead, Liz Gordon, GMB Scotland Regional Officer, says: “We consider that this calculated run-down of the in house service in favour of the reportedly more economical care will not prove to be cost efficient in the long term.  

“It has been acknowledged that the NHS Care at Home service will shrink through the natural wastage of posts. Surely leaving the in-house sector depleted in the short term, while the private commissioned care firms (partners) have not yet recruited sufficient staff. This leaves both private and NHS care bodies are under-resourced.

“Capacity in both in-house and private sector is at present woefully inadequate. Many elderly are dependent upon carers – family members, neighbours, friends, etc rather than have access to the mandated free personal and essential in-house care which they have every right to expect from the NHS.  

“With regard to the communities surrounding Inverness, now to be called The Moray Firth Region, GMB Scotland understands that the independent care firms favour taking over packages of care in these more lucrative, densely populated areas of Highland. GMB deplores the situation whereby independent partner firms are reluctant to take on the more remote areas of Highland, which in-house care at home has always managed to staff.”

“GMB Scotland, while well aware of budget constraints, feels strongly that NHS Highland, along with other regions throughout Scotland should be seeking (if not demanding) more Scottish Government funding to address the serious lack of  resources throughout the adult care sector.”

Responding to the claims, NHS Highland area manager, Jean Pierre Sieczkarek, said: “We are working with 12 independent contractors to promote choice and increase capacity and quality. We have agreed terms and conditions that include paying the living wage and ensuring training needs are met.”

Addressing claims of redunancies or a shortage of care staff, Mr Sieczkarek said: “Whole-time equivalent establishments have been reduced, but no existing staff member has been affected. No member of staff has or will be made redundant.”

And he denied there was any evidence of “cherry picking” by private operators.

Answering concerns about continuity of carers, he said staff were not guaranteed the same clients “as they are employed to support the most vulnerable in our communities”.

Copy of full letter from GMB Scotland:

Elaine Mead, Chief Executive NHS Highland, Assynt House, Beechwood Business Park, Inverness, IV2 3BW.

Monday, 19 October 2015

Dear Elaine Mead,

I write to highlight GMB Scotland concerns over the redesign of the Home Care Service. It is our view that the present outsourcing of parts of the NHS Care at Home Service to the private sector is being done without full regard for the long terms consequences.

It has been acknowledged by the Redesign Group that the NHS Care at Home service will shrink through the natural wastage of posts.  Surely leaving the in-house sector depleted in the short term, while the private commissioned care firms (partners) have not yet recruited sufficient staff. This leaves both private and NHS care bodies are under-resourced. 

It is our understanding;

The client group is already suffering a dearth of care provision, a point discussed and evidenced at various meetings.  

The eventual transfer of all long-term Care at Home clients – now to be termed “maintenance” clients, to the private sector has come as a shock to our members within the NHS workforce, and is causing, what should have been, avoidable stress and anxiety.  

The re-designed role of “Enablement worker” left for in-house carers is not seen as a move to the stated Service of Excellence, but rather as a tool to solve the delayed discharge situation within the Highlands’ hospitals.

Capacity in both in-house and private sector is at present woefully inadequate.  Many elderly are dependent upon “invisible” carers – family members, neighbours, friends, etc rather than have access to the mandated free personal and essential in-house care which they have every right to expect from the NHS. 

With regard to the communities surrounding Inverness now to be called The Moray Firth Region. GMB Scotland understands that the Independent care firms favour taking over packages of care in these more lucrative, densely populated areas of Highland.   GMB Scotland deplores the situation whereby independent partner firms are reluctant to take on the more remote areas of Highland, which in-house Care at Home has always managed to staff.

We consider that this calculated run-down of the in house service in favour of the reportedly more economical care will not prove to be cost efficient in the long term.  

GMB Scotland while well aware of budget constraints, feels strongly that NHS Highland, along with other regions throughout Scotland should be seeking (if not demanding) more Scottish Government funding to address the serious lack of  resources throughout the Adult Care sector.

Where Re-design has already been started, significant issues are coming to the fore;

Walking staff are not being given the option to TUPE over to a new (partner) provider, instead they are being asked to learn to drive or redeploy.  GMB Scotland will be expecting the stated “innovative solutions” for walkers to be fully explored with each individual and for senior management to listen to the suggestions of carers and operational officers who have collectively given their clients many years of faithful service.

In principle the concept of Enablement is laudable, however, not all current staff wish to make the transition from ‘Care at Home worker’ to ‘Enablement or Reablement worker’ (we understand there is some confusion as to the new job title).   GMB Scotland expects that similar negotiations, as those for walking staff, will be entered into for any and all carers for whom Enablement is not a chosen option.

GMB Scotland is alarmed to hear from members that on-the-spot Enablement training was mooted recently. This is not a satisfactory alternative to full and rigorous Enablement training, on the grounds of heightened risk and loss of dignity, for both client and carer.

GMB Scotland has always maintained a resistance to the introduction of outsourcing within NHS Highland and we will continue to do so.

Now that matters have progressed to the point that the NHS is implementing these changes,  GMB Scotland will be broadening its campaign to protect all remaining Care Services to the elderly and other marginalised and vulnerable groups in the Highlands.

Yours sincerely

Liz Gordon, GMB Scotland Organiser