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HSC cuts adult community care

HSC cuts adult community care

Monday 07 November 2022

HSC cuts adult community care

Monday 07 November 2022

Dozens of adults who currently receive health and care support in their own home face cuts in services.

Community care will be reduced for 55 individuals and withdrawn completely from seven people.

The Committee for Health & Social Care said that domiciliary care services were under intense pressure from a combination of staff shortages, increasing demand and greater complexity of care required by the island's ageing population.

The Committee said it was left with no choice but to "change the delivery model for a period to ensure resources are deployed effectively" and pledged that the cuts in services "will not put individuals at risk".

Deputy Al Brouard, the Committee's President, said: "It is with regret that we have had to change our delivery model for domiciliary care. Whilst this is an operational decision that has political support, it is not a decision that has been taken lightly and is one that has been taken after all other options have been exhausted."

Health & Social Care Committee

Pictured: The Committee for Health & Social Care said it supported cutting adult community care services as a last resort.

The States provide an average of more than 8,000 adult community care visits each week. Around 70 of these home visits are currently being withdrawn at short notice because of staff shortages. In addition, there is a waiting list for around 200 hours of care.

The Committee acknowledged that its decision to cut or withdraw a small number of services would cause some worry, but "will give certainty for service users, which is preferable to contacting service users…to change the services that staff can deliver at short notice".

The Committee said that difficulties retaining local staff and recruiting from off island were caused by "the personal cost of working in health and social care through the pandemic, changes related to Brexit [and] the rising cost of living, including accommodation and travel costs".

Dermot Mullin, the Committee's Director of Operations, said: "The pressure on community care services, and the health and social care system as a whole, is the worst I have ever experienced.

"Whilst cancelling or reducing services is a difficult decision to make, it's the right one whilst we are experiencing high demand coupled with global recruitment challenges.

"We are living through unprecedented times and none of us who came into health and social care would ever have expected to be making decisions on these issues."


Pictured: The Committee for Health & Social Care said that the effects of covid-19 and Brexit were among the reasons for staff shortages causing cuts in adult community care.

In a potentially ominous sign of pressure on the island's health and care services over the next few months, Mr Mullin said that "last winter was difficult but we managed to get through it but this winter could be set to be even more difficult, primarily due to the reducing numbers of health and social care practitioners and support workers available to attract or recruit".

"Community care services are just one part of the whole system experiencing service delivery challenges. [Health & Social Care] regularly discuss pressures in children and family services, community services, mental health, adult disability, the acute hospital and of course our services in Alderney at the Mignot Memorial Hospital," he said.

"Care is at the heart of what we do, and we regret that individuals will potentially experience disruption to their care pathway because of the staffing challenges in all parts of the system."

The Committee said that staff shortages in community care were also having an unprecedented knock-on effect at the Princess Elizabeth Hospital. Patients who are ready to be discharged have to stay in hospital longer than needed and this 'bed-blocking' results in the need to postpone some elective surgery.


Pictured: Some surgery is being postponed because of the unavailability of beds occupied by elderly people who do not need to be in hospital but cannot be safely discharged because of lack of resources to provide community care. 

Karen Leach, the Committee's Associate Director of adult community care services, said: "Our community care services have never been busier or more in demand. This is because of the continuing need to provide care to people who wish to live at home and the increasing complexity and frailty of many of the people we care for.

"Our teams of staff have had to make the very difficult decision to reduce or withdraw service users’ packages of care. The multi-disciplinary team has determined care packages using evidence-informed decision making but withdrawing or reducing services is not what we want to be doing when we come to work every day. We are dedicated, caring and compassionate workers who want to provide the best service that we can.

"Our team are aware of the important role they have in people's lives. This will be worrying to read but we felt it important to make people aware of the facts and the difficult position facing our services due to many factors beyond our immediate control. We will continue to do all we can to provide care for those in most need."


Pictured: Deputy Mark Helyar, the Policy & Resources Committee's treasury lead, has said that cutting staff and services is the alternative to significant tax rises which the Committee will try to get through the States' Assembly in January.

Deputies agreed the States' 2023 Budget last week. It provides States' committees with budget increases of £48million to take everyday expenditure next year to £573m, including an uplift of £24m - or 12.7% - for the Committee for Health & Social Care.

However, treasury lead Deputy Mark Helyar warned that cost pressures may push up spending further during the year.

During the Budget debate, Deputy Helyar also warned deputies that they will soon face a clear choice between the biggest tax increases in decades – almost certainly including introducing a goods and services tax [GST] – or large job cuts in the public sector and cuts to services as the States try to deal with a projected hole in their finances of up to £85million a year.


Dep. Helyar warns of public sector job cuts if States reject GST

States' spending in 2023 could go above £48m budget increase

States spending set to increase by nearly £50m next year

"We're nearing the day that we will have to turn off services"

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