Members please see below transcript of a letter sent to Sean Holland, Chief Social Worker.
NIPSA is writing to you in relation to the ongoing Covid-19 emergency and specifically in relation to the pandemic impact upon critical social care services.
NIPSA’s shares the view expressed in your letter to Social Workers, that social care services are critically important not only in maintaining services to the public but also to allow discharges and prevent admissions from and to hospital and other areas as the pandemic progresses. The Social Work remit in relation personal social care, child protection, adult safeguarding and the discharge of statutory functions etc. under various legislative guises across these areas, makes it central to delivery of an integrated health and social care (HSC) system.
In that regard, we wish to register NIPSA’s escalating concerns that social care services are under increasing strain as we head into what we know will be the most challenging of situations. Ongoing concerns regarding the availability and appropriateness of PPE kit and associated training are obviously central worries for NIPSA members across grades and settings.
Unfortunately, the planning processes in all Trusts has, NIPSA believes, highlighted a struggle for social care to be fully recognised in the critical role it holds in continuing to deliver the range of care it does in communities. Whilst our members feel there are many reasons for this, there does appear to be an apparent lack of appreciation of the range of HSC services actually delivered in the community generally.
Whilst NIPSA understands and supports the integrated nature of health services across Northern Ireland, there are specific challenges to be met in continuing to provide frontline social care to the thousands of service users in homes and community settings that the majority of our members work in.
It is NIPSA’s view that the consequences of failing to properly sustain the established models of community delivery and service that support the majority of HSC service users, will inevitably lead to the overwhelming of our acute care colleagues and friends, however good the planning processes in the hospitals.
There are apparent differences in the availability of appropriate PPE and the training for social care staff in the use of this kit, who are working in the same settings across Health Trusts. From our member’s reports, it is clear that such stocks that are in place, appear be running low for staff working in many areas of social care. While we very much welcome the delivery of over 5 million new pieces of kit, there remains strong concern this will quickly be used and we will soon be facing further difficulties and decisions about how social care staff are able to function in the delivery of the services they provide.
Of particular concern to NIPSA is the growing perception amongst members that a ‘keep calm and carry on’ approach driven by PPE availability, rather than an adherence to established international best practice is perceived as driving Trust responses. This is deeply problematic as our members see Department of Health (DOH) and HSC leaders at all levels promoting messages about required PPE that our membership base are increasingly becoming sceptical of.
Such is our concern that we do feel obligated to point out that we are now at the point that should the appropriate PPE not be available going forward, NIPSA will need to offer advice in line with the relevant Health and Safety legislation and, for instance, the NISCC Codes of Practice to members in particular settings. For instance the codes state:
- 3.4 Bringing to the attention of your employer or the appropriate authority, without delay, resource or operational difficulties that might get in the way of the delivery of safe care;
- 5.7 (SW’s and SCW must not) Put yourself or other people at unnecessary risk
- 6.3 Being personally accountable for your actions and able to explain and account for your actions and decisions;
- 6.8 Ensuring that if there is a conflict between the Social Care Council standards of conduct and your work environment, your first obligation is to the standards;
While NIPSA will always take a constructive approach to issues our members raise with us, this is becoming increasingly challenging in how we will further advise our members.
In your letter to Social Workers you state “we have to make choices about what to prioritise”. It would certainly be NIPSA’s advice that members keep themselves as safe as they possibly can while delivering services and the DOH ensure there is enough PPE that is both available and appropriate to all health care staff.
NIPSA appreciates the huge amount of effort being put in place on surge plans, and without question this work is critically needed. Social care services will play pivotal roles in ensuring that vulnerable people are able to remain at home, that hospital services are not overwhelmed and that the entire system does not silt up as the surge works its way through the HSC. In addition to the issues flagged above, NIPSA is requesting engagement on a range of surge issues. A few examples of which are:
Maintaining and bolstering hospital/step down based social work services. Introduction of comprehensive point of discharge Covid testing for all HSC in patient discharges were referral to residential or domiciliary care services are needed to maintain confidence to accept referral in these sectors. Ensuring capacity within community systems in adults and children’s services to deal with the human fall out of the sustained community transmission phase of the pandemic i.e. family breakdown, mental health crises care arrangements collapsing etc.
While we always have member’s interests and the delivery of services at the forefont of our thoughts, NIPSA believes there is also much common ground on the objectives above. We therefore ask the DOH to operationalise policy documents that sees community play its vital role within the HSC service, while promoting excellence in all acute sector settings. It is important the DOH brings the same energy and focus to the very specific challenges faced by social care as that which has been clearly demonstrated on the acute side.
NIPSA will continue to fulfill our role in regard to the pursuit of these objectives across the pandemic period and we are therefore asking to discuss these matters with you along with our earlier correspondence on children’s residential care as a matter of urgency.