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Complex carers are a very important part of the front-line team to ensure quality care and support is provided to those that require it. Providing care and support to our service users requires a lot of hard work and is one of the most difficult occupations. We highly appreciate those that dedicate their lives to helping others.

Kabriya is one of our star complex care workers, who has been providing care for over 10 years. She started her journey as a Domiciliary carer in Wolverhampton and through training and development at Secure Healthcare has progressed her career to become a complex carer. Below in summary Kabriya will be outlining the day in the life of a carer.

By working as a complex carer, within a homecare environment, every day is different and it is more than just a job. You have to be passionate about providing healthcare, you need to be a hard willing worker. For me it is about building strong relationships with the service users and feeling part of a new family. I strive to make a real positive difference to our service users lives, every single day.

Being a complex carer, requires a strong character, you have to remain professional and positive, even though you may be experiencing personal issues. This is the life of a carer.

You may be required to provide care and support during the day or nights. While providing homecare for an individual there will be day to day responsibilities such as supporting service users with baths and showers, dressing, assisting with food, medications, housework movement around the house and much more. There are new challenges that can arise while providing care and support and it is important
that you handle this in a calm and safe manner.

complex carer
complex carer

Throughout my job I have to assess the needs of our service users to ensure tailored quality personal home care is provided.

Listening to people is important, it is vital that I communicate with service users, family members of those that I am providing care for and also with healthcare professionals to ensure that quality care and support is provided.

With the Covid 19 pandemic, it is also important that I use appropriate PPE to protect myself and others from Covid 19. This is done by wearing gloves, aprons, using face masks and disinfecting surfaces when necessary.

It is important that you follow care plans devised, by collaboratively working with case managers to ensure that tailored care and support is provided. It is also important to document everything, so care plans can be adjusted.

I would say that individuals should be passionate about providing care, hardworking and need to have a strong character.

Looking at Kabriya’s experience of working with us as a healthcare worker, if you think that providing care is for you, then feel free to check out the latest opportunities we have available in the West Midlands & Staffordshire and the North, click here to use job search tool to discover roles local to you or contact us on 0121 285 9449 to find out more.

There is over 40 million people that have received their first dose of COVID-19 vaccine in the UK. Approximately 27 million people have received both doses to provide maximum protection and here at Secure Healthcare Solutions we highly encourage individuals to come forward to be vaccinated to help protect against the threat of the new variants.

Public Health England outlines that 2 doses of the COVID-19 vaccine are highly effective against the (Delta) variant, identified in India. This reduces the risk of hospitalisation and death, which prevents the NHS hospitals being overwhelmed and to prevent another lockdown occurring in the UK.

PHE research carried out shows that individuals that received a single dose of Oxford/AstraZeneca vaccine have an 80% lower risk of death, and the second dose provides 85 to 90% protection against COVID-19. Pfizer-BioNTech vaccine provides 80% protection after one dose and 97% after 2 doses.

The UK is one of the leading nations to have vaccinated the population. Over 60% of the population has been vaccinated.
Click here to find out more about the COVID 19 vaccine.

Secure Healthcare Solutions is in the healthcare industry and is a healthcare staffing agency providing quality care and support to service users within care homes, hospitals and for homecare. Our staff members get priority to receive the COVID 19 vaccine and our patients that we care and provide support for have had the priority to receive the COVID 19 vaccine. As the people that we provide care for in the vulnerable category, we highly encourage individuals to take the vaccine.

We provide our service users PPE, including gloves, face masks and sanitiser. Our staff are also provided this too and appropriate PPE clothing to ensure our service users feel comfortable and safe. As a healthcare agency, safety is imperative for us when it comes to COVID 19 and we ensure that we follow all the government guidelines.

COVID 19 vaccine
COVID 19 vaccine

Our healthcare staff and patients are regularly tested for COVID 19 through rapid lateral flow home tests kits.

Here at Secure Healthcare Solutions, we understand that there is a lot of negative rumours about the vaccine, whether it is safe and the long-term side effects of the vaccine.

Who should not receive not receive the vaccine?
– Pregnant women
– Children under 16 (Moderna)
– Children under 18 (Astrazeneca/Oxford vaccine & Pfizer/BioNTech vaccine)
– History of allergic reaction (anaphylaxis) to ingredients in the vaccine, if you unsure about this, before being vaccinated, ask members of staff.

Side effects of having the COVID-19 vaccine
There are many side effects of taking the COVID 19 vaccine, that are generally mild and should not last longer than a week.
These include:
– A sore arm, where the needle has been put in
– Fatigue
– Headaches
– Body aches
– Feeling or being sick

If you have any of the symptoms above, it is recommended to take paracetamols

If you want to find out more about how we support our service users and also how we support our staff with COVID 19 to ensure safety and individuals feeling comfortable, then please feel free to call us on 0121 285 9449. We highly encourage all our staff and service users to take the COVID 19 vaccine.

There is approximately around 15 million people in the UK that have Complex care needs, meaning that they require long term healthcare.

What is Complex Care?
Complex care is a person-centred specialist support service for individuals that have a long-term condition, which could be due to a chronic illness, disability or when discharged from a hospital for care or treatment. At Secure Healthcare Solutions, we understand that every client’s needs and requirements are unique, therefore it is important that we provide tailored care and support to accommodate these needs.

Complex care can be provided within a care home or nursing home setting or within a Homecare setting which is becoming more popular, so individuals are close to their loved ones and are used to their surroundings, care can also be provided in the individual’s own home.

NHS funding for Complex Care
Some individuals with long-term complex health needs qualify for FREE social care arranged and funded solely by the NHS, known as NHS continuing healthcare.
NHS
Individuals requiring complex care will be assessed by a team of healthcare professionals to assess care needs.

Find out more about Complex Care funding by clicking here

Complex care needs managed in a home environment
With technology advancing and if patients are in a reasonable stable condition, it allows individuals to receive homecare within a home environment, close to their loved ones. Care will be provided by, complex carers, who have been specifically trained to deal with the individual needs. Case managers and support workers will work closely with healthcare staff to improve care plans and ensure social support is provided.

Live-in care
Around-the-clock support to individuals in your own home, so that care can be provided whenever you require it. The benefit of a live-in carer is that they will understand complex care needs of individuals and get to know routines. For example, individuals that have had a tracheostomy procedure and require ventilator care are likely to need around the clock care.

Complex Care
Complex Care

Visiting Care
This is when homecare is required on an hourly basis, which allows the individual that requires complex care, choose when and how you need support. This gives the flexibility for carers to pop in once or twice a week or for a few hours a day to provide care and support. This could be to prepare meals, help with housework, assist with washing and dressing and for companionship.

Respite Care
Respite care is delivered on a short-term basis, as an individual’s loved ones may be busy with other commitments, or could be on holiday, and if the individual has come home from hospital, you may require extra support to help your loved ones recover.

Individuals with a long-term illness or injury will benefit from Complex Care to accommodate towards their individual needs. We have a team of clinical Nurses with years of medical expertise and experience who work collaboratively with case managers to ensure the right level of care is in place in the comfort of your own home.

Complex Care Conditions
– Acquired brain Injury
– Spinal cord injuries
– Renal care
– Palliative care
– Cerebral palsy
– Neurological conditions (MS & MND)
– Stroke & hypertension
– Parkinson’s and Huntington’s
– Diabetes care
– Catheter, bowel & stoma care
– Tracheostomy care
– Gastronomy care
– Ventilated patients
– Continence care
– PEG feeding
– Tracheostomy care

If you are seeking Complex Care for yourself or loved one, find out more about our complex care services by clicking here and contact our homecare team on 01902 302017

Providing healthcare for a loved one can be incredibly rewarding, however it can cause a lot of stress factors. You can be affected emotionally and physically, as providing care alongside your personal day to day tasks can cause a burnout. You may be providing care around the clock for years or decades and it can be overwhelming, which can make you feel like you’re in over your head.

Learning and identifying the signs of caregiver stress and burnout is important, so you can take action to prevent things from getting worse and to improve care around your availability to improve things for you and the person you are providing healthcare for.

Signs and symptoms of caregiver stress includes:

  • Anxiety, feeling depressed and irritability
  • Difficulty sleeping
  • Drinking, smoking and eating more
  • Difficulty concentrating and feeling overwhelmed
  • Feeling lonely and isolated, like nobody else can help
  • Exhaustion and finding it difficult to complete simple tasks
  • Frequent headaches and low self-esteem
  • Gaining or losing weight
  • Losing interest with things that you used to enjoy

Signs and symptoms of burnout includes:

  • You may have less energy than you normally have
  • Feeling constantly exhausted, even after sleeping and taking a break
  • You have much less energy than you normally have
  • You ignore your own needs, as you are busy and do not care anymore
  • Increased sickness, such as colds
  • Waking up and dreading the day ahead

Below Secure Healthcare Solutions highlights the main tips to deal with caregiver stress and burnout.

Exercise
Finding time to work out is a great way to relax your body and mind and it can improve your mood. Getting outdoors is a great way to boost your mood. Whether it is short period of exercises such as 10–30-minute runs, daily walks or bike rides. A gym workout at home or at the gym can also be important to keep you occupied and clear your mind. Lack of exercise can increase the risk of anxiety and depression. Exercise is critical to clear your mind and negative thoughts to boost your mood.

Getting enough sleep
Approximately 25% of people in the UK have problems with sleeping on a regular basis. Having enough sleep is an important part of you overall wellbeing and can reduce stress and anxiety. For adults it is recommended to have 7-9 hours sleep per night. The NHS provides some great tips to improve the quality of your sleep which you can read by clicking here.

Hobby
Undertake a hobby such as reading, hiking, writing, cooking, learning to play a musical instrument, playing board games with your family or friends to take your mind off things and keep you occupied.

stress less as a caregiver
stress less as a caregiver

Eating well
We recommend you eating a well-balanced diet to help you feel better in general, this will help you control your moods. It is essential to have a diet that consists of proteins, high levels of vitamins, fruit and vegetables, and it is important that you are eating your five a day, also it is vital that you are hydrated by drinking enough water.

Medication and yoga to reduce stress
It is beneficial to meditate and practice relaxation techniques to help you deal with stress. There is a lot of content on YouTube which you can watch to help you learn about this. The NHS provides a lot of information abut stress and how to deal with it. Click here to find out more

Listen to music
It has been scientifically proven that music stimulates the brain and can lift your mood, lower blood pressure and reduce anxiety. When you are feeling stressed play your favourite music and have a singalong and dance.

Go outside
Spending time outside and breathe in the fresh air, whether it is going for a walk or run or looking at nature, it is an effective way to reduce stress.

Laugh
Laughing releases endorphins in your body which reduces the effects of stress. This could be watching comedies, playing board games with family and friends or going out for food and days out.

Reach out
You are not alone, reach out to your family members and friends to discuss matters. Having someone to talk to and listen to you is important, and extra support is something that you should be thankful for, so your problems can be solved together. As a Healthcare provider, we understand that extra care and support can be required at times, as looking after your loved ones on top of your personal day to day responsibilities can be difficult, which is why we can provide extra care and support for when you need it.

We are here to support you with homecare, whether you require it for short periods of time or longer periods, feel free to get in touch, so we accommodate care plans to suit your needs.

Click here to find out more about our homecare services and contact our Homecare team on 01902 302017 to discuss care plans to suit your loved ones needs.

What is Hypotention ?

Doctors measure blood pressure using two numbers – the first and higher of the two is called the systolic blood pressure, and it occurs when the heart beats and fills the arteries of the body with blood. The lower number is called the diastolic blood pressure, and it’s the pressure in the heart when it rests between heartbeats. A normal blood pressure is said to be in the region of 120/80mmHg (systolic/diastolic) and doctors spend a lot of time dealing with people with high blood pressure. Use a blood pressure chart to see what your blood pressure means.

Low blood pressure (hypotension) on the other hand often requires no treatment but elderly people in particular can find it a problem, especially when standing up from sitting or lying down. In general terms, the medical advice is that the lower the blood pressure the better, and for most people their blood pressure rarely falls below 90/60.

Recognition

However, low blood pressure can sometimes mean there’s not enough blood flowing to your brain and other vital organs, which can lead to symptoms such as:

What to do if you have symptoms

If you think you may be experiencing an episode of low blood pressure, you should:

  • stop what you’re doing
  • sit or lie down
  • drink some water

The symptoms will usually pass after a few seconds or minutes.

When to see your GP

You should see your GP if you have frequent symptoms of low blood pressure. Your GP can measure your blood pressure and help identify any underlying causes of the problem. Read more about diagnosing low blood pressure.

Low blood pressure after suddenly standing up

If you experience symptoms of low pressure after changing positions, such as standing up, it’s known as postural, or orthostatic, hypotension. Symptoms shouldn’t last longer than a few seconds, as your blood pressure will adjust to your new position. This type of low blood pressure tends to affect people more as they get older, when it can lead to more frequent falls. Similar symptoms may also occur after exercise.

Low blood pressure after eating

If you experience symptoms after eating, it’s known as postprandial hypotension. It occurs more often in older people, particularly in those who have high blood pressure or conditions such as Parkinson’s disease and diabetes mellitus. After a meal, your intestines need a large amount of blood for digestion. If your heart rate doesn’t increase enough to maintain blood pressure, your blood pressure will fall, causing symptoms.

Low blood pressure after standing for long periods

Some people experience symptoms after standing up for long periods of time. This is sometimes known as neutrally mediated hypotension, and most often affects children and young adults.

Read more about the causes of low blood pressure and High blood pressure in the elderly

What is Hypotention ?

Doctors measure blood pressure using two numbers – the first and higher of the two is called the systolic blood pressure, and it occurs when the heart beats and fills the arteries of the body with blood. The lower number is called the diastolic blood pressure, and it’s the pressure in the heart when it rests between heartbeats. A normal blood pressure is said to be in the region of 120/80mmHg (systolic/diastolic) and doctors spend a lot of time dealing with people with high blood pressure. Use a blood pressure chart to see what your blood pressure means.

Low blood pressure (hypotension) on the other hand often requires no treatment but elderly people in particular can find it a problem, especially when standing up from sitting or lying down. In general terms, the medical advice is that the lower the blood pressure the better, and for most people their blood pressure rarely falls below 90/60.

Recognition

However, low blood pressure can sometimes mean there’s not enough blood flowing to your brain and other vital organs, which can lead to symptoms such as:

What to do if you have symptoms

If you think you may be experiencing an episode of low blood pressure, you should:

  • stop what you’re doing
  • sit or lie down
  • drink some water

The symptoms will usually pass after a few seconds or minutes.

When to see your GP

You should see your GP if you have frequent symptoms of low blood pressure. Your GP can measure your blood pressure and help identify any underlying causes of the problem. Read more about diagnosing low blood pressure.

Low blood pressure after suddenly standing up

If you experience symptoms of low pressure after changing positions, such as standing up, it’s known as postural, or orthostatic, hypotension. Symptoms shouldn’t last longer than a few seconds, as your blood pressure will adjust to your new position. This type of low blood pressure tends to affect people more as they get older, when it can lead to more frequent falls. Similar symptoms may also occur after exercise.

Low blood pressure after eating

If you experience symptoms after eating, it’s known as postprandial hypotension. It occurs more often in older people, particularly in those who have high blood pressure or conditions such as Parkinson’s disease and diabetes mellitus. After a meal, your intestines need a large amount of blood for digestion. If your heart rate doesn’t increase enough to maintain blood pressure, your blood pressure will fall, causing symptoms.

Low blood pressure after standing for long periods

Some people experience symptoms after standing up for long periods of time. This is sometimes known as neutrally mediated hypotension, and most often affects children and young adults.

Read more about the causes of low blood pressure and High blood pressure in the elderly

Most of us welcome hot weather, but when it’s too hot for too long there are health risks. If a heatwave hits this summer, make sure the hot weather doesn’t harm you or anyone you know. Older people are at high risk for developing heated-related illness because the ability to respond to summer heat can become less efficient with advancing years. Fortunately, the summer can remain safe and enjoyable for everyone who uses good, sound judgement.

Heat stress, heat fatigue, heat syncope (sudden dizziness after exercising in the heat, heat cramps and heat exhaustion are all forms of “hyperthermia,” the general name given to a variety of heat-related illnesses. Symptoms may include headache, nausea, muscle spasms and fatigue after exposure to heat. If you suspect someone is suffering from a heat-related illness:

  • Get the victim out of the sun and into a cool place, preferably one that is air-conditioned.
  • Offer fluids but avoid alcohol and caffeine. Water, fruit and vegetable juices are best.
  • Encourage the individual to shower, bathe or sponge off with cool water.
  • Urge the person to lie down and rest, preferably in a cool place.

Heat stroke is especially dangerous for older people and requires emergency medical attention. A person with heat stroke has a body temperature above 40 and may have symptoms such as confusion, combativeness, bizarre behavior, faintness, staggering, strong rapid pulse, dry flushed skin, lack of sweating, possible delirium or coma.

The temperature does not have to hit 38 for a person to be at risk for hyperthermia. Both an individual’s general health and/or lifestyle may increase the threat of a heat-related illness. Health factors which may increase risk include:

  • Age-related changes to the skin such as poor blood circulation and inefficient sweat glands.
  • Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever.
  • High blood pressure or other conditions that require changes in diet. For example, people on salt restricted diets may increase their risk. However, salt pills should not be used without first asking a consulting doctor.
  • The inability to perspire caused by medications including diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs.
  • Taking several drugs for various conditions. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.
  • Being substantially overweight or underweight.
  • Drinking alcoholic beverages.

Lifestyle factors also can increase risk, including extremely hot living quarters, lack of transportation, overdressing, visiting overcrowded places and not understanding weather conditions. Older people, particularly those at special risk, should stay indoors on especially hot and humid days, particularly when there is an air pollution alert in effect. People without fans or air conditioners should go to shopping malls, movie houses and libraries. Friends or relatives might be asked to supply transportation on particularly hot days. Many communities, charities, networking groups, religious groups and senior citizen centres also provide such services as cooling centres.

Seek help from a GP or contact NHS 111 if someone is feeling unwell and shows symptoms of:

  • breathlessness
  • chest pain
  • confusion
  • intense thirst
  • weakness
  • dizziness
  • cramps which get worse or don’t go away

 

 

 

The brains of SuperAgers (those 80 years old and older whose memories are as sharp as healthy people in their 50s and 60s) shrink much slower than their age-matched peers, resulting in a greater resistance to ‘typical’ memory loss and dementia, a new path-breaking study that shows.

 

This is a MRI scan of a SuperAger’s brain. The portion between the yellow and red lines is the cortex, which contains neurons. SuperAgers’ cortices shrunk over two times slower than average-age peers’ in a recent Northwestern Medicine study, which may contribute to their superior memory performance.

Credit: Northwestern University

The highly engaged and delightful conversationalist, who reads, volunteers and routinely researches questions on the Internet, is part of a new path-breaking Northwestern Medicine study that shows that SuperAgers’ brains shrink much slower than their age-matched peers, resulting in a greater resistance to “typical” memory loss and dementia.

Over the course of the 18-month study, normal agers lost volume in the cortex twice as fast as SuperAgers, a rare group of people aged 80 and above whose memories are as sharp as those of healthy persons decades younger.

“Increasing age is often accompanied by ‘typical’ cognitive decline or, in some cases, more severe cognitive decline called dementia,” said first author Amanda Cook, a clinical neuropsychology doctoral student in the laboratory of Emily Rogalski and Sandra Weintraub. “SuperAgers suggest that age-related cognitive decline is not inevitable.”The study was published in JAMA. Senior author Emily Rogalski will present the findings at the 2017 Cognitive Aging Summit in Bethesda, Maryland, April 6.SuperAger research at Northwestern is flipping the traditional approach to Alzheimer’s research of focusing on brains that are underperforming to instead focusing on outperforming brains.

” It’s Dementia Awareness Week and we are standing united with @alzheimerssoc against dementia

#DAW2017 #UniteAgainstDementia ”

Dementia currently affects around 850,000 people in the UK, with a staggering one in 14 people over the age of 65 living with the condition. To coincide with Dementia Awareness Week, running from 14-20 May, get to know the symptoms and causes of the health condition, along with the treatments and how it can possibly be prevented.

The word ‘dementia’ describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. A person with dementia may also experience changes in their mood or behaviour.

“Everyone, from banks and supermarkets to the local corner shop and hairdresser, share responsibility

for ensuring that people with dementia feel understood, valued and able to contribute to their community.”

What causes dementia?

There are a number of diseases that result in dementia, with the most common cause being Alzheimer’s disease. This is where an abnormal protein surrounds brain cells and another protein damages their internal structure. Over time the chemical connections between brain cells are lost and cells begin to die.

Another common type of dementia is vascular dementia; this occurs when the oxygen supply to the brain is reduced because of narrowing or blockage of blood vessels, leading to brain cells becoming damaged or dying. The symptoms can occur suddenly, following a stroke, or develop over time after a series of small strokes.

What are the symptoms of dementia?

The different types of dementia can affect people in different ways, especially in the early stages. However many of the problems will be cognitive, and a person with dementia will often have problems with some of the following:

Day-to-day memory: Including difficulty remembering events that happened recently.

Concentrating, planning or organising: This could include having difficulty making decisions, solving problems or carrying out tasks.

Language: A person may have trouble following a conversation or finding the right word for what they want to say.

Orientation: They may lose track of the day or date, or become confused about where they are.

Visuospatial skills: This could include problems judging distances and seeing objects in three dimensions.

A person with dementia will also often have changes to their mood. They may become frustrated, irritable, easily upset or unusually sad. The symptoms will gradually get worse over time as dementia is progressive, however how quickly this happens varies from person to person.

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How is dementia diagnosed?

There is no single test for dementia; a diagnosis is based on a combination of factors, including…

Case history: The doctor will talk to the person and someone who knows them well about how their problems developed and how it is affecting their daily life.

Physical examination and tests: Blood tests and other physical examinations will help doctors to rule out any other possible causes for the person’s symptoms.

Mental ability tests: Some tests may be carried out by a doctor or psychologist to assess a patient’s memory and thinking.

A scan of the brain: This can help to confirm a diagnosis and assess which type of dementia a patient has.

Read more about diagnosing Alzheimer’s disease.

What is the treatment for dementia?

There is currently no cure for dementia, however there is ongoing research into how to help symptoms or to slow down their progression. Non-drug treatments available include advice, support and therapies for dementia patients. Talking therapies, cognitive behavioural therapy and cognitive rehabilitation may help some patients, while people with dementia are also encouraged to stay as active as possible – both mentally and physically.

There are some medications available to dementia patients including memantine, a drug that may be offered in the moderate or severe stages of Alzheimer’s disease to help with attention and daily living. Meanwhile people with vascular dementia are likely to be offered drugs to treat the underlying medical conditions that cause dementia, such as high cholesterol, high blood pressure or heart problems.

How can dementia be prevented?

While there is no proven way of preventing dementia, following a healthy and active lifestyle could reduce the risk of developing the condition. This includes maintaining a healthy weight and eating a balanced diet, staying active and avoiding excessive alcohol and smoking, which can lead to narrowing of the arteries. It has also been suggested that staying mentally and socially active into later life may reduce a person’s risk of dementia.

Caring for a loved one with dementia ?

For more information on dementia visit alzheimers.org.uk. If you think that you or anyone you know may have dementia it is important to visit your GP or talk to one of our care professionals at secure healthcare solutions .

How to Get Involved

Last year’s report by Skills for Care on the state of the adult social care sector and workforce in England estimated that just under 340,000 social care employees leave their jobs each year. On average, in care homes there are about 2,800 unfilled manager jobs at any one time while, despite concerted recruitment drives, vacancy rates for social workers in the statutory sector have jumped from 7.3% in 2012 to 11% in 2016, and turnover rates continue to climb.

Sharon Allen, chief executive of Skills for Care, says: “Recruitment and retention is without a doubt the biggest issue for adult social care employers because to have sufficient [levels] of the right people with the right skills is absolutely fundamental to providing quality care and support. It is a big concern for everybody and we’re trying to help promote careers in social care … but there are many challenges.”

With 80% of all jobs in adult social care held by women, something is clearly making women want to leave the sector. And the problems are not just confined to social care. In the NHS, figures from NHS Employers show that 77% of the workforce is female. There are currently 24,000 nursing vacancies (including in social care), according to the Royal College of Nursing (RCN).

In community health nursing, there has been a 12% drop overall in full-time equivalent staffing numbers since September 2009, despite growing demand.

In the East Midlands, district nurse Mary Black says her team and other colleagues are struggling to cope, because of a mixture of unfilled vacancies, maternity leave and long-term sickness absence, which directly affect patient care. “We firefight every single day: moving patient visits, ringing round to see if other teams can help, and we often have to cancel or defer. We have bank and agency nurses to cover vacancies, but not usually sickness or maternity leave, so it means the staff who are left have lots more visits to do each day,” she says. “There is no continuity, as often there’s a different agency nurse each day and there are a lot of duties and patient visits that an agency nurse can’t do, so the complex patients fall to our permanent members of the team. Agency staff often cancel at the last minute and sometimes don’t turn up.”

Black says: “It often feels like we’re not giving our patients a very good service, we cannot spend the time with them that they often need. Incidents and complaints will have risen.”

Rob Davies, a senior physiotherapist at a large hospital in the south-west, which he asked not to be named, says it struggles to attract recruits from further afield. For the last eight months, there have been 12.5 full-time equivalent vacancies for junior physiotherapists and two for senior specialist ones. With major trauma status, and a busy outpatient unit, an overnight and weekend service, the 140 members of the physiotherapy team are swamped, even when they have a full roster of staff. Stress is now the biggest cause of workplace sickness, he says. “[Staff shortages] affect everything from how you manage the caseload, and what you can do for patients, and it contributes to staff stress. It affects morale. I’m surprised that more of us in our department don’t go off sick.

“When you don’t have the right staff levels, we have to see patients on a prioritised basis,” he says. “Patients don’t get the quality and sometimes it means people get sub-optimal outcomes. It’s frustrating and demoralising.” Some of his colleagues have voted with their feet: leaving for private sector jobs with better work-life balance, or moving somewhere with lower house prices. “They are on the same money as it’s nationally done but the property prices are different,” Davies says. In the South-West, the shortages are particularly acute for more junior grades. “It tends to be easier to recruit more senior physios as they are a band up so the pay is better but it still can be an issue getting the right people down to us.”

Last month’s report on the public sector workforce by the Reform thinktank is blunt about the impact of staffing problems. “Public services fail when employees fail,” it concludes. “This is the dramatic lesson from a number of high-profile errors in recent public service delivery. In many instances, quality is compromised, not because of individual incompetence, but the way the workforce is structured and organised.”

With potentially fewer candidates from the EU and more existing staff retiring, it will be crucial for the NHS and social care sectors to attract younger people. Allen says that there is already close working with schools and job centres to promote social care as a career and adult social care has had “phenomenal success” with apprenticeships, although the government’s levy on large employers to help fund apprenticeships could risk this success. “There’s more we can do to promote social care as a really great career for young people,” says Allen. “It’s not just about getting people in, it’s about keeping them.”