Home care workers are being told there is no alternative to the existing 111 service and waiting in the queue when seeking support for the people in their care, despite growing calls for a dedicated helpline for frontline care practitioners.

The Scottish government says it is putting extra resources into NHS 24 but told healthandcare.scot it is up to councils and local health & social care partnerships to ensure the right support and advice is available.

Requests to Scotland’s two largest NHS boards for details of what provision they have put in place to meet the government’s expectations have, as yet, gone unanswered.

healthandcare.scot recently spoke to ‘Maggie’, a council-employed home care worker,  who questioned why staff like her are not getting the same professional support of their NHS peers:

“We deal with so many medical problems and yet there’s nobody medically trained who I can ask for advice. I am supposed to speak to a manager with an SVQ3 and no medical experience,” she said.

“If I have to phone NHS 24 for a service user, I can be on the phone for two hours trying to get help because the lines are so busy. And that is then a disaster for all the other people I’m supposed to see.

“If I have somebody who’s fallen and is on the floor and I can’t help them back up, I am told by my supervisors that, as soon as I know that help is on the way, I need to move on. Put a blanket on them and leave them because we are so short-staffed. But I can’t do that.

“If I was a district nurse or an auxiliary coming in, I’d have a phone number to call for help and I would get through immediately. Why can’t we as home carers get that number?”

Caroline Deane, the Workforce Policy and Practice Lead for the providers’ organisation, Scottish Care, backed the call for a home carers helpline:

“There should be a dedicated NHS 24 number for social care to gain direct access when needed and whilst working. It makes sense in an integrated system that social care workers, either in homecare or care homes, are able to speak with colleagues in health when required.”

The head of Inverness-based Highland Home Carers, Campbell Mair, agrees care staff need access to dedicated, professional support for medical advice and assistance, to be able to  handle their increasingly complex and pressured roles:

“111 calls have been taking an average of 45 minutes to be picked up. Often care practitioners can’t wait that long as they have other people to attend to, so they move onto their next person. But the call handlers will not speak with that care practitioner if they are no longer with the person they’re calling about.

“Here’s just one example we’ve had in the last six months:

“At 8:30 one evening, we had two care practitioners working together who were concerned about the person they were seeing. So one of them called 111. But, after 40 minutes, they needed to move onto the next person in their care.

“One of the care practitioners then returned at 9.45 and called 111 again, but the battery on her phone ran out after another 55 minutes of waiting.

“The care practitioner plugged in her phone, called 111 a third time and joined the back of the queue. 50 minutes later the call was answered and a GP was called out.

“That care practitioner finished their shift just before midnight, nearly 2½ hours late.”

NHS 24 says this sort of length of time for calls to be answered is unusual. Director of Service Delivery Steph Phillips said:

‘As with the rest of the NHS in Scotland, NHS 24 has experience exceptional demand at peak periods over winter. This means that at busy times, callers may have to wait longer than usual to have their call answered.

‘However, this is only at peak times and most callers across the week will have their call answered within a reasonable timeframe. If a call to 111 results in a referral into a local health board for further assistance, NHS 24 does not determine the timescales of the response.’

Ms Phillips added: “With regards to a separate line, all urgent care services are provided through the single 111 number, and we do not have direct access for any specific health and care staff to our services.

“However, regional health boards may have local professional advice arrangements in place to support care staff.’

The Scottish government says the onus is on local NHS boards and health and social care partnerships to ensure the right support is in place. Social Care Minister Kevin Stewart told healthandcare.scot:

“Everyone in Scotland deserves to receive the care and support that is right for them. We are taking the necessary steps to fund social care and support hard-working staff and are always looking at new ways to improve services.

“Although the Scottish government has overall responsibility for social care policy in Scotland, it is for local authorities and integrated health and social care partnerships to commission and provide services for people in their area.

“We expect local health boards and local authorities to have measures in place to allow care at home workers to effectively provide safe and timely care, and local authorities, as the provider organisation, to adhere to health and social care standards, using risk assessment procedures where appropriate.”

healthandcare.scot has agreed not to identify the council  ‘Maggie’ works for. However, requests to Scotland’s two largest boards -for detail of local professional support measures they have in place have not received a response.

Mr Stewart, meanwhile, says that steps have been taken to provide extra call handling resources – but home care practitioners will not be treated differently from members of the public:

“NHS 24 works hard to ensure calls to its 111 service are answered as quickly and safely as possible, however we recognise that during the pandemic, some callers have experienced longer wait times than normal, due to increased demand during peak periods.

“As a result of increased demand and changes to service delivery we have increased funding to NHS 24 by over £20m this year for additional recruitment and the addition of a brand new call centre in Dundee, which opened on 17 December.

“As NHS 24 has said, unless local arrangements are in place, there is no direct access for any specific health and care staff to their services. Urgent care services are provided through the 111 number and 999 should be dialled in emergencies.”

 

Read more: Home carer: We were never trained for this; £40m spent on "small" impact urgent care reforms;  Government to fund new carer fees.

 

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