A workforce the size of the population of Newcastle needs to be recruited urgently to ease the “gridlocked” health and care system and to prevent serious harm to patients, the country’s care regulator has warned.
The Care Quality Commission (CQC) says it is getting “tougher and tougher” to access care because of a massive shortage in the workforce.
There are around 132,000 vacancies in the NHS and 165,000 across social care, about the same size as the population of the north east city.
And this shortfall in the care sector is having a huge impact on NHS waiting lists, hospital bed availability and accident and emergency response times.
The CQC described the entire health and care system as “gridlocked” and “unable to operate effectively”.
The CQC echoes thewarnings raised by health leaders about the need to address the crisis in social care to ease the pressure on the rest of the health system.
Chief Executive Ian Trenholm said the recruitment challenge faced by health and care leaders “is going to translate into real difficulty” this winter and in the years ahead.
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Mr Trenholm said the impact of the gridlock is that people are struggling to see their GP or dentist, wait for longer to get to hospital, and once there can become stuck due to a lack of social care to help them once they are ready to leave.
He said: “And this is not just a care consequence. There’s an economic consequence to all of this as well.
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“People who are ill can’t go back to work because they’re in a backlog, in some kind of queue waiting for care.”
Amanda Pritchard, NHS England chief executive, said there are around 10,000 patients in hospitals who are medically fit to be discharged butmust stay because there is no care provision for them in thecommunity.
The CQC said only two in five people are able to leave hospital when they are ready, contributing to record-breaking waits in emergency departments following a decision to admit, and dangerous ambulance handover delays.
It found in some cases almost half a hospital is full of people who are medically fit to be discharged but are waiting for social care support, it said.
Beds are available but some care homes are closing their doors to new arrivals because they cannot provide safe staffing levels.
And some nursing homes are having to re-register as care homes because nursing staff are leaving and they are struggling to recruit replacements.
Figures from the Association of Directors of Adult Social Services show that more than half a million people (542,002) were estimated to be waiting for assessments, reviews or care to start as of 30 April this year.
Separate data from the workforce body Skills for Care show that the number of filled posts fell – by about 50,000 – between 2020-21 and 2021-22 for the first time on record.
The CQC’s annual report on the state of health and social care in England also warned that the rising cost of living could result in more care staff leaving for better-paid work.
The regulator also pointed to an unprecedented number of care workers in the South East resigning in May and June because of fuel costs.
The CQC said that, without action, more health and care staff will quit, services will be further stretched, and people will be at greater risk of harm.
This will be especially pronounced in more deprived areas, where access to care outside hospitals is under the most pressure.
Analysis: For too long the focus has been on acute care while the crisis in social care has been allowed to grow.
All health and care leaders are saying the same thing.
Health and social care must be seen as the same integrated system.
For too long the focus has been on acute care while the crisis in social care has been allowed to grow.
Years of chronic underfunding has left social care in the state it is now.
But the impact on hospitals and the rest of the health service is now being felt.
The pandemic has swelled the waiting lists and to make any headway on the numbers, patients need to go into hospital and get out as soon as it is safe for them to be discharged.
But patients are going into hospital and staying there because there is nobody left to care for them in the community.
The pandemic helped to change the way we look at social care.
We saw just how vulnerable many people were, and we saw just how undervalued and underpaid social care staff were feeling.
That is why so many have left the sector. Unless pay and rewards are addressed care staff will keep leaving and new recruits will not take their place.
The NHS recognises the importance of social care in preventing patients from coming to hospital in the first place.
Among other measures it is setting up rapid response units to attend to people who have suffered falls.
The vast majority of these patients will not need hospital admittance.
Every time an ambulance crew attends a fall it cannot attend to another emergency.
I spent a day with the London Ambulance Service last week.
Our third emergency that morning was to attend to a 78 year woman who had fallen from her bed.
Elizabeth was thoroughly examined and no serious injury was found.
Records showed that Elizabeth had more than 200 ambulance visits for falls the year before.
If she had a good care package in place then those ambulance visits would not all have been necessary and the paramedics could have been responding more quickly to another emergency.
It’s like The Godfather, one reformed drug trafficker tells me.
The mythical gangster film centred on an organised crime dynasty locked in a transfer of power.
Communities in Scotland currently have a front row seat to a new war of violence, torture, and taunts as feuding drug lords and notorious families grapple for control of Glasgow and Edinburgh.
There have been more than a dozen brutal attacks over the past six weeks – ranging from fire bombings to attacks on children and gun violence.
Image: A firebomb attack in Scotland
Victims left for dead, businesses up in flames
Gangsters have filmed themselves setting fire to buildings and homes connected to the associates and relatives of their bitter rivals.
The main aim, they boast, is to “exterminate” the opposition.
The taunting footage, accompanied by the song Keep On Running by The Spencer Davis Group, has been plastered over social media as part of a deliberate game of goading.
Garages and businesses have gone up in flames. Shots were fired at an Edinburgh house.
Signals are being sent of who wants control of Scotland’s dark criminal underworld.
Image: A firebomb attack that saw a man throw an incendiary device through a building window
Image: The fire attack set to the song Keep On Running by The Spencer Davis Group
What’s caused the gang war?
The former director of the Scottish Crime and Drug Enforcement Agency, Graeme Pearson, explains how a “vacuum of leadership” is playing a part.
Last October, Glasgow-based cocaine kingpin Jamie Stevenson, known as The Iceman, was jailed after orchestrating a £100m cocaine shipment stashed in banana boxes from South America.
The mob leader was one of Britain’s most wanted, running his business like another on-screen criminal enterprise: The Sopranos.
The 59-year-old fugitive went on the run before eventually being hunted and apprehended by police while out jogging in the Netherlands.
Image: Jamie Stevenson. Pic: Police Scotland
Image: Pic: Crown Office
‘Old scores to settle’
But paranoia was running rife about how this notorious gangster could be brought down. Was there a grass? Was it one of their own?
It further fuelled divisions and forced new alliances to be forged across Scotland’s organised criminal networks.
It wasn’t until The Iceman case came to court that it was revealed an encrypted messaging platform, known as EncroChat, had been infiltrated by law enforcement.
It ultimately led to Stevenson pleading guilty.
Ex-senior drug enforcement officer Mr Pearson told Sky News: “It is a complex picture because you have got people who are in prison who still want to have influence outside and look after what was their business.
“On the outside you’ve got wannabes who are coming forward, and they think this is an opportunity for them, and you have got others have old scores to settle that they could not settle when crime bosses were around.”
Mr Pearson describes a toxic mix swirling to create outbursts of violence unfolding in Scotland.
He concluded: “All that mixes together – and the greed for the money that comes from drugs, and from the kudos that comes from being a ‘main man’, and you end up with competition, violence, and the kind of incidents we have seen over the past four to six weeks.”
New wave of violence ‘barbaric’
Glasgow man Mark Dempster is a former addict, dealer, and drug smuggler who is now an author and respected counsellor helping people quit drinking and drugs.
He describes the “jostle for power” as not a new concept among Glasgow’s high profile gangland families.
Image: Mark Dempster
“There is always going to be someone new who wants to control the markets. It is like The Godfather. There is no difference between Scotland, Albania, or India,” he said.
Mr Dempster suggests a shift in tactics in Glasgow and Edinburgh in recent weeks, with 12-year-olds being viciously attacked in the middle of the night.
“It is barbaric. When young people, children, get pulled into the cross fire. It takes it to a different level.
“At least with the old mafiosa they had an unwritten rule that no children, no other family members. You would deal directly with the main people that were your opposition.”
Police Scotland is racing to get control of the situation, but declined to speak to Sky News about its ongoing operation.
It has been suggested 100 officers are working on this case, with “arrests imminent”.
But this is at the very sharp end of sophisticated criminal empires where the police are not feared, there are fierce vendettas and, clearly, power is up for grabs.
Laws may need to be strengthened to crack down on the exploitation of child “influencers”, a senior Labour MP has warned.
Chi Onwurah, chair of the science, technology and innovation committee, said parts of the Online Safety Act – passed in October 2023 – may already be “obsolete or inadequate”.
Experts have raised concerns that there is a lack of provision in industry laws for children who earn money through brand collaborations on social media when compared to child actors and models.
This has led to some children advertising in their underwear on social media, one expert has claimed.
Those working in more traditional entertainment fields are safeguarded by performance laws,which strictly govern the hours a minor can work, the money they earn and who they are accompanied by.
The Child Influencer Project, which has curated the world’s first industry guidelines for the group, has warned of a “large gap in UK law” which is not sufficiently filled by new online safety legislation.
Image: Official portrait of Chi Onwurah.
Pic: UK Parlimeant
The group’s research found that child influencers could be exposed to as many as 20 different risks of harm, including to dignity, identity, family life, education, and their health and safety.
Ms Onwurah told Sky News there needs to be a “much clearer understanding of the nature of child influencers ‘work’ and the legal and regulatory framework around it”.
She said: “The safety and welfare of children are at the heart of the Online Safety Act and rightly so.
“However, as we know in a number of areas the act may already be obsolete or inadequate due to the lack of foresight and rigour of the last government.”
Victoria Collins, the Liberal Democrat spokesperson for science, innovation and technology, agreed that regulations “need to keep pace with the times”, with child influencers on social media “protected in the same way” as child actors or models.
“Liberal Democrats would welcome steps to strengthen the Online Safety Act on this front,” she added.
‘Something has to be done’
MPs warned in 2022 that the government should “urgently address the gap in UK child labour and performance regulation that is leaving child influencers without protection”.
They asked for new laws on working hours and conditions, a mandate for the protection of the child’s earnings, a right to erasure and to bring child labour arrangements under the oversight of local authorities.
However, Dr Francis Rees, the principal investigator for the Child Influencer Project, told Sky News that even after the implementation of the Online Safety Act, “there’s still a lot wanting”.
“Something has to be done to make brands more aware of their own duty of care towards kids in this arena,” she said.
Dr Rees added that achieving performances from children on social media “can involve extremely coercive and disruptive practices”.
“We simply have to do more to protect these children who have very little say or understanding of what is really happening. Most are left without a voice and without a choice.”
What is a child influencer – and how are they at risk?
A child influencer is a person under the age of 18 who makes money through social media, whether that is using their image alone or with their family.
Dr Francis Rees, principal investigator for the Child Influencer Project, explains this is an “escalation” from the sharing of digital images and performances of the child into “some form of commercial gain or brand endorsement”.
She said issues can emerge when young people work with brands – who do not have to comply with standard practise for a child influencer as they would with an in-house production.
Dr Rees explains how, when working with a child model or actor, an advertising agency would have to make sure a performance license is in place, and make sure “everything is in accordance with many layers of legislation and regulation around child protection”.
But, outside of a professional environment, these safeguards are not in place.
She notes that 30-second videos “can take as long as three days to practice and rehearse”.
And, Dr Rees suggests, this can have a strain on the parent-child relationship.
“It’s just not as simple as taking a child on to a set and having them perform to a camera which professionals are involved in.”
The researcher pointed to one particular instance, in which children were advertising an underwear brand on social media.
She said: “The kids in the company’s own marketing material or their own media campaigns are either pulling up the band of the underwear underneath their clothing, or they’re holding the underwear up while they’re fully clothed.
“But whenever you look at any of the sponsored content produced by families with children – mum, dad, and child are in their underwear.”
Dr Rees said it is “night and day” in terms of how companies are behaving when they have responsibility for the material, versus “the lack of responsibility once they hand it over to parents with kids”.
Police investigating the disappearance of a woman in South Wales have arrested two people on suspicion of murder.
Paria Veisi, 37, was last seen around 3pm on Saturday 12 April when she left her workplace in the Canton area of Cardiff.
She was driving her car, a black Mercedes GLC 200, which was later found on Dorchester Avenue in the Penylan area on the evening of Tuesday 15 April.
South Wales Police said it was now treating her disappearance as a murder investigation.
A 41-year-old man and a 48-year-old woman, both known to Ms Veisi, have been arrested on suspicion of murder and remain in police custody.
Detective Chief Inspector Matt Powell said he currently had “no proof that Paria is alive”.
The senior investigating officer added: “[Ms Veisi’s] family and friends are extremely concerned that they have not heard from her, which is totally out of character.
“Paria’s family has been informed and we are keeping them updated.
“We have two people in custody, and at this stage we are not looking for anybody else in connection with this investigation.
“Our investigation remains focused on Paria’s movements after she left work in the Canton area on Saturday April 12.
“Extensive CCTV and house-to-house inquiries are being carried out by a team of officers and I am appealing for anybody who has information, no matter how insignificant it may seem, to make contact.”