Adult Social Care: Staffing

Debate between Lord Shipley and Lord Markham

Tuesday 12th December 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is correct about that; it is a key pillar of this reform. This is why we have tried to learn one of the main lessons from last year, by putting the £600 million discharge fund out early, so we can get those sorts of measures in place. That is why we have expanded the virtual care ward network to 10,000 beds, with the idea that people can be cared for in their own home but with support from the staff there. That is absolutely the direction we are moving in.

[Lord Shipley (LD)]

My Lords, the Minister said a moment ago that three-quarters of local government spending is on adult social care. I would ask him just to check that figure, because if we add to it children’s social care, it basically means that every local authority will, before long, be issuing Section 114 notices. It is very important to get the facts absolutely clear here. What the Minister said demonstrates that local authorities are seriously underfunded for adult and children’s social care, and are cutting other public services as a consequence.

[Lord Markham (Con)]

I will absolutely clarify the number to the noble Lord in writing. It is of course a range, according to different local authorities, but I think we would all agree that it is a level that, as a percentage, is too high.

Recovering Access to Primary Care

Debate between Lord Shipley and Lord Markham

Tuesday 9th May 2023 Lords Chamber

[Lord Shipley (LD)]

My Lords, I support the comments made by the noble Baroness, Lady Wheeler, on the Statement. We on these Benches welcome the aspirational nature of what the Government are proposing. During the Covid pandemic, we all learned that community pharmacists play an absolutely key role in supporting the health system. In my personal experience of securing additional injections, I was very impressed by how well the whole NHS system worked in delivering the inoculation service through community pharmacies. One of the good things about it is that you can book a slot, in the same way you book a slot with a GP. However, for this to succeed—and to free up 30,000 GP slots, as the Government intend—booking an appointment with a pharmacist needs to be just as easy. We then need to be very clear about what pharmacists will do, and what GPs will no longer have a contractual obligation to do.

On the workforce shortages that have been referred to, it would help if the Minister could explain whether the manifesto commitment to deliver 26,000 more primary care staff by next March is deliverable. It is difficult to see how the Government will do that unless more money is made available, so I seek the Minister’s confirmation that more resource will be delivered on the back of this initiative to ensure that it happens.

I will ask the Minister three further questions. First, were patients of different backgrounds, genders and geographies involved in drawing up the plan, and can he outline the patient involvement? Secondly, is there sufficient qualified staff of all professions to deliver the multidisciplinary plan? Finally, as the noble Baroness, Lady Wheeler, asked, when does the Minister does expect the new plan to be up and running?

[Lord Markham (Con)]

I thank noble Lords for their comments and appreciate the general welcome for the tenets of the plan from all sides. I want to say that, rather than “too little, too late”, this is actually a plan that bolsters a service that is already on target for an increase of 50 million appointments from 2019—a service in which we are seeing a 10% increase per month versus pre-pandemic levels. I think that, on anyone’s reckoning, that is a pretty impressive achievement. The Pharmacy First plan that we talk about will free up another 10 million appointments a year in addition to that. Also, the use of digital technology will make it easier to get appointments and ensure that those who need them most can get them. It will ease the 8 am frustrations that we are all too aware of.

Addressing the comments on the pharmacy closures that have happened, this can only help pharmacists by increasing the income-generating services available to them and increasing the footfall into those pharmacies. This can only improve their income and so their overall viability. So I hope we will see, from all of this, an increase in the number of community pharmacies. To answer the point, we will be setting up booking systems so that you can digitally book your pharmacy appointment. Equally vital will be the use of the NHS app and other technologies, such as 111, to navigate through services, so you know when you should be booking an appointment with a doctor and when you should be booking it with a pharmacy. The use of technology will be a vital element in all that.

On the workforce, I absolutely acknowledge, as I think we all do, the importance of making sure we have the right workforce in place. That is why I think we are all pleased with and all supportive of the pension changes that will increase and retain the numbers of people. I am afraid I cannot give any more news on the date of the workforce announcement, but I can say that, as mentioned before, substantial work is going on in this place. Yes, we are committed to the increase of 26,000 staff, and this whole package has £1.2 billion of funding behind it, of which £645 million goes into the community Pharmacy First plan, because a vital part of all this, as noble Lords have said, is making sure that we have we have the qualified staff in place to do it.

So, I think we have a good plan here and it is probably best to hear what the industry has said. We have seen a welcome from across the board.

“This is the most significant investment in community pharmacy in well over a decade”


came from the Pharmaceutical Services Negotiating Committee. The Boots CEO said:

“We are really pleased … Our Boots pharmacy teams sit at the heart of communities, offering easy to access care and expert advice; it is great news that they’ll be able use their clinical expertise more widely to help patients”.


I really see this as a transformational step forward, united with the digital technology which will make huge differences. With that, I commend a plan that will make a real difference to patients and the services they receive from GPs in the community.