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Council / Agency workers come at a price but keep health and care services going

An ageing population means there are more jobs than people to fill them

The job of social care worker has changed beyond recognition in recent years.

SHETLAND’s public sector spent almost £10 million on agency workers during the last financial year (2021/22), new figures have revealed.

This represents an increase of 54 per cent on figures from the year before and more than a doubling of the cost when compared to data from 2019/20.

Both NHS Shetland and Shetland Islands Council conceded that services have been under sustained pressure at times, but they refuted any suggestion that a crisis situation has been reached.

The figures have been obtained by Shetland News under freedom of information legislation.

In 2021/22 NHS Shetland spent £7.2 million on agency staff, employed in a wide array of services ranging from GPs’ out of hours services and the islands’ health centres to employing psychiatric nurses and laboratory services.

These latest figures represent an increase of £2 million on the previous year’s breakdown of cost, However, some of the increase was associated with the mobile theatre project which, over recent months, allowed hundreds of people from Shetland and Orkney to have surgery carried out in Lerwick.

Meanwhile, employing agency staff cost Shetland Islands Council just over £2 million in 2021/22, with three quarters of that going to pay for temporary staff working in community care.

During the first three months of the current financial year (2022/23) agency staff cost increased by an additional 25 per cent, with 82 per cent of spend attributed the community health and care.

As both the public and private sector in Shetland continue to struggle finding staff to fill hundreds of vacant posts across the isles, NHS Shetland reports a 5.6 per cent vacancy rate, which amounts to 38.89 unfilled full-time (or whole-time) equivalent posts.

Meanwhile, the SIC said that as of the end of August it had 37 posts unfilled and was also seeking to fill posts for three rolling multiple full and part-time social care contracts.

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SIC chief executive Maggie Sandison. Photo: Shetland News

Chief executive Maggie Sandison said she would not agree with a suggestion that the council’s health and social care service was relying heavily on agency staff.

She said that currently around five per cent, or 30 of 612 full-time equivalent staff, in community health and care were recruited from agencies.

“Using agency staff has enabled us to maintain our current service levels, without them we would have to stop/reduce/redesign services,” she said.

Sandison added that there were pressures due to rising demand and an ageing population, coupled with high levels of staff absences which are further acerbated due to recruitment issues. There is also an expectation that Covid will flare up again over winter months.

Managing pressures created first by Brexit, then the Covid pandemic and now the cost of living crisis has very much become the way local government appears to work today, she said.

“We were still managing to deliver the services to people, we did not have to close any of our services, we were experiencing similar pressures in other areas such as ferries, so it wasn’t unique to care,” the chief executive added.

NHS Shetland chief executive Michael Dickson. Photo: Chris Cope/Shetland News

“Shetland has paid better than care on the mainland. During the pandemic it became quite apparent how underpaid social care was where it has been provided through the private sector.

“There is a shortage of care workers nationally. I think our economy being strong means there are lots of opportunities for people here in Shetland, and we have more jobs than we have people here.”

Meanwhile NHS Shetland chief executive Michael Dickson said there were times when the health board had to make difficult decisions.

However, no medical services have been cancelled in the acute setting of the hospital, the health board added.

“Like any other health board, we have a number of vacancies and this is normal,” Dickson said.

“We work hard to ensure any gaps do not impact on our delivery of care, however there are times when have to make difficult decisions and move to our contingency arrangements.

“We do all we can to minimise the impact on services and our service users when this occurs. 

“It is clear that people do want to come and work in Shetland, however we know there are a number of barriers, including the increasing challenge posed by the cost of living and the availability of housing for staff.”

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