The outgoing Health and Social Care committee has warned their successors that increased demand for safeguarding services, including around harmful sexual behaviours amongst young people, is expected to continue throughout this year.
The committee has issued the warning as part of its update on HSC’s work in the Government Work Plan monitoring report.
It’s been put together as a ‘roadmap’ of achievements by the current States, with guidance for the States that will be elected in June when Guernsey’s second fully island wide election is held.
In its update, HSC covered a number of topics including the impact of the covid pandemic, staffing issues, and the soaring costs of caring for an ageing population.
It also confirmed that 2024 saw an increase in operational challenges around safeguarding.
HSC is also facing challenges in dealing with growing waiting lists, it said.
“There were a number of growing challenges operationally in 2024, which
has seen an increase in demand and activity in adult safeguarding, harmful sexual behaviour amongst young people and referrals of young people into the Multi-Agency Safeguarding Hub (MASH). These are expected to continue into 2025.
“Furthermore, despite several additional investments, waiting lists for treatments also continue to be higher than before the pandemic. The unpredictable nature of health and care, and the need to respond to needs as they present themselves, makes planning and budgeting for referrals for off-island care particularly challenging.
“It is also anticipated that recruitment challenges will persist for health and social care roles, with a continued reliance on agency staff to deliver core services.”
Money matters
Health and Social Care receives the highest budget of all States committees to enable it to meet its mandate covering the island’s public health services including diagnosis and treatment, prevention services, social care, mental health services, health promotion, environmental health, and much more.
In 2024 it had a budget of £235.6million, and it overspent that by £6.4m.
HSC said this is down to “increasing service demands against the backdrop of a financially constrained States”.
The budget for 2025, before pay settlements, was £245.2m, including 2,291 full time equivalent staff, HSC said.
“Demand pressures will continue to challenge the budget as demographic and other underlying factors continue to impact Guernsey and the World at large.”
Post-covid
HSC acknowledges that its “activity during the 2020-2025 political term has been dominated by the need to respond to, and recover from, the global SARS-CoV-2 (COVID-19) pandemic”.
It explains that post-covid, the “national and international context for the recruitment and retention of health and social care staff has changed and the Bailiwick has not been isolated from these challenges”.
The number of agency and other temporary staff has slowly decreased from a peak in 2022 though. Some of those agency staff roles have been converted to permanent staff but pressure remains acute, said HSC.
It is “positive” around the “increasing number of ‘grow your own’ opportunities for individuals to train locally” and it has reduced the overall vacancies in HSC from 400+ to approximately 350 vacancies during 2024.
Work continues to ‘recover’ from covid, with investment in a number of initiatives to try and reduce waiting lists and backlogs that occurred as a result of the pandemic.
However, HSC admits that “securing the funds and resources to deliver additional waiting list initiatives to further reduce waiting lists remains a challenge”.
Long term care
A “critical” priority for the next States long term, involves the funding of long-term care, warns HSC.
Work has progressed in this area, with decisions made earlier this year around a package of proposals aimed at helping to prevent the long-term care sector reaching crisis point.
HSC warns more needs to be done though.
“The need to address the sustainability of the funding of long-term care is critical.
“Population demographics are such that a proactive, systems-wide response across government is needed to ensure that care and support services can meet the needs of older islanders.
“More broadly there is the need for system-wide reform of health and social care to maximise its sustainability in the future, including how investments in prevention and early intervention can reduce the longer-term demands for hospital and care home beds over the next 10 to 20 years.”
HSC has also flagged that the next committee will need to continue working with Policy and Resources and the Committee for Employment & Social Security to progress the Supported Living and Ageing Well Strategy.
Other HSC priorities
Some of HSC’s work this term has already been put back for the 2025-29 States to deal with.
This includes reviewing the legal status of cannabis and reviewing end-of-life care offerings.
Work on reviewing childcare ordinance, work to reduce the diversion of controlled drugs, and a review of the criteria for access privileges to HSC services is all ongoing.
Work around reviewing medicines laws for both humans and animals and the introduction of allergen regulation is also ongoing.