The Southern Trust is losing more staff from its homecare service than it is recruiting, raising fresh concerns about whether vulnerable people across the Trust area can get the support they need.
The position was confirmed by Health Minister Mike Nesbitt in a written Assembly Answer. The minister said the Trust had advised that it “continues to see a higher number of staff leaving the Homecare service than those starting”.
The disclosure has been criticised by the Independent Health and Care Providers (IHCP), which said the situation was unfolding while independent providers reported restrictions on care packages, shorter visits and reduced call frequency.
Concerns over unmet need and hospital pressure
IHCP Chief Executive Pauline Shepherd said the staffing figures showed that the Trust’s approach was moving in the wrong direction as unmet need increased. She said vulnerable people were waiting for care, families were taking on more responsibility and hospital beds remained occupied when support was not available at home.
The organisation also questioned why care packages were not being released to independent providers where staff were available to deliver them. It called for an urgent independent review of the Southern Trust’s homecare model, publication of the true level of unmet need and an end to blanket reductions in package size or visit length without an individual reassessment.
Figures already in the public domain indicate that the Trust’s internal homecare service cost approximately £39.74 per hour during 2023/24. Independent provision was commissioned at around half that rate. The internal service also recorded more than 41,000 sickness days, with a reported cost of more than £2.5 million, and approximately 550 missed visits.
Trust says demand is outstripping supply
The Southern Trust said it was facing significant demographic pressure, with the number of older people rising faster than in any other Trust area in Northern Ireland. It said the cost and staffing challenges of meeting demand for homecare were “enormous and rapidly increasing”.
Despite those pressures, Trust homecare workers and independent-sector partners support more than 4,550 people every day, delivering around 60,000 hours of care each week, according to the Trust.
The Trust said workforce shortages affected both its own service and independent providers, with recruitment and retention particularly difficult in rural areas. It said it was continuing to recruit and improve community services while working with independent homecare providers to prevent hospital admissions and support timely discharge.
What happens next for families
Following a request from trade unions for more predictable income and access to employment benefits, the Trust has moved more homecare workers onto guaranteed-hours contracts. It said 76% of Trust homecare staff now have guaranteed-hours contracts, while 24% have chosen bank contracts.
The Trust said it was committed to modernising and strengthening homecare, streamlining services and exploring new models with the independent sector. It said care packages were kept under review and key workers were available to advise families about concerns.
However, it also asked families, where possible, to help care for relatives or consider alternative care while waiting for a longer-term option. The IHCP warned that reducing or delaying care does not remove the need, but shifts pressure onto families, hospitals and emergency departments.