How is the Shortage of Personal Assistants in the UK Affecting Disabled People?

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Personal assistants – or PAs – play a vital part in the day-to-day lives of thousands of people living with a disability in the UK. Their roles are multi-faceted and will often range from providing care at home to assisting with daily activities like going to work, attending school or spending time with friends and family.

This month, Baroness Jane Campbell, who has spinal muscular atrophy and uses a wheelchair, has publicly expressed her concerns that an ongoing shortage of PAs will result in disabled people being “forced back into living in institutional settings.”

This would be a tremendous step back and as an Education and Children's Rights Solicitor who regularly works with young people with physical and learning disabilities, I’m deeply concerned about the widespread impact this shortage could have.

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A number of families we’re working with have seen the effects of this shortage and it is impacting on the choices available to them

Sanhita, our client's parent, says: "As a parent of a young person who has disabilities, it’s vital to have competent and reliable care and support. This is required not only for respite for parents but also for helping the young person with daily routine.

"Unfortunately, because of the shortage of carers we have really suffered as parents. The direct payment that the Local Authority gave us was wholly inadequate to secure care support for our daughter. We advertised several times with no response.

"Only after increasing the hourly rate plus adding a significant number of hours, we managed to get someone through personal recommendation from the Local Authority colleagues. This still wasn’t adequate support as there was no back up or replacement when the personal assistant needed leave or was ill due to Covid.

"This meant as working NHS consultants it fell on us parents to pick up most of our daughter’s care needs without break or respite."

  • "We had to involve solicitors and after 18 months of battle, the Local Authority have been able to find substantial care support for our daughter The low pay and the lack of trained carers has left many children and young people with disabilities in a very vulnerable position. We have experienced this first hand in the 18 years we have cared for our disabled daughter.""


    Our client's parent


In England and Wales, the Local Authority provides a budget to pay for the care a disabled person’s needs depending on their individual circumstances. 

Care can then either be arranged and managed by the Local Authority, or funds can be placed into a specific bank account so that an individual can organise their own assistance and recruit a PA.

If a person decides they want to appoint their own PA, they will become an employer and will be solely responsible for advertising the role and finding a suitable candidate. This is a task that has become more and more difficult over recent years.

This month, the BBC Sounds podcast Access All spoke to Anna who has been searching for a PA since June. She described the response she’s had to job adverts as “tumbleweed”, with very few people submitting applications.

Those who did respond and were subsequently hired by Anna only stayed for a short period of time before quitting with little or no notice. This has led her to feel as if she’s living a “temporary life”, a sentiment that is felt by many disabled people struggling to find appropriately suited PAs.

As Education and Children's Rights Solicitors, we’re particularly concerned about the effects of the PA shortage on young disabled people. Many children with disabilities are supported at school and in their wider community by a PA, and not having one could mean they miss out on vital opportunities to learn and socialise with their peers.

As Baroness Jane Campbell highlighted, significant changes now need to be made in order to avoid a situation where we start to go backwards in terms of disability rights.

To address the shortages, the Local Government Association (LGA) who work on behalf of local councils have suggested a review of budgets allocated to disabled people to ensure that they reflect local market conditions.

Currently, care budgets are worked out based on the minimum wage of £9.50 an hour. This has created a situation where many PAs have taken on other better-paying work that offers further benefits such as greater holiday or sick pay.

In response, the Department of Health and Social Care has said that it does have plans to “bolster recruitment and retention” of PAs. This will involve a national recruitment campaign promoting the various adult social care roles available.

If you cannot get PAs in place and are missing out on key social care provision, the first step is to advise the Local Authority to see if they will review your situation. If you can find PAs at higher rates, then you may need to challenge the rate agreed by your Local Authority. If they will not review their decision or refuse to increase the rate, then it could potentially be challengeable by way of  Judicial Review.

Where there is an Education Health Care Plan in place, we may be able to negotiate the allocated social care rate with the Local Authority through the SEND tribunal. But it’s important to note that the SEND tribunal can be reluctant to make recommendations around rates of pay for carers, due to influencing factors such as:

  • Geographical location
  • Experience
  • Training
  • Market conditions

In my experience, families have to fight hard to get their provision in place and also secure any increase in hours or rates, but it is not impossible.

Final Thoughts from an Education Law Solicitor

As an Education and Children’s Rights Solicitor, I frequently assist with Extended Appeal SEND tribunals which often challenge the level of social care support children and young people receive from Local Authorities.

Unfortunately, I’ve seen that clients are currently experiencing similar situations to those reported by the BBC, facing inconsistent and unreliable PA support.

I regularly work with independent social workers to help advise clients on the suitability of the social care packages they have in place. One social worker recently advised that on the open market, PAs will cost in the region of £15-£25 an hour plus any employment and training costs. It is often the case that Local Authorities will have arrangements where families can directly pay PAs at a lower rate, but this isn’t always enough.

One client I helped recently was unable to recruit a PA at the lower rate. As a result, the young person’s parents had to pay a PA £20 an hour even though their direct payment package from the local authority only allocated them £13.75 an hour.

It wasn’t until we went to tribunal that the Local Authority increased its social care offer and agreed to fund PAs at £19.34 an hour for 1:1 support and over £38 an hour for 2:1 assistance. Of course, not all families are able to sustain this level of top up and nor should they have to. Local Authorities should be paying the going rate to ensure that needs are being met.

Get in touch with the Education Law and Children’s Rights team to find out how we could help you.

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