Today’s @skillsforcare report paints a seriously grim picture of the #socalcare workforce situation. It’s not just bad, it’s the worst it’s ever been and may well be deteriorating further. A thread…
First, the vacancy rate. After 2 years of small improvements, look at the huge jump in vacancies between 2020/21 and 2021/22. Then look at the further increase (light green bar) to August this year. This is a problem that isn’t going away.
Vacancies aren’t just a #socialcare problem, they affect the wider economy too. But this chart shows that #socialcare is faring much worse than other sectors. The vacancy rate is 10.7% in social care compared to 4.3% elsewhere.
And here’s the same story but broken down by sector. The NHS is struggling to recruit and so is the hotel/catering sector but #socialcare is performing far worse.
It’s not just that there are more vacancies, the no. of staff has actually fallen. For years, filled posts increased as demand for services was pushed up by an ageing population and increased working age disability. That demand is still there but now we just can’t get the staff.
(By the way, does the rising vacancy rate really matter? Of course it does. It’s not just that people can’t get the care they need, or that hospitals can’t discharge because providers don’t have the staff to provide the support. It also impacts quality, as these stats show. )
The sector IS responding. For one thing, it’s looking to different places to recruit. A greater proportion of new starters are now from overseas…
(In fact, overseas recruitment is now starting to return to its former pattern when there were far more staff from non-EU countries than EU. That narrowed with when Eastern European countries joined the EU but is now moving the other way, presumably due to Brexit)
But, as the govt’s own immigration body has observed, overseas recruitment is by no means the long-term solution to workforce problems in adult social care. What’s really needed is better funding, allowing action to improve terms and conditions for staff. Which brings us to pay…
There ARE hints that the crisis is forcing providers to increase their wages. Pay has started to rise faster than the increase in the statutory national living wage, which it used to follow closely.
But the increase may simply not be big enough to make the sector much more competitive with health, hotels, supermarkets. When we published this blog in August, Tesco was paying its staff £10.10 an hour. Now it’s paying £10.30. kingsfund.org.uk/blog/2022/08/h…
What’s to be done? It’s not simple. There are big, broad economic and cultural issues at work that leave #socialcare staff poorly paid. And many, many other countries are seeing similar difficulties in recruiting enough health and, particularly, care staff.
Providers aren’t powerless. There’s a big difference between the best performers and the average on issues like retention - hanging on to your staff isn’t just about money. And there’s an issue with young people that needs exploring - half of under 20s leave in their first year.
Providers have a difficulty in striking the balance between arguing for more funding/better pay while at the same time trying to persuade people to come and work in #socialcare now. Getting that messaging right repay some thought, though perhaps it is just an impossible tension.
So govt is critical. It should commit to a #socialcare workforce strategy, start delivering on its white paper commitment on training etc, and at least look like it is willing to tackle pay (the £500m discharge fund is a help but not the long-term answer). Will it? No sign yet.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Here’s the classic error of assuming that what applies to the NHS must also apply to #socialcare. Yet you can’t simply apply the NHS ‘shifts’ described here - hospital to community, sickness to prevention and analogue to digital - to social care. 1/5 standard.co.uk/news/politics/…
For a start, two of the three obviously don’t make sense when applied to socialcare, which isn’t currently about ‘sickness’ and already happens in the ‘community’, rather than ‘hospital’. (You can, I think, make more of a case for #socialcare currently being ‘analogue’). 2/5
So the govt is really confusing here the shifts needed in the NHS with the change needed in social care itself. Social care can contribute to the NHS shifts because it is community-based and preventative. But they are not the shifts that it itself needs to make. 3/5
Relaxing immigration rules for overseas careworkers in 2021 was the govt’s single most effective action on #socialcare. It brought down vacancies. Tightening the rules again is a real risk because, while vacancies have fallen, they are still higher than before COVID-19.
This level of vacancies is not ok. It may not be at the crisis level of 2021/22 but it still means that in many places, at many times, providers can’t recruit. That has a huge impact on people using services, on families (who have to step in) and on existing, overworked staff.
The new rules involve a ban on overseas workers bringing families. @JamesCleverly says this won’t affect applications because many care workers will want to come anyway. Let’s hope so but he should publish his evidence and show the decision to tighten rules was not taken lightly.
Today's @thefabians report on a National Care Service offers thorough analysis of #socialcare problems and wide-ranging proposals for reform. It was commissioned by @UKLabour, perhaps the next govt, so should command attention. But it has issues. A thread. independent.co.uk/news/uk/home-n…
The report is comprehensive and, in the main, detailed. There are 48 major proposals, grouped in 10 sections: structure and identity, workforce, co-production, rights, carers, access, models of support, providers, affordability, money.
FOUR big proposals stand out to me...
1> Overall, the direction is toward greater national direction and control over #socialcare. National govt will be responsible for #socialcare funding, provider pricing, workforce pay rates, strategy, leadership and branding. That is a major change from the current system
Why do #socialcare workers stay in their jobs despite low pay? Really valuable report from @resfoundation suggests a) they like their jobs (the caring, autonomy) b) few other jobs offer the flexibility they need. Short thread… resolutionfoundation.org/publications/w…
Here’s the evidence on job satisfaction. #socialcare may not do better than all work but it does better than the other low-paid work with which it competes. (The difference isn’t huge but it’s there).
And this is one of the attractions - the sheer demand for #socialcare workers means it’s relatively secure compared to other sectors like hospitality, leisure, food processing.
The plan announced today by @theresecoffey to support #socialcare falls far short of the measures needed to ensure people get the support they need this winter and beyond. It was also, alarmingly, saw social care entirely through an NHS| lens. A thread. gov.uk/government/pub…
There were 3 measures announced, of which only one has real resources - a £500m fund to support hospital discharge. Details are scarce but it looks like targeted reinstatement of parts of the hospital discharge fund and recruitment/retention fund, both scrapped earlier this year.
The money is of course welcome and necessary but its short term nature and limited focus on discharge means it offers no more than a couple of stitches to the gaping wound that is the state of #socialcare at the moment.
We’re expecting a statement from @theresecoffey on hospital discharge today. It certainly needs urgent action but a thorough plan will require more than just short term £££ and a focus on more than just #socialcare. A quick thread with some stats.
Historically, delayed discharges have not been mainly been due to #socialcare. Before COVID-19, it was responsible for only a THIRD of delays (the biggest issue: home care packages). The rest were due to NHS issues. There are no recent stats on this NHS/socialcare split though.
Have things got worse for #socialcare since then? Yes - there are fewer staff. The vacancy rate rose to 10.7% in 2021/22 (and may now be even worse). The biggest problem is home care, with a 13.2% vacancy rate. All this might well well be pushing up #socialcare delays.