Workforce shortages put more strain on the system

By Paul Burstow | 20 February 2018

The issue of care worker shortages has moved centre stage with the National Audit Office’s hard-hitting report. A dangerous cocktail of high staff turnover and vacancy rates, combined with mounting demographic pressures, demands a radical rethink about what kind of workforce we need. When good reliable substitute care is in short supply, it has big implications for families; it can be the final straw.

Take, for example, Denise who cares for her husband. He has had multiple mobility and health conditions for several years. She was feeling overwhelmed with the level of care required and frustrated that her career progression had stalled since she became a carer. Denise’s story is the lived experience of many carers. Three in five of us will become a carer at some point in our lives; family and friends, who, out of love, solidarity, circumstance or duty, find themselves taking on a caring role.

It is a role that can include anything from practical domestic tasks, to emotional support, to personal care, such as lifting, dressing, washing and helping with toilet needs. It can be exhausting, it can be rewarding. According to the 2011 census, there are three million people, one in nine of the workforce, who like Denise combine caring for a loved one with paid work. Many are hidden in plain sight in the workplace. Juggling work with caring responsibilities can take its toll.

Carers quitting work

A lack of rights or flexibility in the workplace, along with the struggle to get the right support at the right time, can end with carers quitting work. The cost of this to the individual can be lifelong. The cost to the public purse has been estimated at £2.9bn. Back in the summer of 2012 as care minister, I had the opportunity to meet with members of the Employers Forum on Carers. They told me about work they were doing to support carers in the workplace. We discussed employers’ concerns about the need for action to help carers remain in, or return to, work. 

As a result, I commissioned a task and finish group with carers’ organisations and Whitehall departments to scope out options for supporting working carers. The group reported in summer 2013, making thirteen recommendations including calling for the Department of Health to explore ways in which people can be supported to combine work and care.

Carers in Employment project

Fast forward to early 2015. Ministers launched Carers in Employment (CiE), funding SCIE to work with nine local councils across England to test out different ways of supporting carers to remain in work. The activities included information, advice and guidance, free trials and home installation of technology-enabled care, as well as working with employers to raise awareness and offer practical tools and training. Denise was one of the carers who contacted the CiE team in her area and received funding for a weekend of respite care, which delighted her.

Local staff held several meetings with Denise and encouraged her to approach her employer’s HR department about her caring responsibilities, which she had not considered before. Her company had always been very supportive and flexible, but she did not know of their schemes to support carers. In addition to flexible working, her employer teamed up with a third-party specialist care agency to provide emergency support. When she travels for work and returns home late, Denise is now entitled to five hours of paid care from an outside agency, funded by her employer.

Staying in work success rate

A recently published independent evaluation of the project has reported positive outcomes for carers and employers alike. The more comprehensive and intensive the support the more likely the carer can benefit. Nearly six out of ten carers who took part in the project were supported to stay in work. Just imagine if the lessons from the project were rolled out, what that would mean for carers and how much it would save the public purse.

The evaluation also found that emotional and practical help has reduced the sense of isolation that many carers feel. Access to technology-enabled care has offered peace of mind. Advocacy and support workers had helped working carers cope better at critical moments of domestic pressure. And as Denise found, talking to her HR department led to some practical support.

The business case for investing in carer support should be a no brainer. It needs to be part of the mix in the social care green paper. Helping people to remain in work has long-term benefits for them, could save the exchequer billions and is vital to UK PLC.

Paul Burstow is chair of the Social Care Institute for Excellence

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