We are shortly expecting the Government and NHS England to publish a long-term workforce plan for the NHS. While its much-anticipated arrival will be welcomed by many, there is a glaring absence of an equivalent for adult social care in England, which has waited nearly 14 years since its last national workforce plan.
Years of political neglect and underfunding by national government have reduced our social care system to a threadbare safety net. Thousands go without care they need. Last year, the number of people requesting support from local authorities increased but the social care workforce shrank – 165,000 posts, or 11% of roles are now vacant. The NHS and social care workforces are closely entwined, with many lower paid social care staff moving into NHS nursing roles. Introducing a plan to improve conditions for NHS staff without similar measures for social care risks exacerbating the shortages in social care.
Tackling workforce challenges in social care requires additional government funding and a comprehensive plan, including measures to improve pay and conditions, training and development, and recruitment. In our recent polling with Ipsos, we asked the public whether they support a range of workforce policy options, even if they require additional funding or changes to immigration policy.
Pay and conditions
Last year, the government's Migration Advisory Committee said that improving pay is ‘essential to boosting recruitment and improving retention' in social care. The social care workforce is among the lowest paid in the UK and experiences high levels of deprivation. Increasing the national living wage has helped raise median hourly pay rates in the sector. But without parallel increases in government funding, providers have struggled to reward experience and the pay gap between care workers and senior care workers is shrinking. Staff also experience insecure employment conditions. For example, domiciliary care workers are rarely paid for travel between people's homes, putting them at risk of payment below the minimum wage.
Despite this, the Government's social care reform plans include nothing on pay and conditions for staff. Our polling suggests this is out of step with public opinion. The vast majority (84%) support improving working conditions in social care, such as paying travel costs or sick pay. 81% support a minimum pay rate for care workers, set above the national minimum wage. And many (71%) want to see more support for living costs to staff. Fewer (50%) support one-off bonus payments, suggesting a preference for long-term approaches to rewarding staff over short-term fixes.
Training and development
Training and development is another important driver of staff retention. Care workers who receive training are less likely to leave their jobs. Currently though, there is no mandatory training for care workers and a growing majority (57%) do not have any relevant qualifications. While government has recognised the need for action on this, its plans fall short. It is reportedly cutting the promised £500m learning and development fund for the social care workforce – which only amounted to around £110 a year per worker in the first place. This move may prove unpopular since 85% of the public support improving training and development for social care workers.
Recruiting more social care staff
In addition to supporting current staff, recruiting new workers is essential. As our population grows and ages, we may need as many as 600,000 additional social care workers in England by 2030/31. Many people (79%) support a national recruitment campaign for social care – an approach taken through the Government's annual domestic recruitment campaign.
Brexit has made social care recruitment harder. Last year, the Government eased the impact on the sector by temporarily adding care workers to its shortage occupation list and announcing a small fund to support employers with international recruitment. The Migration Advisory Committee has advised government to go further by removing or reducing visa fees for providers and migrant care workers. Support for international recruitment measures is slightly lower compared to other measures in our survey. But a majority support faster visa processes for social care workers (65%), cheaper visa processes (for example, by removing visa fees) (61%) and recruiting more social care workers from outside the UK (57%).
Overall, our polling shows strong public support for a comprehensive set of measures to grow and support the social care workforce. This includes action to increase pay where government policy is notably lacking. Alongside the NHS workforce plan, a long-term plan to reform pay, training, and conditions in social care is long overdue.
Lucinda Allen is senior policy officer, and Genevieve Cameron is programme and research manager, at the Health Foundation
