The Social Care workforce is about to collapse

Workforce challenges in social care have existed just below crisis level for years. But recently the story has changed and it’s about to get a lot worse.

In the last few weeks, things have changed across social care. A number of new dynamics have emerged that, when taken together, are creating the perfect recruitment and retention storm.

Every care provider I’ve spoken to over the past few weeks has told me about their catastrophic staffing challenges. Even today, many are no longer able to provide even a basic service.

The long term trends affecting the sector are well known; terrible hourly wages, poor recognition and perceived lack of career development. But they are now joined by six further dynamics that are pushing services over the edge:

• Mandatory vaccination for care home workers
• COVID-19 self isolation requirements
• Labour shortages across retail and hospitality
• Post-Brexit impact on free movement of people
• 3% increase in NHS pay
• Workforce burnout

Let’s take a look at each of these factors in turn, examine how big this problem is going to get and, finally, see if there’s any cause for optimism.

Mandatory vaccination for care home workers

From 11th November, COVID-19 vaccination will be mandated across frontline care home workers. The government’s own impact assessment estimates that up to 12% of the workforce will leave the sector. Areas of the country with particularly low vaccination rates will experience a far greater impact.

COVID-19 self isolation requirements

The pingdemic is being felt particularly strongly across social care. The demographic of the workforce means that a high proportion of social care workers have childcare responsibilities. One ‘ping’ in any family member may be enough to prevent a frontline worker from leaving the house.

Thankfully with rule changes in due on 16th August, this factor should resolve. Until then, care providers are fighting a daily battle to ensure that there are enough people on the ground to provide even the most basic care.

Labour shortages across retail and hospitality

Worldwide, the retail and hospitality sectors are struggling with labour shortages. There are reports of employers paying candidates just to turn up to an interview and we are are seeing significant wage inflation across these sectors.

In 2013, the average care worker wage was slightly ahead of that of cleaners and retail assistants. By 2019 this pattern had reversed. Data for wage disparities in the past few months is sparse but points to substantially higher wages in retail and hospitality when compared to care. Competition between these sectors is traditionally fierce — there’s a direct correlation between wage inflation in retail and hospitality and people leaving social care jobs.

Post Brexit impact on free movement of people

In all the noise of COVID-19, many forget that the free movement of people across the UK and EU ended earlier this year. Whilst this should have a minor impact on nursing recruitment, the impact on care workers is significant.

And it’s not just in care. The reduction in free movement is exacerbating the supply squeeze in hospitality and retail worsening wage inflation. This is a good thing for workers when industries have the ability to meet that increase. Unfortunately, social care providers do not have anywhere near the financial firepower to do that leaving jobs unfilled.

3% increase in NHS pay

Much has been said about the government’s proposed 3% increase to NHS staff pay. Whether or not you agree with the approach, there is an undeniable negative impact on social care. The majority of care providers are unable to offer anything approaching a 3% rise in wages for care staff — I am hearing stories daily of care workers leaving social care to work in the NHS.

Workforce burnout

The last 18 months have piled unimaginable pressure on the care workforce. As the pandemic morphs into its next phase, the people who have dedicated their lives to the cause are collectively coming down off that adrenaline rush. This is when frustrations and tragedies, pent up for months, come to the surface. Everyone is tired and for some people, the stress and grief will be too much to bear.

How bad is this problem?

Pre COVID-19, care providers reported more than 120,000 vacancies across social care. It is hard to put a number on the combined impact of these six factors but it will be big.

If you add the existing 120,000 vacancies to the government’s central estimate of the impact of mandatory vaccination (40,000 people), we’re left with 160,000 vacant roles. Pile on the exodus of staff to the NHS, retail and hospitality and we could easily hit see a quarter of a million jobs unfilled. That’s a 1 in 5 social care posts unfilled.

At that level, many care services across the country will be unable to provide even a basic standard of care. The impact will be felt by vulnerable people who, through no fault of their own, are left abandoned by a system that could have seen this problem coming.

To emphasise the urgency of this situation… This isn’t a problem that will evolve slowly over the coming years; it is not something to deal with at some theoretical point in the future. It is challenge facing care services today and we have weeks, and at most months, to turn this around.

How do we make it better?

There are three things we need to turn this around.

One, create a defined minimum wage for care workers that is above those seen in competing sectors.

Two, create an immediate funding solution for care providers that allows them to pay this minimum wage without risking insolvency.

Thirdly and finally, treat Social Care with the same respect and esteem as the NHS. This isn’t just rhetoric, it’s done through the implementation of practical policy choices that are fair and equivalent between the two. The recent disparity on COVID-19 vaccination policy is an obvious example. Social care pay rates must be at least equivalent to those in the NHS.

Can we be optimistic?

Yes of course we can. The United Kingdom is one of the richest countries in the entire world and has the economic clout to easily provide a long term solution to social care. The fact that we don’t have the ambition to do this is sad. We are finally seeing some willingness in government to respond but it is moving too slowly. I hope that the solutions that are instigated are bold, conclusive and happen this summer. If not, we’ll be in very serious waters.