Department for Health and Social Care urged to produce workforce strategy

NAO says social care workforce is not meeting growing care demands

Published on 7th February 2018

The National Audit Office has slammed the Department of Health and Social Care for failing to support a sustainable social care workforce.

The number of people working in care is not meeting the country’s growing care demands and unmet care needs are increasing, the report by the NAO said.

“Social care cannot continue as a Cinderella service – without a valued and rewarded workforce, adult social care cannot fulfil its crucial role of supporting elderly and vulnerable people in society.  Pressures and demands on the health and social care systems are increasing, so the Department needs to respond quickly to this challenge by giving the sector the attention it deserves and needs, instead of falling short and not delivering value for money,” said Amyas Morse, head of the National Audit Office.

The report highlights that many people working in care find it rewarding, but workers feel undervalued and there are limited opportunities for career progression, particularly compared with similar roles in health.

In 2016-17, around half of care workers were paid £7.50 per hour or below (the National Living Wage was £7.20 in 2016-17), equivalent to £14,625 annually. This, along with tough working conditions and a poor image, prevents workers from joining and remaining in the sector.

There are around 1.34 million jobs in the adult social care sector in England and the turnover rate of care staff has been increasing since 2012-13. In 2016-17 it reached 27.8% and the vacancy rate in 2016-17 for jobs across social care was 6.6%, which was well above the national average of 2.5%-2.7%.

However, the Department estimates that the workforce will need to grow by 2.6% every year until 2035 as demand for care will continue to increase and people’s cares needs will continue to become more complex.

The NAO outlines that care providers, already under financial pressures, are struggling to recruit and retain workers and are incurring additional costs as a result. Local authorities spent 5.3% less on care in 2016-17 compared with 2010-11, and spending is expected to reduce further over the next two years due to continued government funding cuts. This uncertainty over funding is limiting local authorities’ ability to plan future spending on care.

The report finds that the Department has no national strategy to address this workforce challenge and “key commitments it has made to help make the sector more attractive, through enhanced training and career development, have not been followed through”.

The NAO adds that it has not found any evidence that the Department is overseeing workforce planning by local authorities and local health and care partnerships to help with the challenge. Without a national strategy to align to, few local areas have detailed plans for sustaining the care workforce.

The NAO has recommended that the Department produces a robust national workforce strategy with the support of the Ministry of Housing, Communities and Local Government and that it encourages local and regional bodies to align their own plans to it.

The Department also needs to invest more to enable commissioners to set appropriate fees for providers, so they can pay staff adequately and afford to offer career development and training opportunities.

The government intends to publish a green paper on reforming care for older people by summer 2018.

Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said: “This worrying report reflects the historic underfunding of social care which is putting severe pressure on the care workforce, the provider market and the availability of care.

“Councils only employ a minority of these staff using their own pay rates. However, the increasing staff turnover rate and a vacancy rate more than double the national average amongst the wider provider group, shows the sector as a whole is struggling to recruit and retain staff who feel undervalued.

“The workforce is the lifeblood of social care and government needs to act on feedback from providers to implement a national strategy to ensure there are sufficient well-trained carers to make the care profession more attractive, with reward issues discussed on an industry-wide basis so that some sensible common approaches can be developed. This will help to address rising demand for care from a growing older population whose care needs are becoming more complex.

“Councils can’t plan for the future due to uncertainty over funding and an annual £2.3 billion shortfall that adult social care will face by 2020.

“Councils are doing all they can to protect services that care for older and disabled people, but without genuinely new funding to fully close this gap and long-term sector reform, there is a greater risk of more providers either pulling out of contracts or going out of business.”

Margaret Willcox, President of ADASS, said: “ADASS welcomes the report’s conclusion that the Department of Health and Social Care needs to address this challenge urgently and give the care workforce the attention it requires, so that the sector has the right people to provide consistently safe and high-quality care. 

“ADASS hopes that the upcoming Adult Social Care green paper will provide a long-term, sustainable funding solution, and is committed to working with the Government to support them to achieve this. ADASS recognises, however, that the workforce challenges cannot be resolved with funding only, and welcomes the report’s recommendation that the Department should produce a robust national workforce strategy to address the major challenges currently facing the care workforce,” she added.

The adult social care workforce in England


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