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It’s a similar story up and down the country. Job postings upon job postings. Healthcare assistants, nurses and managers. They are desperately needed in every nook and cranny of all social care organisations. A place where the staff bleed is brutal and many tactics are needed to survive.
How do you create a great workplace culture? What are the consequences of staff shortages? And finally, what does digital play in the retention and recruitment game?
The cost-of-living crisis has taken its toll on many of us and certainly on social care. Providers are struggling to pay employees the full UK living wage. And as a consequence, staff vacancy rates across the sector are now at 18 %. Rent and food prices are soaring, meaning care workers are being priced out of a job in social care. Even if the desire and motivation are there, it’s simply not possible to support yourself on a care worker’s wage.
What can you do when you need staff but can’t recruit them?
You turn to agency staff. Agency staff that comes with a large premium compared to permanent staff. 80% higher cost, to be precise. So, care providers who are already so strapped for cash they can’t pay permanent staff a competitive wage now have to pay for expensive temp staff. The NHS spends approximately £6.2 billion per year on bank and agency nursing shifts, which is, of course, not sustainable. Something’s got to give.
How did we get to a place where 18 % staff vacancy is even possible? Skills for Care estimates there were 165,000 vacant posts in social care in 2022. An increase of 52% and the highest ever. There are 50,000 fewer social care workers compared to 2021 – the first drop ever.
It is expected that there will be 14.5 million people over 65 in 2035. An increase of 44% compared to 2017. Demand for more staff is only going to increase. An estimated 1 million more health and care staff are needed in the next decade. 488,000 are needed to meet demand, while 627,000 are needed to improve services – an increase of 40% and 55%, respectively. Having a shrinking social care sector workforce is simply a recipe for disaster.
The current social care workforce is also showing concerning demographic signs. The number of Registered Nurses working in potential retirement age grew in the last year by 3.7%. If understaffed organisations put more pressure on retirement-ready staff, why would they stick around? Exasperating the already untenable situation. The sector needs to find a way of training more staff. And be able to keep them.
Staff turnover rates within care roles remain high. 29%, or approximately 400,000 people, left their jobs in 2021. 63% of people working in the sector have been recruited from other care roles. Another sign that there are not enough people entering social care to begin with.
The highest staff turnover rates are among the youngest staff. 52.6% of people under 20 leave within a year.
Things are being done to address this. The “People at the Heart of Care” whitepaper outlines the Government’s vision towards solving the staff shortage issue. Specifically releasing £500m committed to the workforce for skills and learning initiatives.
Brexit has also contributed its part to the staff shortage. From 2011 to 2016, the number of staff from EU countries rose by 68%. Brexit essentially cut off that supply of workers and introduced minimum skills and salary requirements for non-EU immigrants that a job in social care did not qualify for. Something that has only recently been addressed by the Health and Care Visa. But only partly addressed as care workers are not included as a shortage occupation. Nor do they meet the annual salary threshold of £25,600.
We have heard for ages that solving the workforce crisis requires a significant boost in wages. But is it that bad? Yes, it is.
4 out of 5 jobs in the wider economy pay more than a care worker’s median salary. Likewise, the average care worker’s pay is £1 per hour less than healthcare assistants in the NHS that are new to their roles. A job that is not exactly known for its high salary. “Parity!” we’ve heard Martin Green and others cry out many times.
And it’s not just entry-level positions that are severely underpaid. Care workers with five years’ experience are paid 7p per hour more than those with less than one year’s experience. No wonder the sector is having difficulties recruiting new staff. Helen Walker, Chief Executive of Carers UK, said:
“Care workers play an essential role in society supporting people to enjoy a better quality of life – a role that is valued by families and should be valued by the Government. It cannot let the care worker shortage get further out of hand.
Adult social care needs a proper long-term workforce plan and significant investment in the system to ensure older and disabled people and their families can enjoy better health and better lives.”
You hear similar stories of a social care sector in crisis from other countries. But how does the UK stack up against other countries? Is it normal to have a social care sector as much under pressure as ours?
Let’s take the number of nurses. Per capita, the UK has 7.78 nurses for every 1,000 people. That is about the same as Lithuania. In comparison, Norway has 18 for every 1,000 people. While it’s always dangerous to make such comparisons between countries, it’s still a significant difference. A sign of the neglect we have all felt in the sector for a while.
What role does digital play?
Digitalising social care has found real momentum in the last few years. The ambition is for 80% of social care to have digital care records by March 2024. The ambition is backed up by many initiatives. Most notably, access to funding through local authorities and the creation of the Digital Social Care Assured Supplier List.
How will digital care records reduce recruitment issues in social care?
Going digital saves time. Compared to paper, it saves 90 minutes per staff member every shift. That is a significant boost for any provider struggling to do more with less staff.
In their regulatory framework, the CQC also uses criteria that are practically impossible to meet if you are still paper-based. You can provide more person-centred care and collect evidence in a much more intuitive and easy way compared to paper.
It sounds too good to be true. Go digital, save time, provide better care, and now there is no staff shortage.
However, these digital benefits are compared to a paper-based alternative. You can’t find 90 minutes per shift in organisations that are already digital. For those organisations, the gains are more incremental. They are also searching for staff non-stop.
Digital social care records are not a silver bullet that solves recruitment issues. It’s a way to ensure that every care organisation gets the most from the hours carers spend working.
This is needed and is more than a dent in the problem. 90 minutes per shift saved translates to 20% increased efficiency. This is possible within a few years – whilst we struggle for structural change to fix the political and financial issues.