The burgeoning workforce troubles of the health and social care sector

The Home Office announced in October that temporarily nurses would be added to the Shortage Occupations List. This marked a U-turn on their previous position, which came after significant pressure from leading industry bodies.

The heated response to the potential of a restriction on nurses able to work in the UK created broad anxiety in the health and social care sector, around the capacity of the existing workforce to safely deliver services in the short-term. However, there also exists systemic problems within the care sector workforce which need to be resolved in order to meet the growing demands of the ageing population in the long-term.

When it was announced earlier this year that nurses would not be included on the Shortage Occupations List, there was an uproar from leading industry bodies, who argued that this would lead to a critical staffing shortage as there simply are not enough trained nurses in the UK. Now that nurses are included on the list, along with ballet dancers, nurses from outside the European Economic Area will have their applications to work prioritised, and this process will be subject to review by the independent Migration Advisory Committee in February 2016.

Temporarily putting migrant nurses on the approved list may ease the supply of skilled labour needed to deliver care. However, in the long-run, the social care sector needs to attract more people who are more skilled and staying in the sector to work longer.

Whilst the NHS is under pressure to significantly reduce spending on agency staff, there are broader, longer-term workforce challenges facing the care sector, including both the increasing and changing demand for services. These strains will only intensify as the population both grows and ages. Overall, the Centre for Workforce Intelligence has forecast a 33 per cent growth in demand for care services by 2030, as the baby boomer generation reaches retirement age.

It has already been widely discussed how the ageing population will see more people needing care and support for an extended period of their life. A more pressing concern is that we will also see the nature of the demand for services change, as the number of people living longer with multiple complex conditions increases from 1.9 million in 2008 to 2.9 million in 2018.

These people will require specialist care and support and the Centre for Workforce Intelligence’s ‘Horizon 2035’ project has already demonstrated that 80 per cent of additional demand currently comes from those living with complex conditions. A more flexible, better trained, and larger workforce will be required in order to deliver high quality and safe care.

The care sector workforce will need to adapt fast. With over four million employees, the health and social care sector is the largest sector by employment in the UK. Whilst demand for service provision grows and current employees retire, a report by the UK Commission for Employment and Skills (UKCES) earlier this year estimated that an additional two million new workers will need to be recruited and trained between 2012 and 2022. A shortage of nurses in the long-run is one of many workface challenges faced by the care sector.

Staffing is the biggest expense for the care sector, which is largely reliant on public funding at a time when the government is reducing the resources available. The UKCES provided tangible recommendations for how to address workforce challenges, such as developing qualifications to attract and train new entrants to the sector, engage lower skilled workers in workplace learning, for employers to conduct workplace planning to analyse how existing roles may evolve in the future.

At a time when care providers are already struggling to meet the demand for services, and with the UK Home Care Association (UKHCA) estimating that an additional £750 million will be needed next year alone to pay for the cost of the National Living Wage, it remains to be seen how care providers will manage to increase investment in staff training and development when they are currently operating on a shoestring.

The health and social care sector faces significant workforce challenges over the forthcoming decade. Providing clearer career paths and pathways for professional development may help to attract and retain the right labour, but the government must also consider the impact that funding cuts are already having on care providers, who are currently struggling to meet the cost of service provision.

The fears of a nursing shortage which were sparked by changes to the now reversed government decision about nurses being included on the Shortage Occupation List shone a spotlight on underlying anxieties in the sector about staffing. The next challenges the government and the sector need to meet together on addressing are the growing skills and labour deficit.