Staff shortages 'a key factor' of burnout amongst care workers and NHS staff

Chronic excessive workload has been identified as a key factor of burnout amongst care workers and NHS staff, with staff shortages identified as “the most important factor in determining chronic excessive workload”, reveals a report by a cross party group of MPs, published today.

The report by the Health and Social Care Committee called ‘Workforce burnout and resilience in the NHS and social care’ follows an inquiry which examined workforce burnout in the NHS and social care, in particular the increased pressures brought about by COVID-19.

'The danger is we do not see it'

In his oral evidence, Professor Michael West of the King’s Fund, explained to MPs sitting on the Committee, the relationship between excessive workload and burnout: “I want to be clear about the issue of excessive workload.

"The danger is that we do not see it. It is like the pattern on the wallpaper that we no longer see, but it is the No. 1 predictor of staff stress and staff intention to quit.”

Staff shortages existed before the pandemic and is not a new issue, the Committee said, but the coronavirus pandemic had put more pressure on staff.

The pandemic impacted workers’ mental health with Covid burnout the result of increased workload and working hours, emotional strain from seeing large numbers of patients dying, anxiety about their own and loved ones’ health and infection risk and worries about being able to provide high-quality care.

149,000 care staff left the sector

Staff vacancies contributed to burnout with Skills for Care data revealing the staff turnover rate of directly employed staff working in the adult social care sector was 30.4 per cent in 2019– 20 - equating to approximately 430,000 people leaving their jobs over the course of the year.

Around 66 per cent of recruitment was from within adult social care, this meant that approximately 149,000 had left the sector.

MPs sitting on the Committee were told that intensity of workload was a factor in causing burnout. Professor West told the Committee that staff could “deal” with “episodic, transient demands” but it became a problem when that demand became “chronic.”

Low pay, less favourable sick pay and pension for care staff

Low pay and reward was also a factor according to MPs leading to stress and burnout. MPs said in the report: ‘The low pay is a particular issue in the social care workforce.

‘For the Local Government Association (LGA), pay was not the only area of reward discrepancy between the social care and NHS workforces, with less favourable sick pay and pension arrangements likely where social care workers are employed in the independent sector rather than by a local authority.

“It also pointed out that NHS workers were also more likely to have access to retail and other discounts, although this was beginning to change'.

Discrimination was another cause of staff burnout. The King’s Fund highlighted that black, asian and minority ethnic staff in the NHS reported worse “and often shocking” experiences compared with white staff and were under-represented in senior posts.

Call for 'Freedom to Speak Up Guardians'

The Committee has recommended the DHSC develops a strategy for the creation of ‘Freedom to Speak Up Guardians’ in social care. MPs said in the report: ‘It is imperative staff have the opportunity and the confidence to speak up. However, this needs to be matched with a culture in which organisations demonstrate that they are not just listening to, but also acting on, staff feedback.

‘While NHS organisations have a formal structure to raise concerns through Freedom to Speak Up Guardians, there is no equivalent for adult social care’ .

The Committee is recommending the Department for Health and Social Care extend the NHS Staff Survey to cover the care sector.

MPs also called for a new metric to assess staff wellbeing and staff mental health that covers both the NHS and social care, to better understand the level of staff burnout.

The NHS Staff Survey it said must include an overall staff wellbeing measure, so that employers and national bodies can better understand staff wellbeing and 'take action'.

The Committee concluded that additional support for staff given during the pandemic ‘will need to be maintained during the recovery period and beyond to stop further staff from leaving’.

The report recommends any help for staff is accessible to all. This will require removing barriers to seeking help and 'embedding a culture where staff are explicitly given permission and time away from work to seek help when it is needed'.

MPs said Integrated Care Systems (ICSs) are needed to enable access to wellbeing support for NHS and social care workers and that they are accountable for the accessibility and take-up of those services.

Care workforce must have 'same access' to resources as NHS

Martin Green, chief executive of Care England, which represents independent care home providers, said: “Whilst the workforce is resilient it is only as resilient as the funding and support behind it hence the need for adequate long-term support for the sector.

"Money alone is not the answer, we need to ensure that social care is established as a career with the kudos associated with due professionalisation and one way to deliver that would be a ten year plan for workforce akin to that of the NHS.

“As we made clear in our written submission and oral evidence, health and social care are two sides of the same coin. It is therefore essential that the adult social care workforce has the same access to resources as colleagues in the NHS.

“Maintaining the financial sustainability of social care providers is of fundamental importance in maintaining the capacity of the integrated health and care system and the resilience of the adult social care workforce”.