The adult social care workforce in England: urgent action needed

May 9, 2018

A Public Accounts Committee (PAC) report into the adult social care workforce in England warns urgent action is required to reverse care work's poor public image and boost recruitment and retention.

The adult social care sector is underfunded, with the care workforce experiencing low pay, low esteem and high turnover of staff.

The care sector is in a precarious state but the Department of Health and Social Care (the Department) has not yet said how it intends to put in place a long-term, sustainable funding regime to meet the ever-increasing demand for care. PAC says that the Department does not know whether the ways that local authorities commission care, and the prices they pay providers, are contributing to the problems within the care workforce.

The PAC is not convinced that the lack of regulation within the care sector workforce and the balance of regulation versus a market-based approach, is supporting the care sector to provide the best care possible.

Added to this, it says that the UK’s departure from the EU is causing uncertainty over how the workforce will be sustained, particularly in areas that are more reliant on non-UK workers.

The report argues that there is an urgent need to reverse the poor public image that care work has to boost recruitment and retention across the care sector.

The PAC is also concerned that the move to supporting people with substantive and critical care needs only is contributing to growing levels of unmet need for people with moderate care needs. These moderate needs may well grow into substantial or critical needs if support is not given.

The report goes on to say that the Department has committed to addressing all these issues through the health and care workforce strategy that it is currently consulting on, and the promised Green Paper on funding of care for older adults. But given the pressures on the sector, the PAC is concerned that the Department sees the Green Paper as a cure-all and underestimates the scale of the challenge.

Adding, the Department must ensure that its delivery partner, Skills for Care, is properly supported and funded to implement the workforce strategy.

Committee Chair, Meg Hillier MP commented, 'Adult social care needs sustainable funding and a stable workforce. The sector is scraping by and without an explicit, long-term plan backed by Government it could soon be on its knees.

'Levels of unmet need are high and rising; short-term funding fixes are a road to nowhere and the ingrained issues that lead to high turnover in the workforce could be compounded by Brexit.

'Government should not content itself with councils’ ability simply to meet the legal minimum for care provision.

'Nor should it seek solace in measures that risk opening a prolonged debate on the challenges facing the sector. Those challenges are already well-documented, clear and pressing.

'We urge Government to publish this year, and then implement, a credible long-term funding plan for care.

'This must go hand-in-hand with financial and other support to improve the recruitment, development and retention of the care workforce.

'Skills for Care summed it up when it described perceptions of care work as a minimum wage sector as "a source of national shame".

'This skilled and vital work transforms people’s lives. It could and should be a source of national pride and we urge Government to give swift and serious consideration to the recommendations set out in our report.'


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