The Care Workforce Crisis
If you’re bucket is leaking don’t just poor water in faster – fix the leaks!
We’ve been privileged recently to have been able to talk to a lot of people struggling to manage their local care system in the face of some of the highest levels of care staff vacancies ever experienced. In the thick of it there seems to be little hope and helping people to develop their long game when it seems that all around them is failing is perhaps the toughest ask of a consultant!
Over the last ten years the pay of care workers has fallen behind other areas of work. According to the King’s Fund between 2012/13 and 2020/21 the relative pay of care workers compared with cleaners has changed from being 28p an hour more to being 6p less and compared with sales assistants was 16p more but is now 20p less. When you add in the impact of plans to require care workers to be vaccinated earlier this year and the frequent moves from being a care worker in social care to taking up a care assistant in the health sector, it’s no wonder there’s a problem. In the system we’ve been working with the levels of vacancies have grown in the last year from 1,500 to 2,600, or from 6.3% to 10.9% at a time when demand is growing, along with the expectations being placed on the care sector by an overstretched NHS.
The pay and conditions for care workers clearly signal that caring for the most vulnerable in our society is an undervalued skill. There’s only so much that can be done to improve working conditions without significant investment and increases in pay. But not investing in our care workforce is a false economy when the lack of capacity in social care causes delays in hospital discharges which makes it difficult for patients to be admitted to hospitals that are overflowing, leading to ambulances stacking up and therefore not being able to respond to urgent, life-threatening situations.
We are told by our politicians that to spend more on public services we first need to generate wealth, get the economy growing again, and then we will be able to afford to reward those who care for some of the most vulnerable in our society. Apart from being morally abhorrent this also doesn’t make economic sense anymore. The COVID impact on economic inactivity is now becoming clear, with increasing numbers of people not working due to poor health or as a result of caring responsibilities for those adversely affected by COVID. Our population is becoming sicker to the extent that healthy life expectancy is starting to reduce in the more deprived socio-demographic groups. This is a mammoth job in itself after decades of failure to invest in prevention, although that’s another story. For now, it’s clear that we can’t wait for the sunny uplands of economic growth when the care sector is in crisis.
I’ve been heartened by the efforts and the creative thinking of those in the thick of trying to sort this mess out, but they’re fighting with one hand behind their backs. Improved pay and conditions for our care workers would reflect the respect we owe them, the importance we place on caring for some of our most vulnerable members of society and makes economic sense for employers in reducing the expensive churn in the system, for staff who will be encouraged to see their work as valuable and worth committing to as a job rather than just as a part-time benefits top-up, and for our economy at this delicate time of recovery from the pandemic.
Respecting and rewarding our care workers is also the best way to fix the leaks and therefore reduce the scramble to find new applicants for jobs that become increasingly difficult to fill. I take my hat off to those working hard to satisfy the needs of local residents in the absence of such funding and hope that it will not be long that this false economy is recognised by those holding the purse strings!