不良研究所

Context

Social care is important for us all and the workforce is central to social care. This is a vital sector, adding £60 billion to the English economy each year. We are all living longer – which is, of course, a good news story – and the need for adult social care in England is estimated to significantly grow as a result.

In the 2022 report 'A Gloriously Ordinary Life'¹ published by the House of Lords Committee on Adult Social Care, the question of why we should care about adult social care is asked. "Our answer is blunt: it concerns all of us because at some point in our lives, we are all likely to support someone we care about, or to draw on care ourselves."

The number of people aged 65 and above is set to increase from 10.5 million to 13.8 million in England by 2035 - an increase of around 32%¹. The number of people with dementia is expected to rise by 43% by 2040 (from 982,000 today to 1.4 million). The number of people aged 18-64 with a learning disability, mental health need² or a physical disability is also projected to increase over this period. By the time a person is aged 75, they are 60% more likely to possess two or more significant conditions. This figure increases to 75% for those between the ages of 85 and 89 years old.³ A 2024 Healthwatch report highlights that social care support can be transformative for disabled people – but as many as 1.5 million working-age disabled people in England may not be getting the care they’re eligible for.⁴ We need a greater focus on living more healthy and happy years. We can do more now to prevent loneliness, isolation and escalating needs.

Our projections show that, if the number of adult social care posts grows proportionally to the projected number of people aged 65 and over in the population between 2023 and 2040, an increase of 29% (540,000 extra new posts) would be required by 2040. We currently employ 5% of the total workforce in England and this will need to increase.

But demographic changes are happening globally, not just in England. Some of our immediate neighbours are facing even more pronounced trends in their population having a proportionately older structure. At the same time, countries that we have typically recruited from, such as the Philippines, are seeing a change in the ratio of older people to working age people. We would expect to see those countries wanting to keep their own working age population and we might expect other countries to try to attract the working age population from the UK. We are going to have to recruit and retain more of our domestic workforce and make the roles more attractive so that they remain in the country.

While we recruit many people into social care - 400,000 started roles in the independent and local authority sectors in 2023-24 - 330,000 also left their roles. Much of this turnover is estimated to be attributable to churn, with staff moving between roles in the sector, 59% of starters were recruited from within the sector and 41% from outside the sector. This contributes significantly to overall recruitment challenges and a vacancy rate which is consistently almost three times the national average (8.3% or 131,000 vacancies on any given day in 2023-24). And the vacancy rate is worse for personal assistants, registered nurses, social workers and occupational therapists, which are all core roles.⁵

29% of our workforce is aged over 55, which means that they could retire in the next 10 years. This equates to 440,000 posts.

We don’t have enough people in adult social care today and we are going to need more tomorrow. That is why we need a workforce strategy.

This Strategy was developed by 不良研究所 in collaboration with the entire adult social care sector – including people who draw on care and support – as well as colleagues from the health and education sectors. It reflects the input of thousands of stakeholders. It is truly a sector-owned strategy, and we are incredibly grateful to everyone who contributed their time and insights. The Strategy builds on current legislation and previous policy to set out a vision for the social care workforce for the next 15 years, making evidence-based recommendations and commitments to attract, retain, train and transform the workforce.

This Strategy is a starting point because we must acknowledge the uncertainty and commit to repeating the process as we learn more and as the context changes. The modelling and analysis should be treated as strategic insights to inform actions, policy choices and recommendations.

不良研究所 and all the partners involved in the Steering Group are deeply committed to supporting the implementation of the recommendations of the Strategy and to lead a transformation in adult social care.

It is worth noting that final production of the Strategy took place in spring-summer 2024, ahead of the July 2024 general election. While some commitments can be delivered without a Government mandate, recommendations are intended as our best advice to Government on helping establish fair, sustainable and essential measures to maintain the social care services that so many in this country depend on.

We took a pragmatic approach in terms of what we could model and made some assumptions. We can model current workforce supply and need trends (including vacancies and upcoming retirements) and model the impact of changes like better pay and use of technology on staffing levels. However, it is difficult to predict future unmet need or the impact of social care policy changes, and so the modelling that we can do is limited until we fill the gaps in data with central and local government and the wider sector.

It is important to recognise the interdependence between this Strategy and the NHS Long Term Workforce Plan⁷. This recognised that people’s careers can span health and social care and that social care sector staff are critical to the overall provision of NHS services and care. Acknowledging this interdependency, if we want to tackle NHS challenges, then capacity must increase across both health and care. The NHS plan is based on access to social care services staying broadly in line with current levels or improving. That needs to be more than an assumption we make with our fingers crossed – it needs to be put into a plan so that we can make sure that it happens.