Ben Weatherall, co-founder and director of Curam, discusses the skills deficit in the social care system and what to do about it.
A country-wide care crisis is putting vast financial pressure on councils in the UK. The King’s Fund Social Care 360 report found that annual expenditure on adult social care in England alone is at £26.9bn, and yet people are still not receiving the vital care that they need.
An ageing population with increasingly complex needs due to living longer means that demand for care is rising, and this will continue incrementally over time. However, the root cause of social care challenges is a fundamental lack of experienced people to provide care.
To put this into perspective, Skills for Care reported in October 2023 that there were 152,000 vacant posts in England’s adult social care workforce, equating to a vacancy rate of 9.9%. London is the most critically understaffed region, with a vacancy rate of 12.1%. The issue is even more prevalent in Scotland, with Scottish Social Services Council’s latest data showing that the vacancy rate was at 47%.
Personal assistants have been undervalued for too long
Why is there such a skills deficit in care? Well, for too long personal assistants (PAs) have been undervalued as professionals, leading to rapid turnover and the role becoming a ‘placeholder’ job while people wait to secure something higher paying and more rewarding.
Being a PA is challenging and demanding, and unfortunately not a viable career, especially for those who have families to support.
The median hourly pay in March 2023 for a care worker in England was £10.11 – a 35p per hour pay cut from the previous year. In comparison, the National Living Wage is £11.44 per hour and Amazon Warehouse employees get paid an average of £12.66 per hour. Additionally, costs such as fuel for travelling between clients are often not reimbursed.
Lack of progression opportunities is another factor driving the exodus from the care sector. It is common for PAs to become stagnated in their role, with no training available to develop new skills, achieve promotions and increase their salaries. Managers make up just 2% of the NHS workforce, compared to 9.5% of the overall UK workforce, demonstrating the flatline of a career in health and social care.
Together, these elements make care an unattractive career path. The turnover rate of directly employed staff working in adult social care in 2022/23 is estimated to be 28.3%, equating to 390,000 people leaving the sector over the year.
Brexit has added fuel to the workforce crisis fire, with the Nuffield Trust finding that there has been a decline in EU recruitment and registration across medicine, nursing and social care since the referendum in 2016. Although recruitment has increased from the rest of the world, it is not enough to plug the gap left by the EU workforce.
How do councils put the PA at the heart of care?
The key to overcoming the deeply entrenched issues in the UK care system is to put carers at the heart of the solution. This means paying them fair wages and providing the tools to excel in their roles, give great care and access better care work opportunities.
Online care platforms’ technology reduces administrative fees and overheads incurred with traditional care agencies and create saved value to reinvest in PAs. That’s because they effectively enable carers to self-manage their careers. On average, earnings increase by £5 per hour, plus there are added benefits such as free training modules to facilitate continuous development and increase career prospects.
We have seen first-hand in Sunderland and North Yorkshire, for example, how taking a PA-centric approach helps to both attract new PAs and encourage people who previously left the sector to return. We also see ex-nurses signing up to online platforms, meaning that the care available truly is top quality. The average experience of a PA working in the UK is around two years, but on online platforms where pay and opportunities are greater, this increases to over 10 years .
As well as stemming the flow of people out of the care sector, using online platforms versus care agencies allows Direct Payment teams to provide better care quicker and give service users more choice and control. Patients are vetted, trained PAs can be connected often immediately, consistency can be guaranteed and specialist care or language skills can be sourced. Online platforms also cost less to the local authority, ensuring greater value for money.
With the care system in turmoil, online platforms are a solution with PAs at the heart, tackling the root workforce crisis that is crippling the sector. This in turn ensures that local authorities are delivering high-quality, cost-effective care to citizens so that no one who needs care has to go without it.
