MPs urge government to publish social care workforce plan

The government must put forward long-term plans to address chronic workforce shortages in the social care sector, including a clear workforce strategy, a new report from MPs has urged.

An influencial select committee said the Department of Health and Social Care (DHSC) was falling short on its promise to fix adult social care in England, amid workforce shortages, chronic underfunding and rising waiting lists.

“Social care is gripped by devastating workforce shortages”

Claire Sutton

The warning this week from the House of Commons’ Public Accounts Committee (PAC) comes at a time when there are over 152,000 vacancies in adult social care services in England.

In 2021, the DHSC published its People at the heart of care white paper – a 10-year vision for adult social care – supported by £5.4bn in funding to reform the sector, including £1.7bn for system reform.

However, in 2023, the DHSC revised plans for system reform, which scaled back plans to £729m between 2022-23 and 2024-25.

The PAC warned in its new report that plans for reform had “gone awry”, noting the fact that many reforms had been scaled back or delayed and essential funding had been diverted.

The committee added that the DHSC faced “significant challenges” in delivering its vision for adult social care reform and that the sector must be able to hold the government to account for its progress.

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The report said: “It is worrying that the department has no roadmap for achieving its 10-year vision for adult social care, or any targets or milestones beyond 2025.

“Though we agree that some flexibility to adapt as the department learns has merit, there is currently nothing meaningful in place to demonstrate progress towards targets,” it said.

The PAC called on the DHSC to set out a roadmap for delivering its vision, bringing together all reform activity and supporting it with key performance indicators that can be measured.

In addition, it said the department should publish a six-monthly update on progress.

Meanwhile, building a social care workforce that can meet current and future demand was a key issue identified in the PAC report.

Earlier this year, ministers unveiled plans to boost the domestic pipeline into the adult social care workforce, by investing in nursing apprenticeships, a new care qualification and a care workforce pathway.

The committee acknowledged these efforts but warned that the DHSC had “still not produced a convincing plan to address the chronic staff shortages in the long term”.

For example, it said reforms were not underpinned by a “long-term comprehensive workforce plan”, unlike in the NHS.

The report said: “Along with differences in the way NHS and adult social care are funded, this contributes to a sense that the two sectors are not equal partners and, unless health and social care are sufficiently integrated, people requiring care will continue to lose out.”

While the 2021 white paper did touch on workforce, the PAC said the coverage was “woefully insufficient”, because it did not address factors impacting on recruitment and retention, such as pay.

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The white paper’s workforce plans also did not go beyond 2025, despite the DHSC forecasting that the number of adult social care jobs will grow by almost one-third by 2035.

As such, the PAC has urged the DHSC to write to the committee, setting out how it will lead the sector to identify and address workforce challenges, including:

  • Achieving a sustained reduction in the number of vacancies in the sector (beyond 2025)
  • Addressing the challenges and risks associated with international recruitment
  • Tackling local variations in vacancy rates
  • Addressing issues around disparity with NHS pay
  • Assessing which workforce initiatives are most effective for recruiting and retaining staff

Dame Meg Hillier, chair of the PAC, said: “The decision to dedicate a single chapter in the adult social care reform white paper to the social care workforce does not do justice to the level of work that will be required and feels to us like a bit of a cop-out.

“While an NHS-style workforce strategy for social care may not be feasible, the DHSC must set out how it will how it provide leadership across the sector to identify and address workforce challenges.”

In response, the Royal College of Nursing’s transformational lead for the independent health and social care sector, Claire Sutton, said: “Social care is gripped by devastating workforce shortages while staff working in the sector take home up to a third less pay than their colleagues in the NHS.

“As demand for social care services continues to increase, the government has serious questions to answer as to why there is no social care workforce strategy to speak of.”

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Ms Sutton warned that there were “not enough nursing staff to give people the case they deserve”.

She added: “Building an effective social care sector requires sustained central government investment, a bold workforce plan and pay parity between care workers and colleagues in the NHS. Anything less fails to appreciate the scale of the crisis.”

A DHSC spokesperson said: “We are committed to reforming adult social care and have invested up to an additional £8.6bn over two years to meet the pressures facing the sector, grow the workforce and improve hospital discharge.

“The report rightly acknowledges progress to boost care workers’ career progression and training to improve retention, including through a new accredited qualification,” they said.

“To drive forward our vision for reform, we are also investing up to £700m on a major transformation of the adult social care system, which includes investing in technology and adapting people’s homes to allow them to live independently.”

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