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Slight improvement in state of social care nursing workforce

The downward trend in the number of registered nurses working in adult social care in England has reversed for the first time in a decade, but the workforce remains in a “precarious” state, latest data reveals.

The analysis was published this week by Skills for Care alongside an announcement that it will be developing a “new and comprehensive” workforce strategy for the adult social care sector.

Skills for Care, the strategic workforce development body for adult social care in England, said the workforce figures for 2022-23 showed some “green shoots” as well as “ongoing challenges”.

The State of the Adult Social Care Sector and Workforce in England report, published on Thursday, adds further detail to data released by the organisation in July.

It confirmed that the number of filled registered nurse posts across independent adult social care providers in 2022-23 had reached 33,000.

This was a 2% increase from the previous year, marking the first rise in registered nurses during the recording period, which goes back to 2012-13.

However, the 33,000 figure is still 17,700 fewer than 10 years ago, representing a 35% decrease in filled registered nurse posts over that time.

The vacancy rate for registered nurses also remained “relatively high” at 11.3%, or 3,600 vacant posts, warned the report.

“The turnover rate for registered nurses exposed in this report is eyewatering”

Oonagh Smyth

Across all professions, the workforce grew by 1% between April 2022 and March 2023, and the vacancy rate fell to 9.9% – around 152,000 empty posts – from 10.6% the previous year.

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Skills for Care said the improvements in the state of the workforce were “largely driven by an increase in international recruitment”.

Meanwhile, the report showed that the sector was still struggling with a high nurse turnover rate, standing at 32.6% in 2022-23 and equivalent to around 9,300 nurses quitting.

While this represented an improvement from 44.1% the previous year, it was still three times higher than that in the NHS, which was 10.9% among nurses and health visitors as of March 2023.

The nurse turnover in social care was also significantly worse compared with other regulated professions in the sector, such as social workers (16.1%) and occupational therapists (14.1%).

The turnover rate across the sector as a whole was 28.3% in 2022-23 – down slightly from 28.9% the previous year.

On pay, the report showed that the mean annual salary for adult social care nurses working in independent providers to be £37,000 in 2022-23. The data excludes local authority employers.

Looking ahead, Skills for Care projected that the sector would need 25% more posts – or 440,000 – across all professions by 2035 to meet expected demand.

The organisation said it was now planning to develop a workforce strategy for adult social care akin to the NHS Long Term Workforce Plan published earlier this year.

“The strategy will identify the social care workforce needed over the next 15 years and set out a plan for ensuring the sector has enough of the right people with the right skills,” said the body.

“It will help employers and commissioners with workforce planning, support the government’s reform agenda and complement the NHS Long Term Workforce Plan covering the same period.”

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The announcement follows long-made calls from health and care leaders for an adult social care workforce plan.

It also comes in the same week that the Labour Party pledged to publish such a plan if it won the next general election.

Skills for Care chief executive Oonagh Smyth said: “It’s good to see green shoots for the sector and workforce in our latest report – which is testament to the hard work that’s gone into tackling the recruitment and retention challenges we face. But the challenges haven’t gone away.”

Among these challenges she cited the fact the sector had a “leaky bucket that we urgently need to repair”, noting that 390,000 people left their adult social care jobs in 2022-23.

“So, we need a comprehensive workforce strategy to ensure we can both attract and keep enough people with the right skills to support everyone who draws on care and support – and all of us who will draw on care and support in the future,” said Ms Smyth.

Responding to the report, Patricia Marquis, director of the England branch of the Royal College of Nursing (RCN), raised particular concerns about the nurse turnover rate in social care.

She said: “The turnover rate for registered nurses exposed in this report is eyewatering – at three times higher than the NHS – and the sector must ask itself the very tough questions about why that is the case. It is unsustainable and unsafe for the people who rely on services.”

She said chronic short staffing in the sector was leading to “over-stretched services, nurse burnout, sickness absence – and ultimately people leaving social care or the profession altogether”.

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On the promised workforce plan, Ms Marquis said it would need “heavy central government investment” in order to work and added that nurses needed to be involved in its development.

“The RCN, as the voice of nursing, has the expertise to support the development of this work and we expect to see very broad consultation and engagement of the college and the professionals we represent,” she said.

Meanwhile, Andrea Sutcliffe, chief executive and registrar of the Nursing and Midwifery Council, welcomed Skills for Care’s plans to develop a new workforce strategy for adult social care.

She said the small increase in filled nurse posts was “good” but warned that “it’s still 35% lower than 10 years ago when the need for these highly skilled professionals is greater than ever”.

“This precarious situation is exacerbated by a high level of turnover with a third of registered nurses leaving their jobs in the last year impacting on the continuity of care that communities need,” she said.

“Social care nurses are a lifeline for people and communities across the UK, and it’s vital their contributions are recognised.

“They need to be supported and valued to deliver the best care they can to improve people’s health and wellbeing,” added Ms Sutcliffe.

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