Social care reform and the social care workforce
A Westminster Hall debate on the ‘Social care reform and the social care workforce’ has been scheduled for Thursday 18 March 2021 from 1:30pm. The debate has been initiated by Barbara Keeley MP.
Proposals to reform adult social care have a long history. The current position, as set out in the recently published health and social care white paper, is that the Government is “committed to the sustainable improvement of adult social care and will bring forward proposals this year.”
Further information, including summary information on reform proposals since 1997, is provided in Library Briefing 8001: Adult social care funding reform: developments since July 2019 (England).
Further information on adult social care funding, including funding pressures and details of additional funding committed since 2016-17, is provided in Library Briefing 7903, Adult Social Care Funding (England).
Adult social care workforceThe adult social care workforce in England in 2019-20 was estimated to comprise around 1.52 million people (compared to 1.3 million in the NHS) working in around 18,200 organisations. Further information, including regarding employment, recruitment and retention, demographics, pay, qualification rates, and future workforce forecasts, is provided in Skills for Care’s October 2020 report on The state of the adult social care sector and workforce in England.
A number of concerns have been raised regarding the adult social care workforce. For example, in its State of Care 2019/20 report, the Care Quality Commission stated that:
Social care’s longstanding need for reform, investment and workforce planning has been thrown into stark relief by the pandemic. There needs to be a new deal for the adult social care workforce that reaches across health and care – one that develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training and supports appropriate professionalisation.
In its October 2020 report Social care: funding and workforce, the Health and Social Care Committee stated that the adult social care workforce was under “significant pressure” and that the rising demand for social care was “calling into question the long-term sustainability of the workforce.” The report added that care workers have “been on the frontline during the coronavirus pandemic” and that, while it is not clear what the long-term impact on the workforce will be, “it appears that existing pressures have left the sector ill-equipped to respond.”
The Committee’s conclusions and recommendations included:
- Improving the level of recognition afforded to social care workers “must be a key focus for the Government to safeguard the future of the social care workforce.”
- The proposals for reform of how people pay for care must provide “a sustainable basis for continued rises in pay above and beyond increases to the National Minimum Wage and in line with increases given to NHS staff.”
- The Government should bring forward proposals to support the improvement of employment conditions in the sector, including reducing the over-reliance on zero hours contracts and improving the provision of sick pay.”
- The Government should “bring forward a plan to streamline the training of social care workers in order to improve routes of entry to the profession and improve career progression for existing social care workers.”
- The Government “must ensure that transitional arrangements are in place to ensure that social care workers can continue to be recruited from overseas for as long as it takes to build sufficient resilience in the domestic supply of social care workers.” Building this resilience “will depend on improving pay and other workforce issues in social care.”
The Government’s response to the report was published in January 2021. Section seven of the response sets out the Government’s position on the Committee’s recommendations regarding the social care workforce. Further information on what the Government is doing to increase recruitment into adult social care was provided in response to a parliamentary question on 8 December 2020.
Subsequently, on 9 February 2021, the Department of Health and Social Care announced the launch of a ‘Care for Others. Make a Difference’ advertising campaign to “drive awareness of long-term career opportunities” in adult social care. It also called on people to apply for short-term opportunities to support care services during the Covid-19 pandemic.
Further information on the overseas adult social care workforce, including the impact of Covid-19 and Brexit, is provided in Library Briefing 8948, Overseas health and social care workforce. Since the briefing was last updated, on 4 March 2021, the Government has announced that senior care workers, and residential, day and domiciliary care managers would be added to the Shortage Occupation List.
Parliamentary Material Committee ReportsSocial care: funding and workforce
Health and Social Care Committee
Third Report of Session 2019–21
HC 206
22 October 2020
Parliamentary Questions12 Mar 2021 | 157095
Asked by: Mr Jonathan Lord
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to protect care home residents during the covid-19 outbreak.
Answering member: Helen Whately | Department: Department of Health and Social Care (DHSC)
The Adult Social Care Winter Plan sets out the actions the Government are taking to support the sector. We are providing free personal protective equipment (PPE) to care homes via the PPE portal until June 2021. In addition, we have provided over £1.4 billion in specific funding for adult social care, £4.6 billion for local authorities to address pressures on public services, infection prevention and control guidance and increased staff testing to identify new cases and protect the workforce as well as residents.
We have placed residents and staff in care homes for older adults in the highest priority group of the vaccination programme, following advice from the Joint Committee on Vaccination and Immunisation.
Health Services and Social Services: Coronavirus
26 Feb 2021 | 155433
Asked by: Darren Henry
To ask the Secretary of State for Health and Social Care, what further support he plans to make available to the health and social care workforce during the covid-19 outbreak.
Answering member: Helen Whately | Department: DHSC
We are maintaining high levels of support for staff, including ensuring they have access to the personal protective equipment and testing they need. Furthermore, all eligible frontline workers have now been offered the vaccine. We continue to expand the workforce, having committed to increasing the National Health Service nursing workforce by 50,000 by the end of this Parliament and promoting social care careers through a national media campaign. We have also put in place a package of mental health support for all staff.
03 Feb 2021 | 142984
Asked by: Thangam Debbonaire
To ask the Secretary of State for Health and Social Care, how many people in England employ their own personal assistants for health and social care at home.
Answering member: Helen Whately | Department: DHSC
Data from Skills for Care’s ‘Individual Employers and the Personal Assistant Workforce’ report estimates that in 2019/20, approximately 70,000 people in England employed their own personal assistant/s (PAs) with funding from social care direct payments, dispersed by local authorities. The Department does not hold data on numbers of individuals who employ PAs outside of social care direct payments.
Social Services: Finance and Reform
16 Feb 2021 | 145094
Asked by: Bambos Charalambous
To ask the Secretary of State for Health and Social Care, when the Government will bring forward proposals for the (a) reform and (b) funding of adult social care.
Answering member: Helen Whately | Department: DHSC
Reform of adult social care is a complex area and a range of options are being considered.
The Government is committed to sustainable improvement of the adult social care system and will bring forward proposals this year.
As announced in the 2020 Spending Review, the Government is providing local authorities with access to over £1 billion of additional funding for social care in 2021/22. This includes £300 million of new grant funding for social care, on top of the £1 billion social care grant introduced in 2020/21.
29 Dec 2020 | 129160
Asked by: James Grundy
To ask the Secretary of State for Health and Social Care, what progress has been made in setting up a commission to determine the future of adult social care.
Answering member: Helen Whately | Department: DHSC
The Government is committed to sustainable improvement of the adult social care system and will bring forward proposals in 2021. The long-term reform of social care is a complex topic, which requires full and thorough consideration, particularly in light of the current circumstances.
The Department has recently held detailed discussions with stakeholders about social care and the impact of COVID 19 on reform priorities, including a roundtable with workforce representatives. We will continue to work with and listen to stakeholders as reform plans develop.
08 Dec 2020 | 120018
Asked by: Jeremy Hunt
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to tackle the workforce shortage in social care in the (a) short and (b) long term.
Answering member: Helen Whately | Department: DHSC
We are taking action to increase recruitment into adult social care in both the short and long term. We have launched an online recruitment tool, Join Social Care, to simplify and fast track the recruitment process, and are offering free and rapid induction training via Skills for Care for new and existing staff and volunteers. In the last year we have run a National Recruitment Campaign across broadcast, digital and social media highlighting the vital work care workers do.
The Department for Health and Social Care is also working with the Department for Work and Pensions to promote adult social care careers to jobseekers, including those who may have lost their jobs during the pandemic from other sectors, such as tourism, hospitality and retail. We are continuing to work with the sector and other government departments to understand how we can further support recruitment and retention, and we continue to work to raise the profile of adult social care careers.
28 Oct 2020 | 98874
Asked by: Jon Trickett
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 6 September 2020 to Question 74439 on Social Services: Reform, what the Government's timetable is for publishing its proposals on reforms to the social care system.
Answering member: Helen Whately | Department: DHSC
The Government’s current one priority for adult social care is for everyone who relies on care to get the care they need throughout the COVID-19 pandemic.
We are committed to bringing forward a plan for social care to ensure that everyone is treated with dignity and respect and to find long term solutions for one of the biggest challenges we face as a society.
27 Jul 2020 | HL6619
Asked by: Baroness Campbell of Surbiton
To ask Her Majesty's Government what plans they have to ensure that any future review of social care they commission will (1) treat social care in parity with the National Health Service, and (2) explore how personalised and community-based social care may be provided to enable recipients to lead socially-connected and fulfilling lives.
Answering member: Lord Bethell | Department: DHSC
We recognise there is a need for long-term reform in social care. The Government’s priority for adult social care is for everyone who relies on care to get the care they need throughout the COVID-19 pandemic.
We are committed to bringing forward a plan for social care to ensure that everyone is treated with dignity and respect and to find long term solutions for one of the biggest challenges we face as a society. There are complex questions to address and it is important that we give these issues our full consideration in the light of current circumstances.
The recent NHS Long Term Plan highlighted integration of services as a key aim - making sure that everyone can receive high quality care that is coordinated around individual needs.
Reports and PublicationsThe following is a selection of Reports and Articles relevant to this debate. Please note: the Library is not responsible for either the views or the accuracy of external content.
The King’s Fund, Stories from social care leadership: Progress amid pestilence and penury, 11 February 2021
Department of Health and Social Care, Response to the Health and Social Care Committee report on Adult Social Care: Funding and Workforce, CP 360, January 2021
Library Briefing 9019, Coronavirus: Adult social care key issues and sources, last updated 8 December 2020
Age UK, Bring our careforce in from the cold, November 2020
Health and Social Care Committee, Social care: funding and workforce, HC 206 20190-21, 22 October 2020
Skills for Care, The state of the adult social care sector and workforce in England, October 2020
Care Quality Commission, State of Care 2019/20, October 2020
Migration Advisory Committee, Review of the shortage occupation list: 2020, September 2020
Skills for Care, The size and structure of the adult social care sector and workforce in England, July 2020
Nuffield Trust, What does the social care workforce look like across the four countries?, 15 April 2020
Nuffield Trust, Supporting those who deliver social care: what can England learn from the rest of the UK? 15 April 2020
Nuffield Trust, Who organises and funds social care?, 18 March 2020
Nuffield Trust, What steps are currently being taken to reform social care?, 18 March 2020
The Health Foundation, What should be done to fix the crisis in social care? 30 August 2019
The Health Foundation, Securing the future: funding health and social care to the 2030s, May 2018