Boost in adult social care workforce from overseas recruitment, undone by ban on care workers bringing families.

The adult social care workforce has seen a significant boost for the second year in a row, primarily driven by overseas recruitment, according to Skills for Care. But the positive news is overshadowed by concerning trends with British worker numbers still diminishing and the volume of immigrant employees falling by 85 percent.

The number of filled posts increased by 70,000, bringing the total from 1.635 million to 1.705 million. Concurrently, the vacancy rate dropped from 153,000 (9.9%) to 131,000 (8.3%) in the year leading up to March 2024.

This trend is a positive shift from March 2022 when vacancies peaked at an all-time high of 164,000 (10.6%) following the first-ever recorded decline in the workforce size. The growth over the past two years stems from the government’s decision in February 2022 to allow care providers to recruit staff from abroad using skilled worker visas.

Increase in Overseas Healthcare Staff 'Decimated'

Skills for Care reports that independent sector providers hired 105,000 individuals for direct care roles in 2023-24, up from 80,000 in 2022-23 and 20,000 in 2021-22. This period saw a near doubling of non-EU staff in the sector, from 140,000 to 300,000, while the number of British staff decreased by 70,000, from 1.26 million to 1.19 million.

However, the recent government decision to prevent overseas care workers on health and care visas from bringing family dependants took effect on March 11, 2024, and Skills for Care noted that this change had already resulted in a sharp decline in visa issuance—from 26,000 per quarter in 2023 to just 3,300 in early 2024.

Future Challenges for Growth

"Changes to immigration rules in March 2024 are likely to significantly reduce international recruitment levels in 2024-25, posing challenges for the sector to grow in line with demand," said Skills for Care.

In response to these concerns, Skills for Care has launched a 15-year strategy for the adult social care workforce, developed with sector leaders. This strategy projects a need for an additional 540,000 posts by 2040, a 29% increase, driven by the growing elderly population. However, it emphasizes the need for reduced reliance on overseas staff due to global competition for care workers.

Persistent Vacancy Rates

Despite the overall reduction in vacancies, the rate remains high at 8.3%, three times the average for the wider economy (2.8%) and higher than sectors like retail (2.4%), accommodation and food (4%), and the NHS (6.9%).

Vacancy rates fell across all adult social care areas in 2023-24, but domiciliary care still has the highest rate at 11.9%, compared to nursing and residential homes at 5%. Independent domiciliary care providers accounted for the majority of the growth in filled posts, with a 7.9% increase (43,000 roles). This compares to 5.3% growth in independent nursing homes (15,000 roles), 3% in local authorities (3,500 roles), and 2.4% in residential homes (7,000 roles).

Pay and Employment

The report also highlights the need for improved pay and conditions to enhance recruitment and retention. A recent Labour government announcement plans to introduce a “fair pay agreement” for adult social care staff to address these issues. Think-tanks Health Foundation and Nuffield Trust have suggested raising pay to attract and retain workers, noting that in 2023, the median hourly rate for care workers was £11, significantly lower than the UK average of £15.88.

Strategies for Improvement

To meet future workforce demands, Skills for Care recommends:

• Improving pay and role quality in partnership with councils, unions, and employers.
• Developing a plan to reduce reliance on overseas staff by enhancing domestic recruitment and retention.
• Attracting younger people, men, and those with tech skills to the sector.
• Establishing a national leadership program to draw graduates and career changers.
• Rolling out the care certificate qualification for new starters and supporting level 3 competence for all direct care staff.
• Overhauling apprenticeships in adult social care due to high dropout rates.
• Requiring a statutory plan for meeting current and future workforce needs.
• Creating a central workforce body to implement and oversee workforce plans.

KPI Care Business Development Manager Rosie Lovatt said, “For healthcare businesses, this evolving landscape presents both opportunities and challenges. By aligning strategies with these new developments, agencies can play a crucial role in shaping a robust and resilient social care workforce. But we also need to substitute the short-term sticking plasters we’ve used over the last few years for a long-term strategy for healthcare training, recruitment and retention.”