It finds that by 2030/31, up to an extra 488,000 healthcare staff would be needed to meet demand pressures and recover from the pandemic – the equivalent of a 40% increase in the workforce, double the growth seen in the last decade. Alongside this, up to 627,000 extra social care staff would be needed to improve services and meet need – a 55% growth over the next decade and 4 times greater than the increases of the last ten years. 

A major boost in the workforce would require significantly more funding over the next 10 years. While the recent funding settlement will go some way to helping the NHS recovery, the REAL Centre’s report sets out that funding for the NHS alone will need to grow at twice the rate of the last decade, and much closer to the historic average. This would mean at least 3.2% annual real terms funding increases for health, around £70bn extra by 2030/31. In social care, the next decade will need to see funding rise more quickly for the NHS, sharply reversing a trend over the last decade where NHS spending increased by 20% and social care spending didn’t grow. 

October 2021 

The REAL Centre sets out projections of the funding the NHS and social care system in England may need to have

Read more here

Public spending on health care in the UK totaled £177bn in 2019, which equates to £2,647 per person for the year. While these are huge sums, this is less than the EU14 average and significantly less than the G7 average, including France and Germany. The findings suggest UK spending will need to rise in the coming decade to meet the care needs of the population if care is not to fall well short of the standards available in Western Europe. 

The findings also highlight the need for longer-term policymaking, to avoid short-term fixes that may prove to be more expensive over the long run. The required increases in funding and the workforce are driven by an aging population, rising numbers of people with long-term chronic health problems, and a major backlog in care as a result of the pandemic. Without additional funding and planning to increase the workforce, the report highlights a growing gap between the demands on services, particularly primary, acute, mental health, and social care, and the staff and resources available to provide care. 

The scale of the workforce challenge means action from the government is needed on several fronts, including investment in training and recruitment, both domestically and internationally. It also means ensuring that staff salaries, terms, and conditions are competitive compared to other work, and that flexible working, progression, and career opportunities are all available to encourage new people to join the profession while convincing existing workers to stay. 

The projected gap in the workforce is in addition to current vacancies across the health and care system – with the NHS 94,000 short of staff and social care at 112,000. The Health Foundation has highlighted that given the time it takes to train new staff and trends in funding for workforce education and training, the findings call into question the extent to which it will be possible to meet the growing demand for care and address the backlog of care over the next decade without a significant boost for workforce training in the spending review. In addition, in order for health care needs to be met in the future there will need to be a plan to ensure the NHS has the equipment and resources it needs to deliver care more effectively, including new technology and equipment, and an adequate building estate. 

‘If the Government doesn’t take action now to invest in the workforce the NHS and social care system are likely to face a decade of increasing staff shortages. 5.6 million people are already waiting for care and the health service desperately needs more staff. Workforce shortages are the biggest risk to post-pandemic recovery. Despite the more immediate challenges posed by COVID-19, the government must not lose sight of the underlying demand and cost pressures facing the NHS and social care over the long term and the need to plan better to increase the workforce to meet this demand. 

‘The money needed to meet pressures in health and social care will need to rise significantly beyond the current settlement, and at an even faster rate in social care. This means the government faces a major balancing act of priorities in the coming decade. 

‘In the forthcoming spending review, it is vital that the government’s recent commitment to put money into day-to-day NHS care is matched with investment to train the health and care staff needed. A comprehensive fully funded workforce plan should be the top priority for the government. Without it, our health and social care service will be unable to keep up with demand, and care will fall well short of standards in other Western European nations.’ 

Total current healthcare spending more than doubled in real terms, adjusted for inflation, between 1997 and 2018; in 2018, it grew by 3.2%, its strongest rate of annual growth since 2009. 

The number of full-time equivalent (FTE) filled posts was estimated at 1.17 million and the number of people working in adult social care was estimated at 1.50 million. An estimated 17,900 organisations were involved in providing or organising adult social care in England as of 2021/22.  

Increasing demand

Demand for social care is growing as the numbers of older people and those with long-term conditions, learning disabilities, and mental health conditions increase. 

  • Sectors of the Healthcare Industry 
  • Health care services and facilities. 
  • Medical devices, equipment, and hospital supplies manufacturers. 
  • Medical insurance, medical services, and managed care. 
  • Pharmaceuticals & Related Segments. 

Why is there a care shortage UK? 

Factors cited for the trend include workforce attrition caused by the immense challenges of working through the pandemic, social care being overtaken, in terms of pay, by other low-paid sectors, such as retail, and the widening gap in remuneration between equivalent roles in social care and the NHS, such as nursing. 

Government seeks overseas care staff to fill mounting shortages

Taskforce launched to boost international recruitment in advance of ‘challenging winter’ 

The government wants to boost international recruitment to fill increasing gaps in the social care workforce. 

The Department of Health and Social Care (DHSC) has launched a task force to bring in more staff from overseas into both social care and health in time for what it said would be a “challenging winter”. 

A DHSC spokesperson said: “We are committed to building and supporting our hard-working NHS and social care workforces and have launched a task force to drive up the recruitment of international staff into critical roles across the system. 

“The task force will work with experts across government and the NHS and social care sectors to agree on actions that will boost staff numbers ahead of the challenging winter period. Further details will be set out in due course.” 

The news comes amid mounting concerns about the impact of rising staff shortages in social care on the disabled, older people, unpaid carers, and the functioning of the NHS. 

The number of vacancies in adult social care rose by 52% in 2021-22. 

Factors cited for the trend include workforce attrition caused by the immense challenges of working through the pandemic, social care being overtaken, in terms of pay, by other low-paid sectors, such as retail, and the widening gap in remuneration between equivalent roles in social care and the NHS, such as nursing. 

Post-Brexit drop in overseas staff

However, some have also cited the impact of ending free movement from European countries following Brexit, in January 2021, in reducing the supply of overseas staff. 

From January to April 2021, just 1.8% of new starters in adult social care were from overseas, compared with 5.2% in the same period in 2019, according to Skills for Care figures. 

The government’s post-Brexit immigration system initially all but locked out people from moving to the UK to work as care workers through a skilled worker visa. 

However, it subsequently relaxed this position by adding, first, senior care workers, and then other care workers, to its shortage occupation list. 

This has enabled employers to recruit staff using the so-called health and social care visa, so long as they earn at least £10.10 an hour. 

Recruitment barriers

However, around half of care workers and a third of senior care workers earn less than this, said a report earlier this year by the Migration Advisory Committee, which advises the government on immigration. 

Also, care workers were only added to the shortage list for 12 months, pending a government review, while employers must pay for a sponsorship license, and then face ongoing charges, to bring staff in on a health and social care visa. 

In its report, MAC called for ongoing charges to be dropped and for the government to make permanent employers’ ability to recruit care workers through the health and social care visa. 

In response to news of the task force, the Independent Care Group, which represents providers in Yorkshire, said a key priority was tackling barriers to overseas recruitment created by Home Office “bureaucracy”. 

‘Home Office bureaucracy strangling the process’

Chair Mike Padgham said: “We agree with the health secretary that we need more overseas staff to ease the shortage but the truth is Home Office bureaucracy is strangling the process. 

“Care providers are waiting months to get their application for a license to recruit overseas workers approved and in the meantime, care is suffering. 

So whilst we applaud the health secretary for highlighting the issue, he needs to get on to the Home Office and sort out the bottleneck, otherwise a situation that is already dire will be critical this winter. 

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