A first-of-its-kind strategy has outlined proposals to attract more nurses and nursing associates into social care and has called for a ‘career framework’ outlining the need for NHS pay parity, funded preceptorships and increased employment protection.
The new Workforce Strategy published today has been labelled a ‘turning point’ for adult social care in England and brings together multiple stakeholders under the leadership of workforce development body Skills for Care.
While it was not commissioned by the government, it sets out a range of recommendations for ministers and has been designed to work alongside the NHS Long Term Workforce Plan, which was published last year.
The latest blueprint for the care workforce was informed by the views of 30 stakeholders in the social care sector, including individuals who draw on services, workforce representatives such as the Royal College of Nursing (RCN), the NHS and others.
It covers the next 15 years and comes as latest data from Skill for Care shows the sector will need 540,000 additional social care posts by 2040 if the workforce is to grow in line with the population aged 65 and above.
Attracting nurses
Attracting registered nurses and nursing staff into social care is a core part of the strategy which suggests work should be taken to increase opportunities for social care placements for all nursing and nursing associate students, including those on apprenticeships.
In addition, it proposes that all integrated care systems (ICS) should have ‘the responsibility for creating the pipeline’ for registered nurses and nursing associates, including placements.
Importantly, it also called on the government and ICSs to ‘develop and implement a career framework for registered nurses working in adult social care’ from 2025.
Such a framework should be aligned with a clear pay structure, equivalent to comparable roles in the NHS, and which make use of apprenticeships to develop nurse specialists, nursing educators, consultants and advanced practice roles in the hopes of improving home care and reducing hospital admission, the blueprint said.
The framework should also be used by the Department of Health and Social Care (DHSC) to ‘improve and fund’ continuous professional development, supervision opportunities and employer-funded preceptorship programmes.
Retaining nurses
Recognising the high turnover rates in adult social care – with a 32.6% turnover for nurses (above the 28.3% for the sector as a whole – the strategy identifies five key areas for improving retention: focusing on higher pay, non-zero-hours contracts, full-time work, training access and relevant skills.
The stakeholders involved in the strategy believe that when ‘all these factors are present, turnover is reduced by half’.
High turnover (28.3% in 2022-23) in social care, especially for care workers (35.6%), nurses (32.6%), and social workers (16.1%), ‘increases costs, disrupts the continuity of people’s support so it is harder to build relationships, and lowers morale’, the strategy noted.
Last October, Skills for Care revealed that the turnover rate for registered nurses working in adult social care in England was around three times higher than the NHS.
Avoiding exploitation
The strategy also called upon the Nursing and Midwifery Council (NMC) to use its regulatory role to encourage organisations employing internationally educated nurses (IENs) to provide ‘pathways and support’ for registration and progression.
The regulator was also encouraged to establish a ‘standard process’ for registered nurses and nursing associates working in social care – including students – when needing to raise concerns around equipment, staffing, safety, policy and processes.
And crucially, the strategy reiterated that nursing associates should not be used as ‘a substitute’ for a registered nurse.
The blueprint also highlighted the role of the Care Quality Commission (CQC) in overseeing the ‘robust, safe and fair recruitment’ of social care professionals, including those employed from overseas and staff with professional registration.
This comes after the DHSC recently extended its funding pilot to support international recruitment within adult social care earlier this year in response to increased reports of unethical employment practices within the sector.
Commenting on the strategy Professor Oonagh Smyth, chief executive of Skills for Care and co-chair of the Workforce Strategy Steering Group, said that ‘the case for change is clear’, and that ‘hundreds of thousands of skilled care workers will be needed over the next 15 years’.
‘A Workforce Strategy isn’t a nice-to-have, it’s a must-have if we’re going to build the workforce we need for the future,’ she added.
And she said she looked forward to working with the government ‘on the areas where their support will be crucial to bringing this game-changing strategy to life’.
‘Social care – and the skilled professionals who work in it – enables people to live well and drives economic growth. This Workforce Strategy takes us a step closer to protecting and properly valuing that vital role,’ added Professor Smyth.
Meanwhile, RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘It is not possible to “fix” the NHS without addressing the poor state of social care.
‘People are living longer with increasingly complex care needs, but governments of every colour have been unwilling to grapple with this issue for decades. Today’s ministers cannot afford to take the same approach.’
She said the strategy ‘highlights the challenges and shows where the new government must develop clear answers’.
But she added: ‘The sector is unsafe, and a full social care workforce strategy could not be more urgent.
‘An effective workforce strategy must be fully funded, evidence-led and include specific interventions, modelled, tested, and assessed against the needs of the population. More must be done to outline roles and responsibilities across the sector, including those of local government.’
