Transform
Transformation of the workforce is needed to ensure we can meet the needs of our ever changing population. The following five areas have been prioritised within the Workforce Strategy:
There is no requirement for a workforce strategy in social care, unlike in the NHS where the Health and Care Act requires the Secretary of State to publish how the health service is meeting the needs of the workforce every five years. There should be a legislative requirement to have a workforce strategy and regular workforce planning for adult social care because this will need sustained, joined up, consistent effort over a number of years. We suggest that the Department of Health and Social Care (DHSC), NHS England and Skills for Care align workforce planning in social care to the drivers and assumptions in any NHS workforce plan.
The role of government departments in setting the direction of this Strategy will be central. However, it would be hard for Government to lead its development and implementation given the design of central government, overlaid with the dispersed and diverse nature of the adult social care workforce. We suggest, that to effectively address the workforce challenges, social care needs a central body with a legislative mandate to not only develop a unified Strategy upon direction by government, but also, crucially, drive its implementation across the diverse landscape.
This expert body would have the autonomy and credibility in social care to develop an adult social care workforce strategy, aligned with government priorities. It would be instrumental in bringing focus, expertise, trust, agility, credibility and neutrality. It would ensure the Strategy translates into tangible action, tackling the critical issues facing the social care workforce.
Skills for Care currently plays this role with a close, strategic relationship with DHSC. Many actions in this Strategy are for Skills for Care, given that role. However, they rely on Skills for Care having a role as a system leader for workforce development.
Without this central co-ordination and leadership, it leaves the sector with a fragmented approach, not least because there are so many different bodies with an impact on the workforce including three government departments, 153 local authorities, 18,000 employers, 42 integrated care systems, at least three regulators, one workforce body, 10 national employer representative bodies, more than 50 local representative bodies and many organisations representing people with lived experience and carers.
Recommendations
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Mandate workforce planning and strategy (2024): there should be a statutory requirement for the Secretary of State to lay before Parliament a plan for how current and future workforce needs across adult social care will be met (mirroring the requirement for the NHS).
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Implement workforce planning: the Government should create a central workforce body to be responsible for the development and implementation of this and future workforce plans (2024), making any necessary changes to legislation and any funding implications for a workforce strategy and workforce plan to be implemented (2024 onwards).
As a steering group we have talked about registration of the care workforce. This has been a debate over years in social care and, as has been the case previously, there is not one common view.
While there might be potential additional benefits to regulating a profession, the legislation states that we regulate a profession in England for public protection purposes.1
There were broadly three views in the steering group:
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Registration is key to the public recognising the sector as the professionals that they are, important for public safety and for development of people working in social care.
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There is not enough evidence to show the impact of registration on the workforce in other countries and, given the scale of the workforce, the cost-benefit argument is not clear enough yet.
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Registration would undermine steps towards personalisation and detract from the person-centred approach essential in social care, prioritising compliance over individualised support.
Recommendation
- Investigate workforce registration (2025 scoping): The Adult Social Care Workforce Strategy Delivery Board will gather evidence on the impacts and potential models of a social care workforce registration scheme.
As well as a national workforce strategy for the social care workforce, we need to have more detailed workforce planning to allow us to match the labour market with changing and growing needs. This should include consideration of:
We will need a particular focus on coastal and rural areas. Given that coastal and rural areas have an ageing population with growing needs, we will have to either entice working age people to live in coastal and rural areas, or entice local people already living in those areas to work in adult social care (The Tribe Project2 has had success in doing this with their model of micro-enterprises) or encourage older people to remain in urban centres by ensuring age-appropriate housing and fiscal incentives.
And, while the Health and Care Act has no specific requirement on integrated care systems (ICSs) around workforce planning for social care, it is inherent in the requirement for integrated planning across health and social care. Systems need to have a particular focus on this.
In the spotlight: Improving referral routes and assessment times
Kirklees Council created a dedicated social care occupational therapy (OT) team in 2020 working alongside social work teams. There are eight OTs and three assistant OTs with freedom to respond to people's needs using rehabilitative, social care and assistive technology interventions. It can directly assess needs, reducing wait times and referrals at every stage. It allows for quicker intervention and helps people live independently for longer, saving the council £1m in 2022-23.
Recommendations
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Attract workers to social care in coastal and rural areas (2025 scoping): ICSs should partner with local authorities, educators (including further education colleges and universities), Local Skills Improvement Partnerships, Department for Work and Pensions and job centres to develop targeted attraction plans. This should include research into whether job seekers in urban areas are willing to move to coastal and rural areas to work in social care, the support available for local people to move into social care roles, and how technology/AI might support this.
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Support ICS workforce planning (2025 scoping, ongoing): Skills for Care, local government, NHS Employers and partners should collaborate to support ICSs in developing workforce strategies, which should:
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have strong national, regional, and local leadership
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promote a ‘one workforce’ approach with equal partnership and investment in health and social care
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analyse demographics and future needs and the local labour market
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focus on aligning terms and conditions, training and wellbeing support for both sectors
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establish a social care academy and shared technology approaches
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support recruitment from new demographics and builds shared career pathways between health and social care
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increase direct contact across the two systems through joint training, placements, and secondments.
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New roles (2026): New research should be commissioned by think tanks, National Institute for Heath and Care Research or DHSC on the extent of new roles in social care that exist now and need to be scaled or developed (for example, community connectors who can link individuals to local services, resources and support networks, fostering community integration and support, discharge co-ordinators and the role of the voluntary sector).
Vital to the success of this Strategy is improving productivity by having modern working practices (digital solutions, assistive technology), innovation in service delivery to improve people’s lives and by having stronger NHS links (NHS Digital Academy, regional teams) for sustainability and integration.
We have produced indicative returns for each £1 of investment on technological interventions. The results suggest that investing in any type of digital technology in the adult social care sector would yield significant benefits for providers, the NHS and people drawing on care and support.
Table illustrating return on investment for technological innovation.
*Quality adjusted life years is the measure of the state of health of a person or group in which the benefits, in terms of length of life, are adjusted to reflect the quality of life. One quality-adjusted life year is equal to one year of life in perfect health.
| Technology (investment £1) | Care provider return | NHS return | Quality adjusted life years*
(health and wellbeing outcomes for people translated into £) |
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Assistive technology
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£4.21
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£4.10
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£4.87
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Care management technology
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£1.20
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£0.36
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£2.16
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Digital social care records
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£6.77
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N/A
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N/A
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Telecare
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£2.84
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N/A
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N/A
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Workforce planning technology
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£1.32
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N/A
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N/A
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New digital skills
A 2021 review, funded and delivered as part of the 'People at the Heart of Care' white paper, found basic digital skill gaps in the social care workforce. The NHS Transformation Directorate and Skills for Care created the Adult Social Care Digital Skills Framework to address this, but for full tech adoption, advanced skills and digital leadership are needed in senior roles.
Recommendation
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Expand digital skills training (2025 scoping and launch): Digitising Social Care should partner with key organisations (Hartree Centre3, Skills for Care, Digital Care Hub, TSA, Partners in Care and Health) to expand access to digital skills training across the workforce.
New digital roles
Scottish Care, a social care membership organisation, has piloted a care technologist role across various locations in Scotland. These specialists help create digital care plans (including tech set-up and online resources) for people drawing on and working in social care. The programme has proved successful and is expanding across Scotland.
In the spotlight: Doing things differently through technology
The Innovation School at the Glasgow School of Art and Scottish Care created care technologist roles to leverage technology in social care. They piloted in Aberdeen, East Ayrshire and Glasgow in homecare and then expanded to care homes and digital inclusion initiatives. The pilot reached more than 600 people drawing on care and support, upskilled the workforce and attracted diverse talent (computer science, data analysis). An unintended consequence was the opportunity for technology to support growing mental health needs in the community, as well as reducing loneliness and isolation.
Recommendation
- Pilot care technologist role (2025 scoping and launch): Skills for Care will partner with others to test and roll out support for creating a new care technologist role.4
Research in healthcare shows benefits for outcomes, staff wellbeing, and the system overall. We should have more of a focus on research in adult social care from government, research bodies (such as National Institute for Health and Care Research (NIHR)) and integrated care systems. We should have a clear national strategy and infrastructure. We should fund more evaluations of our workforce interventions to assess their impact on quality of care, staff satisfaction, and user experience.
In 2023, the NIHR launched a £10m funding programme focused on social care research and IMPACT, the UK centre for implementing evidence in adult social care, funded at £15m over five years. Health research investment reached £5bn in 2022.
Recommendation
- Evaluation of current research priorities and funding in adult social care (2025, ongoing): DHSC should evaluate existing research routes, priorities and funding in adult social care to ensure they are fit for purpose in relation to the workforce.
- Adult social care is prioritised by the National Institute for Health and Care Excellence (NICE) (2025, ongoing): NICE should have more of a focus on social care and particularly on disseminating its work to social care. This should be done in partnership with the Social Care Institute for Excellence (SCIE) who already carry out related research.