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Care in a post-Brexit climate: How to raise standards and meet workforce challenges

Although some carers and care providers manage to provide outstanding, compassionate care in difficult circumstances, there are growing concerns about the standard of social care services relied upon by some of the most vulnerable people in our society.

There are three primary concerns: high levels of user dissatisfaction, rising numbers of abuse alerts and the large number of providers requiring an action plan for improvement.

Poor outcomes are associated with chronic underinvestment, weak regulation and oversight, and a lack of effective workforce planning and management skills. NHS statistics such as delayed transfers of care are increasingly demonstrating that higher demand for adult social care and pressure on local authority social care budgets is seriously affecting NHS performance, and threatening the financial stability and sustainability of the health and social care systems.

A reliance on migrant labour in the care sector has masked the absence of effective workforce planning strategies, with employers turning to migrant labour to fill posts that may otherwise be difficult to recruit for.

Around 6 per cent of people employed in social care – approximately 60,000 workers – are European Economic Area migrants. Around 20,000 of these workers have arrived since 2012. With uncertainty around the future of freedom of movement the flow of EU migrant workers could provide a less reliable source of labour for British employers in future. Even if freedom of movement were to be preserved as part of a future Brexit deal, it is unlikely that labour shortages can be avoided in the short to medium term. However, the majority of immigrants working in social care (191,000 people) come from non-EU countries. As the government has pledged to review non-EU migration, the future flow of workers from non-EU countries is also less secure. We project that the UK will need to have recruited and trained 1.6 million low-skill health and social care workers up to 2022 in order to replace those leaving the profession as well as to meet increased demand. This is the equivalent of two-thirds of the current low-skill health and social care workforce, and is larger than for any other occupation in the UK.

Social care competes with other low-wage sectors for its workers. If it is to attract more UK workers, the care sector will have to consider how to improve working conditions and strengthen opportunities for development and progression. There is, therefore, an urgent need for an ambitious workforce strategy that tackles longstanding weaknesses in the workforce structure and working conditions.

There are growing calls for a cross-party consensus on funding before the end of this parliament to prevent the complete collapse of the social care system. Successive governments have commissioned reviews into social care funding – most recently the Barker commission in the last parliament. While the recommendations we outline below will help tackle the problems identified in this report, these cannot fully be addressed without a sustainable funding solution for social care.