Creating a sustainable labour market for health and social care

With a staffing crisis in the NHS, the REC looks at what Trusts and the government can do to address this problem

“The greatest workforce crisis in the history of the NHS and social care.” This is how the Health and Social Care Select Committee’s report on workforce described the current staffing situation in the sector. And the Recruitment and Employment Confederation (REC) agrees. We have a large number of long-serving, experienced and dedicated recruiters who have been working with medical professionals, NHS Trusts, local authorities and care home providers for decades. They all say that the level of staff shortages we are seeing now is very alarming..

Labour shortages
The numbers support this too. As of September 2021, there were 99,460 vacancies in the NHS and a further 105,000 vacancies in social care. What’s even more worrying is the industry’s future. Research says that almost a million more healthcare workers are needed by the early 2030s due to the growing demand for services. This is striking. The question on many lips is – where is the future workforce strategy? To help think this through for this sector and others, the REC has published a new report Overcoming Shortages – How to create a sustainable labour market.
The report finds that not addressing labour shortages across the economy could cost the UK economy £39 billion a year. To put into context, the total cost of NHS staff in 2019/2020 was £56.1 billion. Included in the report are a set of recommendations for governments and businesses to deal with labour and skills shortages. Central for all is putting the people at the heart of the agenda. For governments and policy makers they should create specific home within the Cabinet Office or with an independent commission for creating a future workforce strategy. This builds on from the REC’s call for governments and departments to deliver a long-term workforce planning. We are glad that there is now more talk of doing this for the health and social care sector but we must see action too.
“People stuff”
Employers also need to play their part, by putting the “people stuff” first and meet the needs of their workforce. Employers need to engage their workforce to improve working conditions and give tailored workplace support. This means many things, from flexible working arrangements to mental health support. In August 2021 alone, the NHS lost half a million full-time equivalent days due to mental health issues. The staff burnout and resilience in healthcare is not a new issue, hence the Health and Social Care Select Committee’s 66-page report on the issue.
What we are hearing on the ground backs this up. Recruiters tell us the main reason NHS workers are leaving their permanent posts is the lack of flexibility and work-life-balance. Flexibility at workplaces is becoming increasingly important. But this is even more distinct in the healthcare sector where flexibility isn’t always guaranteed. More needs to be done on this and Trusts must look at how to improve the working conditions for frontline workers.
Working via agencies or bank is a popular alternative. But to create a more sustainable labour market, Trusts and care home providers need to borrow the insights, experience and expertise of agencies who are already successfully responding to workers’ asks. This important collaboration will help more permanent frontline staff enjoy a similar level of flexibility.
Equality, diversity and inclusion (ED&I) should also be at the core of any people plan. There has been abundant evidence on how a more diverse workforce is a more productive and more efficient workforce. According to the NHS Workforce Statistics 2020, 22.1 per cent of NHS staff were from ethnic monitory background. This is within the context of a 15.2 per cent non-white population across England and Wales. However, only 55.5 per cent of NHS staff feel that there are equal opportunities for all. 7.8 per cent of NHS staff said that they have experienced discrimination in the last 12 months from patients or members of the public while 9.1 per cent said they had such experience from colleagues. This is a distressing truth about ED&I at the heart of the NHS. No colleague should ever go through negative experiences based on their ethnic background – especially within a sector where international recruitment is active.

International recruitment    
Speaking on international recruitment, the REC urges government to have policies around immigration that stimulate growth and allows access to medical talent from abroad. While we fully support home-grown talent strategies, we need an immigration system that meets the labour market needs of the UK and supports the growth and innovation that the sector seeks to deliver well for patients.
The costs, the bureaucracy and the duration of the visa process are frequently cited as challenges for both workers and employers. But not being able to bring extended family members (such as parents) and uncertainty of their future career at the end of the first visa also play a big part. This goes further for care workers and care assistants who have been added to the Shortages Occupation List on a temporary basis. Workers need greater certainty and job security before they pick up their lives and start over across seas. For these social care roles in particular, the minimum salary requirement is also a huge blocker. The immigration point is one for policy makers. But without the pressure from employers and the industry, we are less likely to achieve changes.
Another key point around overcoming shortages in healthcare is the need to view skills as an investment, not a cost. Increasing investment and funding is critical and necessary for growth, progress and innovation. Governments must think about how to support added funding for training for medical professionals while employers think about how to provide adequate and equal opportunities to train for both permanent and temporary staff. People still need to pay their bills and put food on the table when they go back to training. So, in-work training and adequate financial assistance is important.  
Not all recommendations from our Overcoming Shortages report are short-term and most require a series of discussions and actions from more than one party including governments. But staff shortages in the industry are bringing some services to breaking point. More and more workers are leaving their permanent jobs and often leaving the industry all together. Agencies are here, in many cases as a safety net, catching the leavers – who would have otherwise left the industry all together – and bringing them back in.
Agency support
There are plenty of examples where agencies are providing tailored, individual support with a focus on ensuring the optimal working arrangement for each worker. Some agencies have a robust staff engagement strategy and NHS Trusts and care home providers should be doing the same.
What’s important for the industry is a genuine partnership and collaboration where agencies’ expertise and technology meet employers’ resource and hiring needs. Achieving this true partnership model is a critical step in the right direction to manage staff shortages, where the industry can strategically marry the strength that both permanent and temporary staff placements have to offer to support our healthcare system.

About the REC
The REC is the voice of the recruitment industry, speaking up for great recruiters. We drive standards and empower recruitment businesses to build better futures for great candidates and themselves. We are champions of an industry which is fundamental to the strength of the UK economy.