Sustaining the workforce
Parliamentary Office of Science and Technology (POST); 2025.
What investments and actions are required to create a sustainable health and social care workforce?
Key issues discussed included:
1. Workforce Challenges
- High vacancy rates: Over 100,000 NHS and 131,000 ASC vacancies in 2023/24.
- Heavy reliance on international staff: 21% of NHS and 19% of ASC workers are from overseas.
- Retention issues: High leaver rates, use of temporary staff, and limited uptake of return-to-practice schemes.
2. Strategic Plans and Reforms
- NHS Long-Term Workforce Plan (2023): Aims to reduce international reliance and address a 150,000 staff shortfall.
- ASC Workforce Strategy (2024): Focuses on sector growth, education, and changing care demands.
- Government reforms (2025): £86M for facilities, new career structures, digital platforms, and a national care commission.
3. Systemic and Structural Issues
- Underinvestment in community care: Primary care funding fell from 8.9% to 8.1% (2015–2022).
- Infrastructure and training gaps: Outdated systems, limited training opportunities, and fragmented ASC labour market.
- Leadership diversity: Ethnic minority staff underrepresented in senior roles despite making up 25% of ASC workforce.
4. Policy and Organisational Changes
- NHS England to be absorbed into DHSC (2025): Aims to reduce bureaucracy and improve care delivery.
- New roles introduced: Enhanced care workers and others to address skill shortages, though concerns remain about regulation and outcomes.
5. Improving Retention and Productivity
- Beyond pay: While better pay helps, non-monetary factors like flexible working, wellbeing, and leadership are crucial.
- Management and morale: NHS is under-managed; better training and support for managers needed.
- International recruitment concerns: Reports of exploitation led to a £12.5M fund and new guidance for ethical recruitment.