Workforce health in social care
Are you a stakeholder in social care with a view on this? It would be great to hear from you via this stakeholder scoping inquiry.
I presented on workforce health in social care at the Future of Care Leaders Conference in March 2023. Here are my presentation notes.
Context
There are over 250 000 vacant posts across health and care and this is limiting service delivery
The two systems are symbiotic and their staffing needs must be addressed together
Workforce health is relevant to recruitment, retention, safety and productivity
What is occupational health all about?
Occupational health is all about the relationship between work and health
Health affects work and work affects health
In general, work is good for our health but work can also cause and exacerbate ill health
The most common work-related ill health is mental ill health
What does occupational health do?
Occupational health clinicians assess workers living with ill health
They can recommend changes to the workplace to help keep people working living through a period of ill health
They assess when someone is not well enough to work and put a plan in place to get them back to work when their health and function improves
Occupational health clinicians also help organisations assess and manage workplace health hazards and risks
How does occupational health fit into the healthcare landscape in the UK
Occupational health was excluded from the NHS when the health service was set up
This means that access varies according to employer
We do not have a grip on exactly who has access to occupational health and who doesn’t
Even the most generous estimates suggest around 50% of workers do not have access to any occupational health support
Workers in the public sector and large private sector companies are more likely to have access to occupational health than workers at SMEs
People who are in insecure employment and on zero hours contracts are least likely to have access to occupational health
What does this mean for social care?
The social care workforce is around 1.8M
There are around 160 000 vacancies
The sector is made up of almost 18 000 employers, mainly small and medium sized enterprises
25% of the workforce, and a larger proportion of domiciliary care workers are on zero hours contracts
Pay for a social care worker is around £8000 less than an NHS HCA
There is no way of interrogating what is happening with workforce health across 18 000 different employers
The ‘profile’ of care providers as SMEs means they are unlikely to be providing occupational health support to their staff
There is likely to be a big gap in workforce health support for social care workers compared to NHS workers
The two workforces are exposed to similar hazards and risks at work
We know from the 2022 NHS staff survey that at least 30% of the workforce felt unwell as a result of work-related stress in the last 12 months
Work- related stress is driven by factors including demand outweighing resource, which we know is an issue in social care as well as health care
Burnout and moral injury are likely to be happening in social care too
Other hazards and risks workers across health and care are exposed to include biological risks (infection) and ergonomic risks (manual handling)
An NHS HCA is more likely to have occupational health support at work for dealing with these challenges than a social care worker
What are the challenges?
Because of how heterogenous the social care sector is, we do not know exactly what is happening in terms of work and health issues and work and health support in each organisation
Evidence tells us that occupational health support keeps people working increases the safety and productivity of staff and improves safe service delivery
If we want to deliver more occupational health services and standardise what is available for social care, the challenge is that all stakeholders (tax payer/ service user/ employer/ worker) are stretched
As well as the financial barrier to getting support, small business owners say they do not have the time to invest in identifying their own needs
The corporate wellbeing industry is not always evidence based and without support navigating the market it could be easy to spend money on something that does not address the workforce need or help the organisation
Are there any solutions on the horizon?
The Spring Budget 2023 highlighted the gap in the occupational health landscape and suggested some solutions but we are still very far away from universal access
The government’s response to the health and social care committee enquiry on burnout suggested extending the NHS staff survey to social care which will help us clarify what is happening across the social care sector
Integrated care systems could be a way of bridging the gap between health and social care organisations, and there are some initiatives that are connecting the department of work and pensions in at ICS level, and bringing in strategic occupational health input too
What else would help?
Parallel workforce planning across health and care
Across the NHS and social care we need a better understanding of what is happening with retention, mobility and attrition
Growing occupational health services to meet the needs of the social care workforce as well as the needs of the NHS workforce