What does the social care workforce look like across the four countries?

This explainer describes the social care workforce in each UK country including recruitment, registration and regulation.

Blog post

Published: 15/04/2020

Key points

  • In each of the UK countries, the social care workforce represents a large proportion of employment. In England alone, most recent figures estimate up to 1.6 million jobs in the sector.
  • The four countries have shared challenges around recruitment and retention of the workforce – challenges that are linked to poor pay and conditions, and perceptions of attractiveness of the sector.
  • England is the only country that does not have a non-departmental public body which is responsible for the regulation and registration of its workforce. In the other UK countries, all social care workers must be on a register, and in Scotland and Wales, a qualification is necessary to work in social care. There is early evidence that this is having a positive impact on retention and perceptions of the workforce.

The total number of jobs in adult social care is in the region of 2.6 million UK-wide, of which 1.8 million are full-time equivalent (FTE).[1]

England

Wales

Scotland

N. Ireland

Number of jobs in adult social care* (2016)

c. 1,200,000

(800,000 FTE)

c. 72,000

(54,000 FTE)

c. 140,000

(103,000 FTE)

c. 38,500

(29,000 FTE)

Workforce organisation/
workforce regulator

Skills for Care

Social Care Wales

(workforce regulator)

Scottish Social Services Council

(workforce regulator)

Northern Ireland Social Care Council

(workforce regulator)

Year of setup

2001

2017

(previously Care Council Wales, set up 2001)

2001

2001

Type

Charity/delivery partner

Non-departmental public body

Non-departmental public body

Non-departmental public body

Registration

N/A

Mandatory and qualifications-led

Mandatory and qualifications-led

Mandatory, not qualifications-led

Registration timeframe for frontline workers

N/A

Domiciliary carers to be registered April 2020.

Residential carers registered 2020–22

Support workers in care home for adult services to be registered by 2015. Workers in care at home and housing support to be registered by Sept 2020.

All social care workers designated by Department of Health registered by 2018, including domiciliary care

* There is no UK-wide dataset as each workforce organisation is responsible for its own data collection, which means there are discrepancies in the ways data are collected and reported. While these are not the most recent numbers of workers reported for each nations, they have been collated and presented together by Skills for Care and Development, the sector skills council for the sector and the partnership of professional bodies across the four nations. These rounded figures are used for comparability purposes – for more recent figures see England, Wales, Scotland and Northern Ireland. Timeframes for registration were set up prior to the pandemic and emergency changes to registration have been put in place to facilitate the social care response. However, at present these are not forecast to have major delays on registration processes.

Distribution of the adult social care workforce in Residential and Nursing versus Domiciliary Care 15/04/2020

Chart

Source:  

Skills for Care and Development, 2018. Note that the reports use 2016 figures, which are not most up-to-date but have been adjusted and approved by each professional body for comparative purposes in adult social care only (and which exclude employment in adult social services and child services). Total proportions do not sum to 100% as the graph does not include other types of adult social care employment, e.g. day care and personal assistants.

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Northern Ireland and Scotland do not record residential and nursing care separately, so the above chart presents residential and nursing care together. It is worth noting that proportions of domiciliary care workers are highest in Scotland, where personal care is free.

All four nations of the UK share similar challenges relating to their workforce. Workforce conditions are poor, with many staff on zero-hours contracts and earning close to the minimum wage (although the proportion of workers on zero-hours contracts varies across the nations).[2] In addition, there is little opportunity for continued professional development. As a consequence, the sector experiences high turnover due to low levels of recruitment and retention.[3] As such, there are high levels of vacancies. We have previously calculated that to provide care for current unmet need in England alone would require up to 90,000 additional workers.[4]

England

Skills for Care came into being in 2001 and is the delivery partner to the Department of Health and Social Care for the development of the social care workforce in England.

Skills for Care acts as the main source of knowledge on the workforce, and collects comprehensive data in the Adult Social Care Workforce Dataset as well as publishing yearly reports. The most recent figures published in 2019 estimate the total regulated adult social care workforce at 1.49 million people in 2018 (and 1.62 million jobs),[5] of which 600,000 were employed in residential[6] and nursing[7] care (305,000 and 295,000 respectively), and 520,000 in domiciliary care[8].

England is the only nation in the UK to have no professional body mandated by – and accountable to – government, with responsibility for the regulation of social care workers. Stakeholders have suggested this has hindered the development of a strong professional identity underpinned by shared improved status, standards and qualifications (i.e. professionalisation),[9] and as such, makes having an accurate picture of the workforce more difficult.

There is a growing interest in professionalisation as a solution to the workforce shortages England faces. The rationale is that developing a strong professional identity for social care workers, facilitated by registration and adherence to common professional standards, would make the sector more attractive to new entrants as well as encouraging workers to stay within the sector by offering more opportunities for career progression in social care. However, there is to date a limited evidence base on the effect of professionalisation on retention and recruitment levels.[10] Beyond this, one of the biggest challenges with the professionalisation of the English social care workforce is its size, as well as the vast number of settings in which the workforce operates. Developing mandatory registration as a first formal step in professionalising the workforce would require large amounts of planning and resources, especially if registration is to increase the attractiveness of working in the sector.

Wales

Social Care Wales came into being in 2017, as a continuation of the previous Care Council for Wales. It was set up under the Regulation and Inspection of Social Care Act (Wales) (2016) in line with the Social Services and Wellbeing Act of 2014. As such, Social Care Wales acts as a Welsh government sponsored body – a non-departmental public body that is legislated, funded, and accountable to the National Assembly for Wales. It has three main functions: workforce regulation, workforce development and service improvement.[11] The act also creates a definition in law of a ‘social care worker’[12] – an individual engaging in relevant social work – and this is not place-based.

Social Care Wales is in the process of implementing a mandatory qualifications-based register with continuous professional development schemes, under which all registrants must demonstrate fitness to practise.[13] Stakeholders have suggested this has formalised the need for more structured information.

Social Care Wales acts as the main source of knowledge for the workforce, and publishes workforce reports such as, most recently, the Workforce Profile 2018 for Commissioned Care Provider Services and the Workforce Profile 2018 for Local Authority Regulated Services, which both cover social care workers, social workers and workers employed in children’s services. The Skills for Care and Development 2018 report[14] estimates jobs in the regulated social care workforce at around 72,100, of which 27,700 (38.4%) were in residential and nursing care and 22,900 (31.8%) were in domiciliary care.

Due to the recent nature of registration activities, there has been little evidence of its impact on professionalisation and whether it has enabled a greater recruitment and retention of the workforce. Some concerns have been raised that the need to undertake a qualification in order to be a social care worker could act as a disincentive for individuals, especially for those who only work a few hours a week.[15]  A further complexity occurs where staff work across the English–Welsh border and therefore become subject to two separate legislations.

Scotland

The Scottish Social Services Council (SSSC) came into being in 2001 under the Regulation of Care (Scotland) Act. As such, the SSSC acts as a non-departmental public body that is legislated for, funded by, and accountable to the Scottish parliament. Its main functions are registration and regulation of workers, development, and ensuring fitness to practise.[16] It is important to note that social care workers (termed ‘social service workers’ in legislation) are defined in relation to the place of their work, not their profession, which has arguably made the development of a professional identity more difficult.

Registration is mandatory, and qualifications-led, making it an offence to exercise social care work without being on the register. Applicants can sit on the register before acquiring their qualifications  (registration with condition).[17] Registration is ongoing, having started shortly after the Regulation of Care Act in 2001[18] with the aim of developing a strong professional identity that would be valued both by workers and service users[19] as well as strengthening the sector’s skills base. Workers employed in domiciliary care services are to be registered in their entirety by October 2020.[20] Stakeholders reported that holding a mandatory register for almost 20 years had real benefits in terms of knowledge of workforce makeup, its movements, and for future planning.

The Scottish Social Services Council develops and publishes official and national statistics on the social services workforce, and publishes yearly reports on workforce data. These cover social care workers and social workers for both adults and children in receipt of services. The Skills for Care and Development report[21] estimates jobs in the regulated adult social care workforce at around 138,000, of which 53,700 (38.9%) are in residential and nursing care and 69,000 (50%) are in domiciliary care. More recently, 2018 data reported by the SSSC estimated the total adult social care workforce (using total registration data, excluding children’s and social services) to be around 140,000. The domiciliary care workforce is increasing, and is now estimated at around 71,350.[22]

Beyond the challenges of recruitment and retention shared with the other nations, conversations with stakeholders have highlighted concerns around the sustainability of the workforce. This is further compounded by concerns around current Migration Advisory Committee proposals for immigration, which could limit the number of foreign workers coming to Scotland to work in social care.

Northern Ireland

The Northern Ireland Social Care Council (NISCC) came into being in 2001 under the Health and Personal Social Services Act (Northern Ireland). As such, the NISCC acts as a non-departmental public body that is legislated for, funded by, and accountable to the Department of Health in Northern Ireland. Its main functions include the registration and regulation of social care workers, setting standards of conduct and practice, and supporting the learning and development of the workforce.[23] The Act also provides a definition of a ‘social care worker’, and as in Scotland this is defined around place-based employment rather than professional competencies.

Registration is mandatory but not qualifications-led, making it an offence to exercise social care work or call oneself a ‘social care worker’ without being on the register (although the offence falls on the registered employer rather than employee).[24] Being on the register is intended to demonstrate that a worker is compliant with the standards of conduct and practice, making them accountable for the quality of care they provide.[25] Stakeholders suggested introducing mandatory qualifications would help to raise the quality and status of the workforce and it remains a long-term ambition.

The NISCC has completed the registration of the designated groups of social care workers, with the final group of domiciliary care workers registered in 2018. Northern Ireland is the first UK country to achieve complete registration of its domiciliary care workforce. It is also the first country to undertake an evaluation of its registration process,[26] which finds that mandatory registration and adherence to fitness to practise standards have increased confidence among the workforce. Service users and workers have also reported a positive impact on the quality of care.

The Skills for Care and Development 2018 report[27] estimates social care workforce regulated jobs at around 38,500, of which 18,400 (47.8%) were in residential and nursing care, and 15,200 (39.5%) were employed in domiciliary care. A more recent study reports that the social care workforce represents 4% of all employment in Northern Ireland,[28] and there are currently 36,753 people listed on the register[29].

Particular challenges to Northern Ireland include raising the value and status of social care and determining the most effective models of delivery for social care, given the current lack of legislative change to the social care system. The implications of Brexit have also raised concerns around free movement of workers across the (currently open) border with the Republic of Ireland, where an estimated 500 workers are employed.

 

Suggested citation

Oung C, Curry N and Schlepper L (2020) 'What does the social care workforce look like across the four countries?', in Adult social care in the four countries of the UK. Explainer series, Nuffield Trust.

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