Professional Comment

Why Workforce Health Should Be at the Centre of Social Care

This month, reports that the government are set to halve the £500 million they pledged to invest in the social care workforce came as a blow to the sector. There are currently around 250 000 vacant posts across health and social care, with more than 160 000 unfilled post in social care. The NHS and social care are dependent on each other to work efficiently. While the NHS is facing its own challenges, a functioning social care system is necessary to keep people well in the community and to discharge them safely home after acute treatment.

Workforce health is relevant to recruitment, retention, safety and productivity of staff. Working in social care has similar challenges to working in health care- including hazards and risks around manual handling, infection and mental health of staff- causing issues including work-related stress and burnout. But while NHS workers have access to occupational health services to help keep them well and keep working, access for social care workers is likely to be more limited.

What is occupational health and where does it fit into social care?

Occupational health is all about the relationship between work and health: how our health affects our work and how our work affects our health. Occupational health teams support people working while living with ill health, such as through recommending changes to the workplace or the role. When someone is not well enough to work, occupational health can 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 hazards and risks in the workplace.

Occupational health was excluded when the NHS was first set up, which means access varies from employer to employer. Even the most generous estimates suggest around 50% of workers do not have access to any occupational health support. People working for organisations with <250 employees are less likely to have access to occupational health compared to workers at large private sector organisations, or the public sector. People who are in insecure employment and on zero hours contracts are least likely to have access to occupational health.

The social care sector is made up of more than 18 000 employers, mainly private sector small and medium sized enterprises, with at least 25% of the workforce on zero hours contracts. This profile of organisation is unlikely to be providing occupational health support to its workforce. Pay for a social care worker is around £8000 less than an NHS healthcare assistant. But pay is not the only working condition. Workforce heath matters too.

How does the social care sector move forward?
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.

Yet, all stakeholders stretched in resourcing any change. 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 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. Meanwhile, 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. We need parallel workforce planning across health and care, and as part of this we should be growing occupational health services to meet the needs of the social care workforce as well as the needs of the NHS workforce.

There is a long way to go but understanding where we are is important. 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.