Category Archives: Workforce

You cannot fix the homecare workforce without fixing commissioning

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Jane Townson OBEDr Jane Townson OBE is Chief Executive Officer of the Homecare Association. This post first appeared on the blog of the Adult Social Care Workforce Partnership (Care Work). (801 words)

Why do people leave care work, and what would persuade more people to join and stay? Research into pay, wellbeing, training, management, and culture can help employers improve working lives.

But in homecare, there is another question we cannot overlook: what kind of jobs does the system make it possible for employers to offer?

That is why the Care Work Partnership matters. Its research into how commissioning shapes pay, conditions and retention gets beneath the symptoms to examine the structures producing them.

Homecare shows the problem starkly. Councils and the NHS buy around 80% of homecare hours, much of it through frameworks that guarantee providers no volume of work and pay in arrears for contact time – sometimes literally the minutes recorded in someone’s home. In our research, only 1% of public bodies used block contracts guaranteeing income, while 61% bought no more than 500 hours per provider each week [1].

Three commissioning decisions shape the employment offer: how much local work each provider receives, the price commissioners pay, and whether they pay for planned capacity or individual contact minutes. Continue reading →

Why are people leaving social care jobs, and what could help them stay?

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Wenjing Zhang (Research Fellow, KCL), Ann-Marie Towers (Professor of Social Care Research, KCL), Bo Hu (Associate Professorial Research Fellow, LSE) and Annette Boaz (Professor of Health and Social Care, KCL) discuss findings from the Leavers Study, which involved interviews with 30 people who had left adult social care roles within the previous two years. First published on the Care Work website. (747 words)

Adult social care depends on skilled, compassionate people. Yet across England, many workers are leaving the sector because the pressures of the job are becoming too difficult to sustain. This matters not only for staff wellbeing, but also for the quality and continuity of care that people receive.

To better understand why people leave adult social care and what might have encouraged them to stay, we carried out a study with former adult social care workers in England. The research builds on a 2023 national survey of more than 7,000 people working in adult social care in England. Around one in three said they intended to leave their job as soon as they found another one, with low pay, stress and burnout identified as the main reasons. By 2025, 12% of those who took part in a follow-up survey (1,073 people) had left adult social care altogether, including a small number who did not intend to quit two years earlier.

To better understand these decisions, we interviewed 30 people who had left adult social care roles within the previous two years. Participants included care workers, social workers, occupational therapists, personal assistants and managers. Some had moved into jobs in other sectors, while others had retired early or left work altogether because of health or caring responsibilities. Although every story was different, common themes emerged.

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How the Health T Level can help the NHS and social care address their workforce crisis and support inclusive growth

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Professor Richard Griffin, MBE is Visiting Professor of Healthcare Management at King’s Business School. Today sees the publication of his report for The Gatsby Charitable Foundation: Inspiring the next generation: T-levels and health and social care workforce planning and progression (PDF). (640 words)

Both the NHS and social care face severe and enduring shortages of staff. Fit for the Future: The NHS 10 Year Plan for England published last year, highlighted the need for the NHS to build local, sustainable workforce pipelines and to recruit more people from the communities the NHS serves.

Recent research by King’s College London, funded by The Gatsby Charitable Foundation, suggests that T Levels – technical qualifications largely delivered by Further Education colleges – offer a route to support both objectives, alongside delivering wider benefits.

First introduced in 2020, T Levels are two-year technical qualifications for 16–19-year-olds, equivalent to three A Levels and including an industry placement. The T Level in Health launched in 2021 and is now the second most popular route, with almost 4,000 students in 2025. Continue reading →

New research shows how better pay and training could rescue social care in England

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Republished from the LSE Business Review Blog (12 October 2025).

Low pay, job insecurity and post-Brexit recruitment challenges are plaguing the adult social care sector in England. With rising demand and chronic underfunding, work conditions are only getting worse. Andreas Georgiadis and Andreas Kornelakis suggest ways to improve the situation, including better pay and training.

Adult social care suffers from a long-standing “workforce crisis” in England. Recent reports from industry bodies highlight the challenges to the sector’s workers and their ability to offer high quality care. Staff in social and health care are overworked, exhausted and stressed, sometimes to the point of becoming ill, leading to absenteeism or quitting altogether.

Increased workloads and time pressures arise partly due to increased demand for services by a rapidly ageing population. At the same time, over half of adult care providers said they faced challenges recruiting new staff; 31 per cent struggled to retain employees. Difficulties in recruitment and retention intensified after Brexit, as the sector relied heavily on migrant workers.

It is widely known that adult care is one of the lowest paying jobs in the UK. Forty-three per cent of all adult social care workers in England are paid below the real living wage. It will continue to be challenging for care providers to retain pay differentials between those on the wage floor and those with more experience and qualifications. But pay levels are not the only challenge for care workers, as they also face problems of job insecurity and unpaid overtime.

For example, most of those who do home visits are not compensated for the time they spend travelling to homes, which can make up to a fifth of their working day. The use of contingent contracts in social care may deliver some cost savings for providers, but has the drawbacks of job insecurity for workers, and concerns about service quality. Continue reading →

At HSR 2025: On new roles in UK health and social care

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Antonina SemkinaDr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. Antonina brought together contributions for this blog from the other presenters at this Health Services Research conference session in Newcastle. (773 words)

One of the core functions of conferences is to allow colleagues to present and discuss work in progress. Here we share the results of a fruitful session where colleagues researching the introduction of new roles in health and social care saw many important parallels that will help them in developing and sharpening their analysis.

On the 2 and 3 July 2025 Newcastle University hosted the 18th annual Health Services Research conference. It featured nine thematic streams including Person Centred Care, Workforce, Digital, Social Care and Health Inequalities. Delegates had an opportunity to attend research discussions and Pecha Kucha sessions (short form presentations), workshops (e.g., ‘How do we know if HSR impacts on Policy?’ led by Unit Director Professor Annette Boaz), plenary sessions (e.g., ‘The 2030 workforce: how will innovative research deliver impact’?), meet ups (e.g., for Early career researchers) and to view research posters.

HSR UK 2025 conference poster

One of the research discussion sessions in the Workforce stream featured four presentations related to various new roles being developed in UK health and care services. Unit researcher Dr Antonina Semkina presented on the ‘New Roles in Health and Social Care: What is the nature of new care coordinator roles?’ project that she is conducting as part of the Health and Social Care Workforce Policy Research Unit programme of work. The research project, developed in collaboration with the Unit Public Contributors Involvement and Engagement group, focuses on what kinds of new care co-ordinator roles are being created, what tasks are delegated to them and the implications for various stakeholders (e.g., colleagues’ workload). Continue reading →

Widening Participation and Apprenticeships in health and social care: Report and Call for Research Participants

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Cat Forward reports from a roundtable event held by the NIHR Policy Research Unit in Health and Social Care Workforce as part of two studies in its current programme of work – on Widening Participation and Apprenticeships. If your NHS Trust or Integrated Care System is interested in taking part in these studies, do get in touch with catherine.forward@kcl.ac.uk. (414 words)

As part of its core programme of work, the Unit hosted a hybrid roundtable event on 2nd April 2025 with 88 online and in-person attendees from NHS trusts, NHS-England, local authorities, academia, public representative bodies and the charity sector. The event titled “Refreshing approaches to Widening Participation and Apprenticeships: The New Agenda?” sought to facilitate discussion about existing Unit work, to share current and best practice in Integrated Care Systems and Trusts, as well as discussing directions future research might take. Continue reading →

In Search of Hidden Healthcare Workforces: NHS Therapists for Children and Young People with Special Educational Needs and Disabilities (Part 2)

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Prof Ian Kessler of the NIHR Policy Research Unit in Health and Social Care Workforce is Professor of Public Policy and Management at King’s Business School. He introduces a new report from the Unit, scoping the demand and supply of NHS therapists for Children and Young People with Special Educational Needs and Disabilities.

This, the second of two blogs, focuses on the supply of, while the first addressed the demand for, therapists for children and young people with Special Educational Needs and Disabilities.

The Supply Side

Commissioning. While the capacity to address this increased demand rests in large part on the scale, structure, and capabilities of the therapy and, as already implied, the wider health and care workforce, the commissioning process for CPY with SEND, is pivotal. Commissioning determines the services available and at what level of resource, inevitably feeding through to determine the workforce required to provide them: to put it crudely, if a service is not commissioned, a workforce is not required. The close connection between service design and the workforce is apparent from various ‘good practice’ commissioning models [1]. These typically distinguish different levels of services linked to the nature of need and support, with implications for the requisite workforce: for example, accessible universal services delivered by a wider workforce; targeted services provided by registered therapists and their support co-workers; and specialist services the exclusive preserve of the registered therapist. Continue reading →

In Search of Hidden Healthcare Workforces: NHS Therapists for Children and Young People with Special Educational Needs and Disabilities (Part 1)

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Prof Ian Kessler of the NIHR Policy Research Unit in Health and Social Care Workforce is Professor of Public Policy and Management at King’s Business School. He introduces a new report from the Unit, scoping the demand and supply of NHS therapists for Children and Young People with Special Educational Needs and Disabilities.

This, the first of two blogs, focuses on the demand for, while the second discusses the supply of, therapists for Children and Young People with Special Educational Needs and Disabilities.

Context

The workforce delivering care and support for children and young people (CYP) with special educational needs and disabilities (SEND) is an elusive one. In part this elusiveness stems from the diffuse and fragmented nature of the workforce as CYP with SEND typically engage with a variety of services- education, health, social care and sometimes housing. Even drilling down into these discrete service segments, tying the SEND workforce down in terms of its size, skill mix, and capacity remains challenging. Take health as an example. CYP with SEND will have a range of developmental, physical, and mental health care needs, addressed by a variety of staff groups to be found in different clinical settings including: nursing in both community, acute and mental health settings, clinical consultants in a similar range of settings, GPs in primary care, and healthcare visitors in the community. Adding to the challenges is the fact that those in any one of these staff groups will have clients which include but are rarely limited to CYP with SEND. With policies often framed by and centred on ‘children and young people with SEND’ as the named client group [1], the hidden nature of the workforce caring for and supporting them becomes a real challenge in meaningfully delivering on the policy initiative. Continue reading →

In Pursuit of Ethically Sustainable Approaches to International Nurse Recruitment

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Prof Ian Kessler of the NIHR Policy Research Unit in Health and Social Care Workforce is Professor of Public Policy and Management at King’s Business School. He introduces a new evaluation from the Unit: International Nurse Recruitment and the Use of Memoranda of Understanding: The Kenya and Nepal Pilots. (1,447 words)

With rising health and care needs as national care systems seek to cope with aging populations, the growing incidence of chronic conditions, and the shock of the Covid pandemic, there has been increasing pressure on the global supply of healthcare workers. Traditionally drawing upon overseas staff, this raises new and important questions for the NHS about how such employees are accessed and managed. The recent NHS England’s Long Term Workplace Plan, 2023, for example, cautions against an over reliance on any specific source of labour. More profoundly, the pressure on the supply of overseas healthcare workers prompts renewed concerns about the ethics of international recruitment as a practice.

Earth seen from space

There has been longstanding debate on the ethics of overseas recruitment by the NHS and other high income countries. This is reflected in international attempts to regulate the practice through, for example, the World Health Organisation Global Code, 2010, designed to ‘establish the ethical international recruitment of health personnel, accounting for the rights, obligations and expectations of source countries, destination countries and migrant health personnel.’ Debate on the ethics of the process has deepened with the new labour supply side pressures, and in response, government-to-government, or bilateral, agreements, whether in the form of Memorandum of Understanding (MoU) or tighter, more formal treaties, have emerged as a potential vehicle for addressing ethical concerns. Continue reading →

Occupational Health and Wellbeing (OHWB) and the Health and Social Care Workforce

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Antonina SemkinaDr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (613 words)

Unit researchers Antonina Semkina and Caroline Norrie attended the annual Health and Wellbeing at Work Conference that took place in Birmingham National Exhibition Centre on 12-13 March, 2024. The conference featured 13 themes, including Future of Work; Equality, Diversity, and Inclusion; Health and Conditions; and Culture, Values and Engagement, among others. There were 100+ exhibitors representing Occupational Health providers, NHS and social care organisations, consultancies, training agencies, and charities.

Caroline and Antonina recently published the final report from their NIHR-funded study “Exploring the awareness and attractiveness of Occupational Health (OH) careers: perspectives of trainee doctors, nurses, OH trainees, OH career leavers” so they particularly enjoyed the opportunity to connect with and hear presentations from policy makers, researchers, practitioners, and providers in the field of OH. Continue reading →