Introduction

 

The most important asset to health and social care in the UK is its workforce. The 2.5 million people working across England are highly varied, and all vital. They include the very visible workforce – the surgeons and nurses working alongside the caterers and cleaners in hospitals, as well as the GPs, pharmacists, physiotherapists and those providing care in the community and at home. But they also include the less visible workforce, such as those working in corporate support services performing crucial roles such as keeping track of millions of appointments, making payments for the drugs and equipment used every week, and planning for future services. The social care workforce is just as crucial, delivering front-line care both in people’s own homes and in care homes. Health and social care are major contributors to the wider economy – accounting for about one in 10 jobs. This varies across the country, from 6% in London to over 12% in the north east (Figure 1).

Figure 1: Health and social care workers as a percentage of the total workforce, 2015/16

 

Source: Social care data are from Skills for Care, The state of the adult social care sector and workforce in England, 2016. NHS data are from NHS Digital (2017), NHS workforce statistics.

There are growing concerns that the NHS and social care don’t have enough of the right staff in the right places. NHS England’s Five Year Forward View sets out plans to transform services to meet the changing needs of an ageing and growing population with rising chronic health conditions. But these plans risk being undermined due to an increasingly overloaded and stressed workforce. The recruitment and retention of staff is now one of the biggest challenges facing NHS leaders in England. Workforce issues are never far from the media spotlight, and have already featured in the debates in the run up to the June 2017 general election.

This is the third in a series of briefings to help inform the debate ahead of the election. In our first two briefings, we looked at NHS and social care finances and the quality of care provided by the NHS in England.

In the first briefing, NHS and social care funding – Three unavoidable challenges, we showed that funding since 2010 has not risen as quickly as the pressures on the NHS, which include meeting the health care needs of a growing population, and the rising costs of staff, drugs and other essentials. In the second briefing, Quality of care in the English NHS – In the balance, we drew attention to the deteriorating waiting times for hospital and emergency care, but also showed that there have been improvements in other dimensions of care since 2010 – such as outcomes for stroke and heart attack – due in no small part to the commitment and quality of the people working in the NHS.

This third briefing identifies the fundamental challenges facing the workforce today, and considers what steps might be needed to make sure the NHS and social care in England have enough of the right people to deliver high quality care in the future. We have focused on England, as health and social care have been a devolved matter since the late 1990s, but we have used UK data where this is the only information available.

For more information on the data and reports mentioned in this briefing, please see the list of sources at www.health.org.uk/publication/election-briefing-sustainable-workforce


* Where we refer to social care, we mean adult social care.

1.2 million people work in the NHS (headcount not full-time equivalent) and 1.3 million in social care.

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