London Calling

As part of Care in the Capital week, Havering
director Anthony Douglas, author of the Is Anybody Out
There? report into social care recruitment in London, charts a
course through the mounting problems in recruitment and calls on
the government to bolster mainstream services.

The staffing crisis in social care is part of
a recruitment and retention crisis facing much of the UK public
sector. Not a week goes by without the lack of staff in a key
public service such as teachers or nurses being highlighted in the
press, and in London the crisis is at its most severe.

The
Home Counties had less of a problem than the capital five years
ago, partly because qualified and experienced staff were keen to
move out of London to cheaper housing. Now, most regions face staff
and skill shortages. To compound the problem, near full employment
is traditionally a tough time for public sector
recruitment.

Despite additional funding,
demand in social care continues to exceed resources in areas such
as delayed transfers of care from acute hospitals, with an excess
of assessments and insufficient residential care provision the main
reasons in London. One of the most popular community care services
is respite care, but providers are reluctant to provide respite and
intermediate care beds because the care demands are more stretching
than managing long-term care beds with a stable group of residents.
But the main problem is that few people want to do residential work
any more, with its unsocial hours. A core group of loyal and
committed staff keep social care services going. But then it has
always been like that.

Many
jobs in London are repeatedly advertised before an appointment can
be made. Extra funding for new initiatives creamed off staff from
mainstream services, but it is now just as hard recruiting to new
initiatives. In creating a more attractive employment market for
its new initiatives, the government has unwittingly contributed to
the care drain of staff away from jobs in statutory teams,
particularly children in need teams and duty and assessment teams.
At a time when the Victoria Climbie case and other part eight
reviews in London demonstrate the importance of services to
children in need, it is irrational to be putting more money into
specific grants and services such as Sure Start and Connexions.
Mainstream services are struggling. One social worker I know
refused a loyalty bonus of £5,000 to remain in a children in
need team, preferring instead to transfer to a leaving care team
that was well resourced through the new ring-fenced leaving care
grant. This is not a set of arguments for moving backwards, but for
a strategic grip of the consequences of moving forward.

There
is also the problem of employers trying to recruit from the same
pool of workers. One provider’s attempts to stabilise its workforce
can be immediately undermined by a neighbouring provider (or
council) hiking its pay, putting on a market supplement, or
introducing a range of financial incentives designed to lure staff
away from close competitors.

In
London, councils are often competing not only with each other, but
also with social work agencies, which offer a mix of assignments
and even long-term careers. Staff are often enticed away from
statutory providers to work for an agency that offers a higher
salary, funded from selling the member of staff back to their
previous employer at an inflated salary and premium. Agency staff
constitute the majority of staff in some teams, yielding a
multi-million pound salary overspend across London. Yet agencies
are a fact of life and play a valuable role in keeping staff within
social care.

All
this competition for staff means that the “race for talent” needs
to focus on the importance of recruiting, retaining and promoting
staff from ethnic minorities.¹ London boroughs such as
Brent, whose ethnic minority population is more than 50 per cent,
have an even higher percentage of staff from those communities.
Through positive action, social care can become a popular and
respected job within an individual community, even if it isn’t in
the wider population.

London, with its large
regeneration projects such as Thames Gateway and Terminal 5 at
Heathrow, competes for inward investment in worldwide markets with
other cities for example Manchester, Liverpool and Birmingham.
While the economies of the major UK cities are booming, their
health and social care infrastructures cannot keep pace. The new
funding for the NHS announced in the March 2002 budget, will create
a new employment market for overseas doctors and nurses. Overseas
staff already form the backbone of many social work teams in
London. Globalisation is a fact of life, and economic growth in
countries such as China and India, as well as increasing movement
of labour around the world means it is likely that increasing
numbers of the UK’s ageing population will be looked after by
temporary workers from overseas. Politicians have a responsibility
to prepare the general public for the large social changes that
flow from global economic change.

All
this makes providing social services in London one of the most
complex challenges faced by the UK public sector, which is
highlighted by the fact that 60 per cent of London councils were
recently awarded a one-star rating. The future is unclear and it is
easy to find evidence to support both an optimistic and a
pessimistic perspective. In a recent Mori poll 54 per cent
disagreed and 36 per cent agreed with the question “In the
long-term this government’s policies will improve the state of
Britain’s public services”. A year ago, 54 per cent agreed and 32
per cent disagreed.²

Asustained media offensive to
publicise a career in social care, and the value to society of the
support many thousands of vulnerable people receive every day, is
vital. The government’s campaign is a start, and only government
can afford the cost of full-page advertisements in national
newspapers, slots on prime-time television, or free CD-Roms showing
the work of a social worker. This is not a profession young people
are jumping up and down about, although new graduate entry schemes
are helping. How to attract young people en masse into social care
is the big dilemma.

Another big issue in social care
is pay. The two-day strike last week by public sector union Unison
over London weighting has been partly fuelled by other public
sector keyworkers having big increases in London weighting. Police
for example receive £6,000 a year; social workers receive less
than half that. Police officers also receive free rail travel for
up to 70 miles around London.

But
social care employers cannot afford the necessary increase, and
here is a case for a specific grant for London social care staff,
similar to the teachers recruitment and retention fund. Other pay
gaps for example the gender pay gap, important for social care with
its high proportion of low-paid, part-time women workers, will need
to be bridged as European case law starts to bite.³ The
pay bill in future years could be formidable.

Trade
unions usually seek across-the-board pay increases, which tend to
make many councils’ support services such as cleaning and catering
uncompetitive. Local grading reviews of specific groups of posts
with recruitment and retention difficulties are more sensible. Such
difficulties tend to be occupationally specific and geographically
concentrated. In London this means concentrating on social workers,
residential workers, senior practitioners, and junior managers,
whose pay should be put under a rolling review as the market is
moving so fast.

Middle
and senior managers are a different issue. In these posts, staff
are more inclined to stay where they are as long as there are not
wide geographical differences in salaries. The quality of the work
experience is just as important.

Many
public services now depend on a transient, casualised and
relatively untrained workforce, often employed by external
contractors. The rush towards delegating a wider set of
semi-professional tasks to unqualified staff, such as learning
assistants in schools, is only worrying because it increases the
risk of key tasks being carried out by inexperienced as well as
unqualified staff, if experienced staff are not
available.

Workplace learning and
development is a core objective of a recruitment and retention
strategy. While workforce planning and succession planning is
complicated by staff shortages, each provider needs to calculate
the number and type of staff it will need in the future. Between 20
and 25 per cent of all statutory social work in England takes place
in London. Its fragmentation among 33 London boroughs and many
thousands of care providers makes it hard to oversee and guarantee
a capital-wide consistency and quality of service, and to plan
coherently for the future.

At
times, it seems that social care in London is without direction. It
is tempting to think about more structural change, for example by
creating a London-wide service for child care, a sector-based
service for mental health and disability, leaving older people’s
services at the borough level because of their sheer volume,
especially with coterminous primary care trusts. But recent moves
to London-wide services, such as Cafcass and the probation service,
have been riddled with re-organisation problems. It would be better
for representative agencies in London such as the Local Government
Association, the Association for London Government, the Sector
Skills Council, and the regional training forum of the Training
Organisation for Personal Social Services, to identify the skills
gaps across London. This should also include the independent
providers in each sector or borough, and to develop local action
plans to bridge the gaps within the existing structure.

London
should be a pilot for a social care workforce development project
run by the Sector Skills Council, with its own centre of vocational
excellence. In London, collaboration between the Social Services
Inspectorate, LGA, ALG and Greater London Association of Directors
of Social Services is taking place, but this is only touching the
surface. An office for the recruitment and retention of health and
social care staff should be established to co-ordinate efforts and
to resource large-scale programmes such as a central recruitment
bank for London.

However, many social care
employers are taking positive steps to respond to this crisis and
are making a real difference. The main impact has come from help
with housing, help with child care, promoting a better work-life
balance for staff, improving office accommodation, introducing
flexible leave systems, helping with travel costs including free
parking permits in controlled parking zone areas, developing staff
transfer schemes, and promoting later retirement rather than early
retirement. Organisations that promote professional development
also score highly in retaining staff. And having a good line
manager helps most of all.

While
individual employers have a clear role to play, only the government
is large enough to resource a national recruitment and retention
strategy properly. In London, for example, there are more than
4,000 social care employers, with no single co-ordinating body,
unlike health service providers which have the NHS. Although a
start has been made to co-ordinate workforce planning and
recruitment and retention strategies in social care, much more
remains to be done.

At the
moment, the problem is running away from us. Different arms of the
public sector are competing for the same staff, and as social care
has less priority for the government than the health service, the
police or the teaching profession, it is not surprising that more
is being done in these areas.

However, these services also
depend on an efficient social care service, in areas such as
intermediate care, youth justice, and care planning for children
with severe emotional and behavioural difficulties. The
interdependence of the public sector means that social care should
be accorded equal status with other services if the crisis in
recruitment, skills and all-round confidence within social care and
about it is to be reversed.

– Care
in the Capital Week is supported by Celsian

Anthony Douglas is executive director of
community services at the London Borough of Havering. His report on
the recruitment crisis in social care in London, Is Anybody Out
There? is published this week by Community Care.

It is available in full at www.community-care.co.uk
 

References

¹ Angela O’Connor,
The Race for Talent, CD-Rom 2002, available from telephone 020 8379
4140, and L Burnham, Keeping the People who Keep You in
Business, Amacom, 2002

² Mori Local
Government Research Unit, Delivery Index: on Future
Expectations for Public Services, Mori, 2002

³ Equal Pay Task
Force, Just Pay, Report to the Equal Opportunities
Commission, Equal Opportunities Commission, 2001