‘Unsustainable’ reliance on agency care staff needs urgent government action, warns provider body

Survey of 95 care providers finds 80% using more agency workers than in 2021, with 90% finding them harder to source, amid widening staffing crisis

Care home resident and worker
Photo: Alexander Raths/Adobe Stock

Social care’s “increasingly unsustainable reliance” on agency staff needs urgent government intervention, a provider body has warned.

Research by Care England found almost eight in 10 providers (78%) were using more, or significantly more, agency staff in May and June this year than they had been in April 2021, found the survey, answered by 95 care home, home care and supported living providers, collectively responsible for 70,000 registered beds.

An even larger majority (88%) said it had become more difficult to book temporary workers than in April 2021, with a similar proportion (86%) stating that the cost of agency staff had risen over that period. Providers said the cost of engaging an agency worker was double that of a permanent staff member for both carer roles (£19.57 versus £9.90 per hour) and nursing positions (£37.56 versus £19.49).

Respondents also said that their increasing reliance on agency staff was affecting quality of care, with 73% finding locums less reliable.

Reliance on agency staff ‘unsustainable’

Care England chief executive Martin Green said the sector’s “costly and increasingly unsustainable reliance on agency staff” was a response to the 52% rise in vacancies – equivalent to 55,000 positons – during 2021-22, reported recently by Skills for Care.

Green added: “The use of agency staff has been a bandage over more deep-routed recruitment and retention issues, which now, expectedly, are unravelling. The results of our recent survey demonstrate the severity of these issues, with the usage and cost of agency staff increasing dramatically over the last year. This is not only affecting the quality and continuity of care but compounding pressures on the NHS.

A range of factors have been cited for social care’s staffing shortage, including burnout relating to working through the pandemic, employees leaving for better-paid roles in other sectors such as retail, and comparable jobs in the NHS offering more money.

Just under eight in 10 (77%) of respondents to Care England’s survey, which included residential and domiciliary care and supported living providers, said their staff were leaving the sector, according to exit interviews. Two-thirds cited pay and just under half mentioning stress.

However, some of those who left roles due to pay were in fact moving into higher-paid agency work.

Almost nine out of 10 (86%) of respondents to Care England’s survey described the hourly rates invoiced for by agencies as being challenging for their organisation to meet, while a similar proportion (84%) said they were having to pay ‘higher’ or ‘significantly higher’ rates than previously.

As well as employees leaving, survey participants reported that around 11% of their workforce had moved from permanent roles to zero-hours contracts over the past year, with 7% moving from permanent to bank roles.

“The effect is an increasingly transient workforce which necessitates an increased reliance on agency staff that, in turn, threatens the quality and continuity of care,” the report said. “It was also noted that unregulated agency fees created negative work environments, increased the likelihood of unsafe care practices, increased the pressure on the NHS, and further destabilised an already unsustainable care sector.”

Government action ‘wholly insufficient’

Last week, the government announced plans to expand overseas recruitment, while it is also allocating £500m to boost the career development and wellbeing of social care staff over the next three years. 

However, Green said this was “wholly insufficient”, with the £500m amounting to “5.7p per hour for each sector employee; this does not begin to touch the sides of such vast workforce pressures”.

Care England backed calls, issued most recently by the House of Commons’ levelling up select committee, for the government to inject £7bn a year extra into adult social care, including to boost recruitment and retention, while also urged action to tackle use of locum staff, including consideration of a cap on agency fees, as is the case in the NHS.

“Whether it be a proportional cap on agency fees, a mandatory approved framework or further discussions with stakeholders in the sector to come up with pragmatic solutions, this is a matter of urgency; not just for the ASC workforce, but for vulnerable people in receipt of care, and the wider population,” it said.

A government spokesperson said: “Our social care workforce is valued, appreciated and supported, which is why we are providing at least £500m to develop and support the workforce.”

They added: “Most care workers are employed by private sector providers who set their pay and terms and conditions, independent of central government.”


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2 Responses to ‘Unsustainable’ reliance on agency care staff needs urgent government action, warns provider body

  1. Don Quixote August 18, 2022 at 10:16 pm #

    ‘Social work Jim, but not as we know it’! (To paraphrase that well known (though disputed phrase) from play on Mr Spock’s supposed reply to Captain Kirk in the Star Trek series, ‘It’s Life, Jim, but not as we know it’).

    I commend the articles assertion that reliance or using agency workers is not the way to run social services, either adult or children’s services. Hardly surprising such as happened! Things like this don’t happen due to some totally unforeseen reason. Government cuts, increasing legislative responsibilities being placed upon an already over burdened social care system, poor pay etc etc . All contributions to the perfect storm!

    Those local authorities who adopted the ‘ bunker mentality’ such that they continue to keep digging a hole they would find difficulty in finding a a way out of. These are now found to be the most at risk. If you only read the local ombudsman investigations into complaints you will see a pattern emerging amongst those local authorities who kept digging a hole deeper than others!

    One organisations misfortune becomes another’s opportunity. Agencies ready and waiting for the call. Supplying experienced & committed social workers who just want to do what they do best, focus on what matters – making a difference! Plus for a reasonable wage … and, yes you can just say ‘goodbye’! if the organisation does not value your services. Someone else will. The numerous adverts that now profile how they value their staff, encourage their development and care enough about what day in day in the job is about. that from top to bottom the organisation actually cares about what it does and who for – those who!! Well we all use different words, terminology for whom we serve, our own humanity & the injustices, misfortune we see each day.

    Why does this matter to me? This has been the only job I have ever wanted to do and have tried to do so for 43 years now. Though past retirement age, I still want to do what I believe is good and ethical.

    As we seem to be entering a period of recession, social care will undoubtably have to face un presented demands upon already a service in trouble. History does teach us something – it can give us lessons from the past. Even if you were not around, or believe history can teach us little! That the ‘smart ‘ digital age will save us, please think again.

    Social work is about the up-keeping of and accessing opportunities in life in which a persons humanity, identity self worth, their safety has a real meaning to that person, their families. We need to work in organisations that also believe in this & create environments in which we also feel safe and valued to carry out such.

    In the last recession of the 1980’s the words of ‘Yosser Hughes’ I believe have some currency- ironically at a current time of relative full employment and difficulties in filling social work posts.

    ‘I can do that, give us a job’

    ‘Boys of the Black-stuff, set in Liverpool, portrayed by Bernard Hill. Written by Alan Bleasdale in 1978 and televised in 19882.

    Bleasdale shows the complete disintegration of Yosser’s life as his children are taken into care (after he is beaten up in his own house by four policemen), he is made homeless and finally tries to commit suicide in a lake. Constantly trying to run the gauntlet of psychiatrists, social workers and creditors, Yosser makes numerous pathetic attempts to re-establish his identity and sense of self-worth.

    Finally. A personal note.

    ‘I can do that, give us a job’

  2. Chris Sterry August 31, 2022 at 4:35 pm #

    Yes, this Governments response to the many areas of crisis in social care are wholly insufficient, but at least they are offering something, but much too little and could swell be much too late. But this crisis is nothing new, for it has been coming for years, perhaps since social care was ever needed, so all previous Governments ate to blame.

    Social care has never been recognised for the service it is and needs to be, as it is as essential as any other service, even the NHS and perhaps even more so. It is generally believed especially by many of the UK population and indeed many in Government as a non-skilled profession, when, it is a very skilled or should be profession.

    It is not just social worker, but even more so care workers and not only care workers in care homes for the elderly but care for both children and adults in home care, supported Living, respite and hospices.

    The pay for care workers has never been, anywhere near the level it should be for the work care workers need to do, for it is not just, wiping bums and getting meals r4eady. There a whole range of skills required.

    Yes, personal care. but also

    emotional support
    financial management
    and much more

    They need to respect the persons they are caring for showing dignity and respect for their choices and much more.

    But, that is not all as there are issues with

    unsocial hours,
    sick pay
    travel costs
    working conditions
    employment contracts
    holidays and holiday pay
    and others

    pay around the National Living Wage of £9.50 or even the Real Living Wage of £9.90 are way insufficient as £14/15 would be more near, just for a starting pay rate.

    All of this, plus the UK Immigration criteria are all adding to the crisis, as did the austerity cuts on Local Authorities and then COVID costs.

    A failure to sufficiently support social care, will have disastrous consequences on the NHS, making it untenable.

    We all say Save the NHS, well to do so, firstly, we have to Save Social Care.

    The Government, have to, immediately reverse all austerity cuts to LAs and make it ‘ring fenced’ for social care, while not allowing LAs to reduce the funding already there. The funding, as to, at least, increase in line with inflation and really much more so.

    This is no time to ‘fence sit, but of immediate actions.