Costing a national workforce strategy in adult social care in England
Research by Skills for Care suggests that an additional 440,000 posts will be needed in adult social care by 2035 to meet the needs of the ageing population in England. This will further exacerbate the issues faced by the adult social care sector, which is already experiencing recruitment and retention challenges.
To ensure that there is sufficient capacity to meet these needs, Skills for Care published a national workforce strategy in close collaboration with other sector stakeholders.
Alma Economics was commissioned by Skills for Care to provide high-level estimates of likely costs associated with the recommendations developed as part of this strategy. The recommendations aim to improve service delivery through better training, compensation, career progression, and health offerings for care staff.
In particular, the recommendations we costed included:
Improving digital skills and expanding the use of technology and AI in adult social care
Extending the Assessed and Supported Year in Employment to newly qualified social workers in occupational therapist and registered manager roles
Creating advanced practitioner roles for occupational therapists and registered nurses
Promoting the existing NHS Health Checks among the adult social care workforce
Expanding the enhanced NHS health and wellbeing offering to adult social care workers
Enforcing the current minimum wage
Introducing a sector minimum wage in line with:
a. Real Living Wage
b. National Living Wage +£1 per hour
c. National Living Wage +£2 per hour
Introducing a national pay scale aligning with the existing NHS framework
We worked in a flexible and integrated manner with the Skills for Care team, costing recommendations as they were being developed and offering steers for the workforce strategy.
To that end, our team first carried out a scoping exercise, identifying the likely impacts of the proposed recommendations. We then created cost-benefit analysis (CBA) models with sufficient evidence and carried out a costing exercise for the recommendations where a full CBA was not possible. The CBA models were built in line with HM Treasury Green Book guidance, considering both the impact on public finances as well as the wider impact on society compared to a business-as-usual analytical scenario.
The main benefits identified across recommendations included: (i) improved wellbeing of adults receiving care; (ii) avoided injuries for adults in care; (iii) reduced costs to the NHS; and (iv) avoided recruitment costs.
Our findings suggest that all proposed recommendations would create more benefits than costs and could lead to recruiting at least 179,800 new social workers and help more than 296,300 social workers remain in employment.
In particular, the recommendations with the highest benefit-cost ratio were creating advanced practitioner roles for occupational therapists and registered nurses (£2.5 for each £1 invested), followed by promoting NHS health checks to adult social care staff (£2.4 for each £1 invested).
At the end of the project, our team delivered a comprehensive technical report outlining the methodology and findings of each costed recommendation. Our report aims to inform future policymaking to help ensure sufficient care provision to meet the needs of the adult population in England.
You can find the full report here.