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Is immigration a sustainable solution for the labour supply shortage in Adult Social Care?

Updated: Nov 15, 2023

Florin Vadean, Gintare Malisauskaite, Julien Forder

Workforce is the most important input to the provision of Adult Social Care services. According to the Skills for Care report, the sector employs 1.52 million people, which is more than the NHS (1.43 million) and equivalent to more than 1 in 20 people employed in England. Still, many care staff are being paid at statutory minimum wage and are employed on contracts without guaranteed working hours (i.e., zero-hours contracts). Moreover, following the introduction of the National Living Wage in 2016 and due to the austerity measures during the 2010s (which limited the fees Local Authorities could pay for social care services) many care providers could increase wages only for the lowest paid. This also eroded the differences in wages that care providers could pay to workers with more experience and skills (i.e., pay progression), making retention and recruitment of care staff increasingly challenging.

Initially the COVID-pandemic gave care providers some relief related to the workforce issues, due to high redundancy rates in sectors like retail and hospitality and more people trying to find jobs in Adult Social Care. However, the additional strain on staff during the pandemic (i.e., increased workload without additional pay, periods with lack of suitable PPE equipment, and even abuse) led to a substantial (50%) increase in vacancies in Adult Social Care once the lockdown measures were over, peaking at 164,000 in 2021/22.

Skills for Care reports that in 2022/23 the number of filled posts increased by 20,000. This was mainly due to increased recruitment from abroad (70,000 in 2022/23). Overseas recruitment was, nonetheless, higher than the number of additionally filled posts, showing evidence of substantial replacement of British and EU care staff (whose numbers reduced by 30,000 and 5,000 respectively), while some migrants (about 15,000) have left the sector before the year end (i.e., either returned to their home countries or moved to other sectors in the UK).

Immigration can provide opportunities but also additional challenges to the Adult Social Care sector. For example, a forthcoming Adult Social Care Policy Research Unit study shows that for the first time since the introduction of the National Living Wage, in 2022 care providers started paying more staff above the statutory minimum. This may be linked to the new immigration system introduced in January 2021, and the requirement to meet a salary threshold set above the National Living Wage to qualify for a work visa. However, the increase in immigration also led to a sharp rise in reports of labour exploitation and modern slavery in the care sector. A recent story by BBC News draws attention to some of the difficulties experienced by immigrant care workers, with some agents charging up to £25,000 for sponsorship certificates, immigrants having their passports taken away, exploitative work shifts etc., suggesting that immigrant care workers can find themselves in very vulnerable positions after arrival.

These concerns highlight the need for more and better evidence on whether overseas recruitment is a sustainable way of tackling the shortage of the social care workforce in the long-term. For example, it would be important to learn if there are ways to reverse the observed displacement of the UK nationals and settled migrants from care jobs and what would motivate them to stay in the care sector. Whether wage thresholds above the National Living Wage for overseas recruitment lead to higher wages for the existing staff or rather to inequities and further sources of dissatisfaction. And what effect the exploitation of immigrant workers may have on the international reputation and employment attractivity of the UK social care sector in the long term.

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