Healthcare staffing shortage to challenge care home sector - what's the solution?

Staffing is one of the most important considerations for a care home operator with appropriately skilled staff required to provide the very highest level of care to residents.  
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Categories: Healthcare UK

Yet tension is emerging in staffing costs; one which challenges the very viability of some care home facilities.  Knight Frank’s 2016 Care Homes Trading Performance Index found that across the sector average staff costs account for some 58% of home turnover and that this had increased by 3.2% over 2016.

Staffing costs break back to an average of £21,040 per care home resident.  At these levels, and with further wage inflation likely, it may well become unviable for some to operate care home facilities.   

There have been numerous articles in the press highlighting the potential staffing crisis within the healthcare sector. The BBC recently published an article stating that the “social care system was ‘beginning to collapse’ as 900 carers quit every day” whilst The Daily Telegraph ran a story entitled  “UK social care sector in crisis due to staff shortages”. Staff shortages have resulted in care home and nursing ward closures.

According to the latest figures from the Office for National Statistics, of the 751,000 externally advertised job vacancies across the whole UK economy in the three months to January 2017; more than 15% (circa 117,000) were in the health and social work sectors.

"Further wage inflation likely, it may well become unviable for some to operate care home facilities. "

This leads to some important questions.  

Why is there a shortfall of nursing / care staff in the UK? What impact is this shortfall having on care home operators?  What are the potential solutions to alleviate this acute problem? 

Causes of the shortfall 

Carers work in a challenging environment looking after the frail, elderly and those with complex needs. For responsibility at this level, carers are paid a wage rate that most would argue is inadequate and which is certainly leading many staff to consider alternative careers.

For those carers who are passionate about their jobs and wish to stay within the healthcare sector, the living wage will certainly help with staff retention, but this does pose further financial constraints on home operators who presently operate on lower average weekly fees and once again questions the viability of some homes. 

Similarly, nurses also work in challenging environments. Care home operators can lose nursing staff to jobs within different sectors or to NHS hospitals, attracted by better pay packages.  

"The UK will need to attract and train 1.6 million health and social care workers up to 2022 in order to replace those who leave the profession."

Further concerns involve a large portion of current nursing staff reaching closer to retirement age coupled with a fall in applications by students in England to nursing and midwifery courses at British universities.

The number of applicants fell by 23% in the 2017/18 academic year compared with the previous year, influenced no doubt by the Government’s decision to charge fees to nursing students and replace NHS bursaries with student loans. 

The Government’s cap on public sector pay rises, at 1% per annum, which is below the prevailing rate of inflation is also demotivating for care staff working within the public sector. The Trades Union Congress believes this to be the key factor in causing recruitment and retention issues within the sector. 

Of course Brexit is likely to only exacerbate the crisis further. According to the Institute for Public Policy Research, the UK will need to attract and train 1.6 million health and social care workers up to 2022 in order to replace those who leave the profession.

The impact on operators 

As for the impact on care/nursing homes, the shortage in nursing staff will only drive up wage rates for nursing home operators giving nurses the power/flexibility to job-hop to better pay packages, resulting in high staff turnover. It will also have an effect on homes that are at fill stage where potential admissions may be put on waiting lists until sufficient staffing is available, in order to determine the correct staffing ratios. 

Consequently, we may see a trend, with an increase in residential care home developments where no medical/nursing staff is required.

As per BBC’s article, staff turnover rate in adult social care increased to 27.3% in 2015/16, which is nearly twice the average of other professions in the UK. High staff turnover will reduce continuity of care with residents, increase staff agency costs and therefore affect profitability. 

" Turnover rate in adult social care increased to 27.3% in 2015/16, which is nearly twice the average of other professions in the UK."

Mitigation strategies

The government has recently committed to invest an extra £2bn into the social care system, which will hopefully help mitigate the staffing crisis issue to an extent. Government policymaking could also play an essential part in attracting staff to the healthcare sector. In order to improve staff retention, care providers will need to provide competitive salary packages to staff.

With the use of Medical Technician/Team Leaders, pressure can be released off nurses; therefore shortage of nursing staff can be mitigated via employing staff more effectively. For new care home developments, comprehensive due diligence will need to be carried out on staff recruitment.