Workforce challenges in Adult Social Care

Researchers shed light on workforce challenges in adult social care, using an expansive dataset held by UBDC

Researchers from the Universities of Glasgow and Strathclyde used data on online job adverts, sourced from Adzuna and held by the Urban Big Data Centre, to look at workforce challenges in adult social care (ASC), and, in particular, the use of signing bonuses and potential recruitment of migrant workers in response to recruitment shortages.

There have been longstanding recruitment problems facing ASC. Awareness of the wider consequences of the ASC crisis on the NHS and unpaid care providers is growing. For example, unfilled carer roles are increasingly identified as a critical factor behind delays in patients being discharged from hospitals. Resultant bottlenecks increase the challenge of tackling high and rising NHS waiting lists. Those responding by supplying unpaid care and growing numbers of people on NHS waiting lists are often left with no alternative but to drop out of the labour force.

In tight labour markets, recruiters can typically use various strategies to attract workers, including improving pay, working conditions, training and progression opportunities, guaranteeing minimum hours and other benefits or flexibilities.

However, within ASC, the nature of the work and the way the sector is predominantly funded limit the options available relative to other occupations with a shortage of workers.

In their working paper, the researchers use an extensive database of online job adverts (49.6 million job ads) covering January 2018 – March 2022 to explore two strategies ASC employers might feasibly use to respond to these challenges.

One strategy various employers adopted in response to labour shortages in several occupations was to offer signing bonuses. This approach became increasingly prevalent through 2021 as total vacancies exceeded the number of people unemployed, and we can see this rising trend in the Adzuna data. (See full report below for graphs).

To what extent were signing bonuses used in ASC – and did their use reduce the number of advertised vacancies?

To look at this, we break out adult carer roles from Health care and Social Work jobs and that the increase in signing bonuses persisted:

What do we know about the size of these signing bonuses? And how do these compare to other occupations?

The median value of signing bonuses for ASC roles was £500 at their peak in November 2021. Their value was found to be low relative to the average signing bonus across all occupations (Figure 7 Panel B) and relative to warehouse operatives (Figure 7 Panel C), an occupation for which acute but short-lived shortages were evident at the end of 2021.

Broader evidence shows that the pay premium that had previously existed in ASC relative to other occupations has been reversed… e.g. "sales and retail assistants… earned 13p an hour less than care workers in 2012/13, but in 2019/20 they earned 21p an hour more on average" [Sarah O'Connor, FT, 22 August 2022]

Others have argued that care workers could now earn more by working in a supermarket, where they would generally have less responsibility and more standard working hours.

Part of the story here is what has happened with pay compression at the lower end of the wage distribution, which has been linked to the implementation of successive rises in the national minimum (or living) wage and, crucially, funding pressure on Local Authorities.

Another strategy used to address labour shortages in ASC is to attract migrant workers. On 24 December 2021, following the recommendation of the Migration Advisory Committee, the UK Government announced Adult Carers would be added to the list of shortage occupations eligible for working visas. The ASC visas became effective from 15 February 2022. But it is important to note that ASC employers saw problems with this approach.

First, employers' costs when applying for a visa are significant: first, administrative costs are involved in registering, then fees of £536 for small businesses and charities or £1,476 for medium/large organisations per application. A further concern was that having sponsored a worker (and paid the cost of doing so), there was nothing to stop the worker from moving to another sponsor, particularly to similar but better-paid roles within the NHS, leaving the ASC employer out of pocket and back where they started.

More crucial, however,  an eligible migrant ASC worker must have an offer of employment which pays at least £20,480 gross per year (regardless of hours worked) or 39 hours per week paid at a minimum of £10.10 per hour.

What do we know from the data about salaries in ASC?

Analysing Adzuna's pay information, it becomes clear that only the best-paid 5% of advertised roles met the salary threshold in Febuary-March 2022. Furthermore, a smaller proportion of job openings met this threshold in March 2022 (the first full month of the scheme being operational) than four years earlier; this further illustrates pay compression and falling median hours of paid work within the sector.

In short, whilst the recent decision to offer visas for those working in ASC might be helpful to alleviate challenges in ASC recruitment, further changes must be made to ensure that more advertised roles exceed the salary threshold.

This evidence adds weight to urgent calls for additional government action, including the need to make progress with long-overdue funding reforms. Without this, unmet care needs will continue to grow, as will consequential problems within the UK's National Health Service.

Read the full paper here.

UBDC’s Adzuna datasets are available for non-commercial academic use here.‍