Staffing a ‘fundamental challenge’ for home care sector

Incoming HPMA president says HR needs to be at the centre of plans to modernise the NHS

Recruiting and retaining home care staff is a “fundamental challenge” for the health sector, according to experts including the incoming president of the biggest HR healthcare body.

A report from the King’s Fund has estimated there are around 110,000 unfilled vacancies at any one time in the home care sector, and said this is figure was likely to “increase significantly” as demand grows.

“Securing adequate workforce is one of the greatest challenges facing domiciliary care,” the report said.

“Many of the providers we spoke to identified difficulties in recruiting and retaining an adequate workforce, fuelled by a perceived unattractiveness and the low status of care work, which in turn relates to poor pay levels and job security.”

It added the demand for staffing was being exacerbated by competition for labour from both the NHS and from other forms of work including supermarkets, which offer more regular shift patterns, less anti-social hours, more stability in the number of hours available and in some cases higher wages.

Dean Royles, who was recently announced as the next president of the Healthcare People Management Association (HPMA), said the report highlighted the urgent need to address low pay in the sector. “We can’t go on expecting highly skilled staff to care for some of our most vulnerable citizens on the minimum wage, sometimes less,” he said.

“As a society, we have to question why we value caring roles so poorly. With an ageing population and a recruitment crisis in health and care, this is an urgent issue for politicians and policy makers.”

Royles, who will take over from Deborah Tarrant as HPMA president in April 2019, added the lack of funding in the home care sector reflected an issue affecting the whole of the health sector.

A “significant period of underfunding” in the NHS, as well as ongoing recruitment problems, has put more pressure on staff to deliver services and made keeping morale and motivation high a challenge, said Royles.

On top of this, and the additional staffing issues brought by Brexit, the NHS is going through a period of modernisation, during which Royles says HR needs to be “right at the centre”.

“What we effectively have is a system organised to deliver healthcare for pretty historic needs, when heart and lung disease were big killers,” he told People Management. “But increasingly, we need people to be cared for closer to home. We need to stop people getting into hospital in the first place, and we need the same sort of parity of esteem for mental health services as we have for things like cancer services.

“Those change in the way that healthcare needs to be delivered in the future [are] about the way we deploy people, the way that we train people, how we skill them up to deal with different things and also how we work them together more effectively in teams across different organisational boundaries to deliver that care. That’s HR right at the centre of that sort of change.”

This also means investing in upskilling line managers, who often come from a clinical background, to make them more effective people managers.

Royles added the health sector can’t continue to look at HR as a back office function “[The NHS] needs the best recruitment and selection processes, the best talent, the best training and development to deliver that and keep pace with a changing world,” he said.