Key points

  • COVID-19 is putting unprecedented pressure on people working in health and social care. However, even before the pandemic, staffing was the biggest single challenge for the NHS and social care in England, and was having a direct impact on patient care and staff experience.
  • Our updated projections show that the NHS faces a workforce shortfall of over 115,000 full-time equivalent staff in England this year. On current trends, this gap will double over the next 5 years. These projections are based on data released up to February 2020 and do not account for any COVID-19 impacts.
  • While the NHS is experiencing significant staffing pressures, the issues in social care are even greater and the outlook is concerning. One measure of the workforce supply gap is the vacancy rate. This rose from 5.5% in 2012/13 to 7.8% in 2018/19, and 9.3% in London – the region with the highest rate. The number of vacancies in social care in England is estimated to average 122,000 at any one time.
  • The long-term impact of COVID-19 on the health and social care workforce will take time to quantify and understand. In the meantime, a comprehensive workforce plan for both the NHS and social care is needed now more than ever.

How big was the workforce gap in the NHS in England going into the COVID-19 outbreak?

COVID-19 is putting unprecedented pressure on people working in health and social care. But even before the COVID-19 outbreak staffing was the biggest single challenge for the NHS in England, and was having a direct impact on patient care and staff experience.

Our updated projections indicate that based on current trends, existing NHS workforce gaps in England will expand significantly in the coming years, undermining future service sustainability.

We assume that the number of staff in post follows the average trend since 1995/96 and that the number of additional funded posts grows in line with health care activity growth in Securing the future. Even before accounting for the implications of COVID-19, the NHS is projected to face a workforce shortfall of over 115,000 full-time equivalent staff in England this year. Based on current trends, and without major shifts in workforce policy and planning, this NHS workforce supply gap will double over the next 5 years and is projected to exceed 370,000 by 2030/31.

What’s the current picture for social care workforce vacancies?

While the NHS is experiencing significant staffing pressures, the issues in social care are even greater and the outlook is concerning.

Other analysis in this series highlights the stark impact of the COVID-19 pandemic on the social care sector. This chart explores long term and significant gaps in the social care workforce supply.

The available data on social care are insufficient for us to offer a projection of the potential future shortfall in social care workforce supply, as we do for the NHS. However, the staff vacancy rate can be used as one measure of workforce supply gaps. Research also suggests that increases in vacancy rates in social care are associated with poorer standards of care.

According to data from Skills for Care, the vacancy rate in social care roles in England rose from 5.5% in 2012/13 to 7.8% in 2018/19.

The number of vacancies increased by 54% between 2012/13 and 2018/19 and is estimated to average 122,000 at any one time. This figure is substantial given that the sector employs around 1.5 million people in England.

London has consistently registered the highest vacancy rate across all regions, with over 16,000 recorded social care vacancies in 2018/19. This amounts to a vacancy rate of 9.3%. In other words, a vacancy exists for approximately every ten people employed in social care jobs in the capital.

What should be done?

A comprehensive workforce plan for both the NHS and social care, along the lines of the Interim NHS People Plan, is needed now more than ever. With the publication of a full NHS People Plan having been delayed well in advance of COVID-19, this now needs to be a focus.

Understanding the impact of COVID-19 and how it interacts with long term challenges facing the health and social care workforce will take time. The Health Foundation is establishing the REAL Centre to provide independent, objective and impartial evidence relating to long-term issues in the health and care system. Exploring and analysing the factors underlying workforce issues in health and social care will be a primary focus for the REAL Centre.

Nihar Shembavnekar is an Economist at the Health Foundation.

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