New horizons: What can England learn from the professionalisation of care workers in other countries? – The Nuffield Trust

Published: 13/09/2022
Nina Hemmings
Camille Oung
Laura Schlepper
There is growing public recognition that care workers have long faced a formidable number of challenges. These include low pay, poor terms and conditions, hugely variable access to training, and limited opportunities for career development. These have been exacerbated in recent years by increased rates of sickness and burnout during the pandemic and changes to immigration rules following Brexit, which have led to intensified recruitment and retention challenges.
Perceptions of care work as ‘low skilled’ continue to persist, despite the pandemic highlighting just how vital care workers are. Their dedication and capability has also been recognised in Baroness Cavendish’s report. In recent years there has been increased debate around the ‘professionalisation’ of this staff group. This generally refers to the creation of a statutory register of staff and their professional regulation, and can involve improvements to pay, training and career development, and terms and conditions.
Our report reviews what the evidence shows about the professionalisation of care workers in other countries. It draws on the experiences of those other countries to inform policy reforms that England may wish to consider as part of a longer-term strategy for the adult social care workforce in this country.
Our review found that:
Care workers are first on the front line, delivering care in precarious conditions, but last to see meaningful acknowledgement of their perseverance. Protecting the health and safety of these staff should be a longstanding priority for employers and the DHSC, and not just during a pandemic. Ensuring that pay, training, and terms and conditions better reflect the value of care work to wider society is in the public interest. A number of workforce initiatives have recently been introduced, however, and there is now an opportunity for policy-makers to go further to reverse the deepening workforce recruitment and retention crisis in England. As governments across the world are taking increasingly bold and creative action to embed workforce reforms, there is much for England to learn as it pushes forward with planned reforms while considering further action as part of a longer-term adult social care workforce strategy.

Hemmings N, Oung C and Schlepper L (2022) New horizons: What can England learn from the professionalisation of care workers in other countries? Report, Nuffield Trust.
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