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What Does Brexit Mean for the UK Social Care Workforce? Perspectives from the Recruitment and Retention Frontline

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What Does Brexit Mean for the UK Social Care Workforce? Perspectives from the Recruitment and Retention Frontline View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Bournemouth University Research Online Received: 4 December 2017 | Revised: 9 October 2018 | Accepted: 22 October 2018 DOI: 10.1111/hsc.12684 ORIGINAL ARTICLE What does Brexit mean for the UK social care workforce? Perspectives from the recruitment and retention frontline Rosie Read | Lee‐Ann Fenge Faculty of Health and Social Sciences, Bournemouth University, Abstract Bournemouth, UK The UK’s departure from the European Union (Brexit) is likely to result in greater im‐ Correspondence migration and employment restrictions on European Union/European Economic Rosie Read, Faculty of Health and Social Area (EU/EEA) nationals within the United Kingdom. EU/EEA citizens constitute a Sciences, Bournemouth University, Bournemouth, UK. significant proportion of the current social care workforce. Research evaluating the Email: [email protected] impact of Brexit on social care has highlighted potentially severe future workforce Funding information shortfalls, but has not engaged in detail with the experiences of social care personnel Bournemouth University involved in day‐to‐day recruitment and retention activities. This article explores how social care managers evaluate Brexit’s prospects for future workforce sustainability, through the prism of their organisation’s workforce requirements. This qualitative study incorporated in‐depth semi‐structured interviews and questionnaire surveys with domiciliary and residential care managers. Data collection focused on an urban conurbation in south‐west England, with demographic characteristics likely to make post‐Brexit recruitment and retention in social care particularly challenging. A key finding is that, irrespective of whether they employ EU/EEA workers or not, research participants have deep concerns about Brexit’s potential impact on the social care labour market. These include apprehensions about future restrictions on hiring EU/ EEA nurses, as well as fears about increased competition for care staff and their or‐ ganisation’s future financial viability. This article amplifies the voices of managers as an under‐researched group, bringing their perspectives on Brexit to bear on wider debates on social care workforce sustainability. KEYWORDS Brexit, care homes, domiciliary care, management, migration, social care workforce 1 | INTRODUCTION Age, 2016), concern has been raised about the impact of any future immigration restrictions after Brexit. The health and social care The narrow victory for “leave” in the referendum on Britain’s mem‐ workforce shortfalls resulting from various possible post‐Brexit im‐ bership of the European Union (EU) in June 2016 produced much migration policies have been statistically modelled (Independent commentary about the impact of Britain’s exit from the EU (Brexit) Age, 2016; Marangozov, Williams, & Bevan, 2016), and the dra‐ on the health and social care workforce. As both sectors’ reliance matic decline in UK registration of nurses from the EU over the past on skilled and unskilled migrant labour from the EU and European 12 months has received much media exposure (see, e.g., Campbell, Economic Area (EEA) has grown over the past decade (Independent 2017, Triggle, 2017). Yet the perspectives on Brexit among social This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2018 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd. Health Soc Care Community. 2018;1–7. wileyonlinelibrary.com/journal/hsc | 1 2 | READ AND FENGE care personnel at the frontline of recruiting and retaining care staff have not yet been researched in detail (c.f. Moriarty, Manthorpe, & What is known about this topic Harris, 2018). This article deepens understanding of how social care manag‐ • European Union/European Economic Area (EU/EEA) ers in the UK perceive Brexit’s impact on future staff recruitment citizens make up a significant proportion of the UK’s so‐ and retention within their organisations. Based on research con‐ cial care workforce. ducted across residential and domiciliary social care organisations • The UK’s departure from the EU (Brexit) may result in in the south‐west of England, this study explores the perspectives greater immigration restrictions on EU/EEA workers. on Brexit among social care personnel with detailed working knowl‐ • Potentially serious workforce shortfalls could result edge of social care labour markets, who are directly involved on a from Brexit, exacerbating current recruitment and re‐ day‐to‐day basis with managing and recruiting care staff for their tention problems in social care. services. What this paper adds • A detailed, qualitative investigation of social care man‐ 2 | THE SOCIAL CARE WORKFORCE IN agers’ perspectives on Brexit. ENGLAND • Insight into their varied concerns about Brexit’s impact, whether their organisations rely on EU/EEA workers or In England, social care is characterised by a decentralised quasi‐mar‐ not. ket model of provision (Glendinning, 2012). Service users’ eligibil‐ • Analysis of how these concerns reflect the labour re‐ ity for state support in financing care is determined through tight quirements and conditions of their organisations. means tested criteria (Tanner, Ward, & Ray, 2017). The impact of central government austerity measures since 2010 has resulted in reductions to state funding for social care, creating financial difficul‐ proportion of total costs. Recent analysis by the CQC suggests that ties for organisations that rely heavily on publicly funded contracts “staff costs are around 60% of total costs in residential care homes, (CQC, 2016; Kings Fund, 2016; Local Government Association, and around 80% in domiciliary care” (CQC, 2016, p. 58). The limits 2016). Most social care is funded privately from the income and as‐ on available funding constrain the ability of many employers to offer sets of individual service users (Glendinning, 2012; Mayhew, Smith, wages at an attractive level, and low pay in social care remains wide‐ & O’Leary, 2017). spread (Hussein, 2017). The majority of the 1.58 million jobs that make up the social The UK position is mirrored across the economically developed care workforce in England are not professionally regulated and en‐ world to a greater or lesser extent. Demand for care and support tail the provision of front line direct care (Skills for Care, 2017a). for managing long‐term conditions linked with ageing populations is Professionally regulated jobs (e.g., nurses, social workers) account on the rise, while waged care workers and informal care providers for only 5% of the total workforce and supervisory and management (such as family carers) are in increasingly short supply (Gammage & roles only 7% (Skills for Care, 2017a). The Care Quality Commission Stevanovic, 2018; Hussein & Manthorpe, 2005). In much of the de‐ (CQC 2016, p. 58) recently estimated that “non‐British EU workers veloped world, migrant populations bolster the overall supply of care made up 7% of the adult social care workforce in 2015/16—equating workers (Glinos, 2015; WHO, 2017; Yeates, 2012). Problems with to around 90,000 jobs.” recruitment and retention of care workers in long‐term care settings Demand for social care services in England is growing expo‐ have been observed internationally and linked to a common set of nentially, yet recruitment and retention are long‐term endemic issues, including low pay and poor working conditions, low public problems. Across the United Kingdom as a whole, turnover rates in esteem for the work, and lack of opportunities for career advance‐ non‐professionally regulated direct care roles increased from 28.4% ment (Chenoweth & Lapkin, 2018; Estabrooks, Squires, Carleton, in 2012%–2013% to 33.8% in 2016–2017 (Skills for Care, 2017a) Cummings, & Norton, 2015; Hussein & Manthorpe, 2005; Razavi & with vacancy rates hovering around 7% (Skills for Care, 2017a). Staab, 2010). Turnover is higher among lower paid and less secure jobs, in par‐ ticular “zero hours” employment contracts, in which the employee is not guaranteed a minimum number of working hours and may be 3 | SOCIAL CARE AND BREXIT asked to change their working hours regularly and at short notice (Skills for Care, 2017a). These patterns persist despite the imple‐ The UK/EU referendum and its aftermath focused public attention mentation of the National Living Wage which has increased wages on EU/EEA immigration to the United Kingdom and amplified calls in the lowest paid roles, indicating that “employers are struggling for its future restriction after Brexit. From the 2016 referendum to find, recruit and retain suitable people to the sector” (ibid, p. 5). until the time of writing, the UK government and the main opposi‐ Increased wages not only incentivise recruitment into the workforce tion Labour party have remained committed to ending Freedom of but also heighten financial pressures as staff costs represent a high Movement, a key principle of EU law which enshrines the right of EU READ AND FENGE | 3 citizens to live and work anywhere within EU member states, free 5.1 | Research location from discrimination based on their nationality. The UK government has recently reaffirmed its commitment to a post‐Brexit immigration The choice of research site was methodologically significant, as
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