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Social Care’s unsustainable reliance on agency staff needs urgent government intervention

Updated: May 10, 2023

As providers of social care services continue their struggle to recruit more staff there is increasing evidence of more reliance on agency staff to sustain their level of service.

A study carried out by ‘Research by Care England’ found almost eight in 10 providers (78%) were using more, or significantly more, agency staff in May and June this year than they had been in April 2021.

The findings were based on a survey, answered by 95 care home, home care and supported living providers, collectively responsible for 70,000 registered beds.

An even larger majority (88%) said it had become more difficult to book temporary workers than in April 2021, with a similar proportion (86%) stating that the cost of agency staff had risen over that period. Providers said the cost of engaging an agency worker was double that of a permanent staff member for both carer roles (£19.57 versus £9.90 per hour) and nursing positions (£37.56 versus £19.49).

Respondents also said that their increasing reliance on agency staff was affecting quality of care, with 73% finding locums less reliable.

The reliance on agency staff is unsustainable

Care England chief executive Martin Green said the sector’s “costly and increasingly unsustainable reliance on agency staff” was a response to the 52% rise in vacancies – equivalent to 55,000 positions – during 2021-22, reported recently by Skills for Care.

Green added: “The use of agency staff has been a bandage over more deep-routed recruitment and retention issues, which now, expectedly, are unravelling. The results of our recent survey demonstrate the severity of these issues, with the usage and cost of agency staff increasing dramatically over the last year. This is not only affecting the quality and continuity of care but compounding pressures on the NHS.

Factors affecting staff shortage

A range of factors have been cited for social care’s staffing shortage, including burnout relating to working through the pandemic, employees leaving for better-paid roles in other sectors such as retail, and comparable jobs in the NHS offering more money.

Just under eight in 10 (77%) of respondents to Care England’s survey, which included residential and domiciliary care and supported living providers, said their staff were leaving the sector, according to exit interviews. Two-thirds cited pay and just under half mentioning stress.

Government response to the problem

The government have announced plans to expand overseas recruitment, but reported delays in granting work permits will do little to alleviate the problem in the short term. It is also allocating £500m to boost the career development and wellbeing of social care staff over the next three years.

However, Green said this was “wholly insufficient”, with the £500m amounting to “5.7p per hour for each sector employee; this does not begin to touch the sides of such vast workforce pressures”.

Care England backed calls, issued most recently by the House of Commons’ levelling up select committee, for the government to inject £7bn a year extra into adult social care, including to boost recruitment and retention, while also urged action to tackle use of locum staff, including consideration of a cap on agency fees, as is the case in the NHS.

“Whether it be a proportional cap on agency fees, a mandatory approved framework or further discussions with stakeholders in the sector to come up with pragmatic solutions, this is a matter of urgency; not just for the ASC workforce, but for vulnerable people in receipt of care, and the wider population,” it said.


Social care reliance on agency staff is unsuitable and that is why we have seen so many go to the wall. The only winners in this situation are the agencies who are charging double the hourly rate normally paid to staff.

The government response I believe is just a sticking plaster that is totally inadequate to the real need of social care that has been identified by the House of Commons’ levelling up select committee.

We will have to wait until the new Secretary of State for Health and Social Care Therese Coffee gets her feet under her desk and comes up with a realistic plan. What we do know is bed blocking is costing the NHS millions and depriving people of their independence. Money that could be better spent on quality social care services in the community.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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