Key messages
- staff turnover in social care is shaped by pay, conditions and progression opportunities
- recruitment initiatives include fast-tracked learning routes, apprenticeships and graduate programmes
- national recruitment campaigns have been used to raise the profile of social care work
- evidence on the effectiveness of innovations is uneven
- most evaluated initiatives pre-date the COVID-19 pandemic.
Policy implications
- workforce strategies should combine recruitment with retention-focused approaches
- learning and progression pathways may support workforce stability
- national initiatives need alignment with local labour market conditions
- future policy should build on a stronger and more current evidence base.
Gaps
- much of the evidence is pre-pandemic
- limited evaluation of long-term impacts on retention
- variation in study quality and outcome measures
- insufficient insight from staff into lived experiences of innovations.
Commentary
This rapid review highlights the range of approaches that have been used to attract and retain social care workers in the UK. Initiatives such as apprenticeships, accelerated learning routes and national campaigns reflect ongoing attempts to stabilise a workforce facing high turnover.
The findings also show how limited the evidence base remains. While many innovations appear promising, few have been robustly evaluated, making it difficult to assess which approaches genuinely improve retention over time. The predominance of pre-pandemic studies could arguably limit their relevance to current workforce pressures.
Thinking about equitable social care, the review raises questions about who benefits from workforce innovations. Access to training, apprenticeships and progression opportunities may vary by role, region and personal circumstances, potentially reinforcing existing inequities within the workforce. Where initiatives focus on entry rather than conditions, they may do little to address the factors that drive turnover among lower-paid or marginalised workers.
Overall, the review suggests that improving workforce sustainability requires more than isolated innovations. Building equitable and effective recruitment and retention strategies depends on better evidence, attention to working conditions and a clearer understanding of how initiatives affect different groups within the social care workforce.
Key messages
- workforce shortages across health and social care threaten the sustainability of services
- recruitment and retention difficulties are linked to low pay, poor working conditions and limited career progression
- a long-term workforce strategy integrating both health and social care planning is required
- international recruitment remains an important component of workforce supply
- continued policy inaction is likely to widen workforce gaps and affect service quality and outcomes.
Policy implications
- development of a long-term national workforce strategy that includes social care alongside the NHS
- improved pay, conditions and career pathways to support recruitment and retention
- workforce planning that accounts for demographic changes and rising demand for care
- ethical and sustainable approaches to international recruitment.
Gaps
- limited analysis of the contribution and pressures placed on unpaid carers within the workforce system
- the paper focuses on national workforce planning rather than regional variation in workforce pressures
- further research is needed on how workforce strategies can be implemented across both health and social care systems.
Commentary
This paper examines the structural drivers of workforce shortages across the UK health and social care system. It highlights how long-standing issues in workforce planning have left services vulnerable to rising demand and demographic change. Recruitment and retention challenges, combined with workforce ageing and increasing service pressures, contribute to persistent staffing gaps.
A key theme is the difference between workforce planning in the NHS and social care. While the NHS has national workforce planning mechanisms, social care remains more fragmented, with workforce planning largely shaped by local authority budgets and provider capacity. This creates variation in staffing stability and service provision across the system.
Financial pressures also influence working conditions and career opportunities. Lower pay and fewer structured progression pathways in social care contribute to high turnover and recruitment difficulties, reinforcing the cycle of workforce shortages.
In terms of care inequities, the paper highlights how workforce shortages can translate into uneven access to services. Areas with greater financial pressures or fewer available staff may experience more service disruptions and reduced continuity of care. At the same time, inequities within the workforce (particularly around pay and conditions between health and social care) reflect broader financial imbalances across the system. These dynamics demonstrate how funding structures influence both workforce stability and the distribution of care.
Overall, the report argues that sustainable workforce planning requires coordinated policy across health and social care. Without long-term investment and strategic planning, workforce shortages will continue to affect service availability and contribute to financial and structural inequities in care provision.
Key statistics
- around 65% of social workers reported insufficient staffing to adequately support people drawing on care and support
- workers aged 30-39 reported the highest sickness absence and strongest intentions to leave
- intentions to leave were not strongly associated with region, gender or job role.
Key messages
- perceptions of unsafe staffing levels are widespread
- workload and burnout negatively affect mental wellbeing
- increased administrative demands reduce time for direct practice
- reliance on agency staff reflects workforce instability
- wellbeing concerns are closely linked to intentions to leave the profession.
Policy implications
- safe staffing standards are needed to support practice quality and worker wellbeing
- reducing administrative burden may help retain staff
- addressing burnout could reduce sickness absence and turnover
- workforce planning should consider age-related risk of exit from the profession.
Gaps
- the sample is weighted towards respondents from Northern Ireland
- findings rely on self-reported data
- further research on safe staffing thresholds is ongoing.
Commentary
This study highlights the relationship between perceived staffing adequacy, wellbeing and retention among social workers. Many participants described feeling unable to meet the needs of people they support due to insufficient staffing, alongside growing administrative demands.
The findings show how workload pressures translate into sickness absence and intentions to leave, particularly among mid-career workers. Dependence on agency staff was described as both a symptom and a driver of instability, adding complexity to team functioning and continuity.
From a care equity point of view, the study illustrates how workforce shortages affect both workers and service users. Where staffing levels are inadequate, social workers have less capacity to provide timely and consistent support, increasing the risk of uneven access and outcomes for people drawing on care and support. At the same time, burnout and poor wellbeing disproportionately affect those in high-pressure roles.
Overall, the paper highlights that safe staffing is not only a workforce issue but a care quality issue. Improving staffing levels and working conditions is essential to sustaining an equitable social care system that supports both practitioners and the people they serve.
Key messages
- relationships between care staff and individuals drawing on support were central to job satisfaction
- pay was an important factor influencing decisions to stay or leave
- job fulfilment was linked to feeling valued and able to provide good care
- some staff actively sought alternative employment due to working conditions
- retention was shaped by a combination of relational, financial and organisational factors.
Policy implications
- retention strategies should recognise the importance of relationships in care work
- pay and conditions remain key levers for reducing turnover
- interventions to improve job satisfaction may support workforce stability
- intellectual disability services may require tailored retention approaches.
Gaps
- findings are based on qualitative data
- the study focuses on intellectual disability services only
- limited insight into the impact of specific retention interventions
- further research is needed on how organisational change affects retention.
Commentary
This study highlights the complex reasons why social care staff choose to remain in or leave roles, within intellectual disability services. While pay emerged as an important consideration, the quality of relationships with individuals receiving support was equally influential in shaping job satisfaction.
Participants described care work as meaningful when they felt able to build trusting relationships and provide consistent support. Where organisational pressures limited this relational aspect, motivation to stay diminished, even when staff valued the work itself.
Considering care equity, the findings point to how workforce instability can disproportionately affect people with intellectual disabilities. High turnover and staffing instability disrupts relationships that are central to continuity and quality of care, potentially leading to uneven experiences. At the same time, low pay and poor conditions reflect broader inequities faced by a workforce that is often undervalued.
Overall, the study suggests that improving retention requires attention to both material conditions and the relational nature of care. Supporting staff to remain in post is essential not only for workforce sustainability, but for delivering equitable and person-centred support to people with intellectual disabilities.
Key Stats:
- Almost two thirds of social workers stated that their service did not operate with a ‘staff-to-service ratio’.
- over 75% staff who have taken between 11 to 20 sick days from work are respondents who stated they do not work in a safe ‘staff-to-service’ ratio work environment.
Key Messages
- England has the highest proportion of staff working in unsafe staff-to-service ratios, followed by Northern Ireland.
- Staff in unsafe conditions are twice as likely to leave their organisation compared to those in safer environments.
- Workload pressures are increasing, with insufficient staffing to meet care needs, leading to unsafe working conditions.
- Staff report compromised practice, poor decision-making, and inability to follow procedures due to being overstretched.
- There is no capacity to cover absences or annual leave, resulting in frequent overtime.
- Staff are forced to prioritise administrative tasks over direct care, reducing time with those they support.
- Wellbeing is impacted: staff feel burned out, less resilient, and overwhelmed by unmanageable caseloads.
- Post-COVID pressures persist, with unreasonable demands from management and lack of understanding of burnout. Staff feel ignored by managers, with delayed responses and insufficient support from senior leadership.
- High turnover and intentions to leave the profession are driven by daily pressures and feeling unheard.
Commentary
This paper highlights the increasing pressures faced by the social care workforce due to limited capacity and insufficient administrative support. Staff report burnout from covering understaffed shifts, receiving low pay, and being unable to take annual leave without burdening their colleagues. These conditions compromise staff wellbeing and restrict their ability to move beyond crisis management, limiting opportunities for training, skill development, and career progression. While staff remain committed to meeting the needs of those who draw on care and support, the current staff-to-service ratios are unsustainable. Many report having less time to provide personalised care, with the shortfall directly impacting people who are drawing on services. This is recognised as a national issue, not just an organisational one, with widespread capacity challenges across the sector.
This article calls for urgent action to address workforce capacity, improve training, and support newly qualified social workers, who experience particularly high turnover rates. Current practice falls short of BASW’s guidance, which recommends 80% of time spent engaging with service users and 20% on administration. Limitations of the study include a homogeneous sample in regards to ethnicity and an overrepresentation of respondents from Northern Ireland. Additionally, authors note that findings may not be representative of all social workers, as those who responded to open-ended questions likely held strong views on the issues discussed.