LTCcovid Country Profiles

Responses to 2.09. Impact of the pandemic on workforce shortages in the Long-Term Care sector

Australia

Staff shortages

Care providers have experienced staff shortages. As of 14th January, workforce surge staff have filled around 60,000 shifts in aged care facilities due to COVID-19.

Last updated: January 18th, 2022

Austria

According to a recent report by The Federation of European Social Employers, Austria has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Belgium

According to The Federation of European Social Employers (February 2022 report), Belgium has reported an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Bulgaria

According to a recent report (February 2022) by The Federation of European Social Employers, Bulgaria has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Canada

There are media reports of a surge in COVID-19 cases driven by the spread of the Omicron variant resulting in staffing shortages across the country, and leading to shortages of a range of services, including home care. Providers reported that the recent staffing shortages throughout the workforce have left the already troubled sector in further crisis (see section 2.04 of this report for more details on access to care).

Last updated: January 26th, 2022

Croatia

According to a recent report (February 2022) by The Federation of European Social Employers, Croatia has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Czech Republic

An OECD paper  as well as other sources indicated that Czech Republic faced  staff shortages during the pandemic, the country attempted to address those by providing financial help to LTC facilities to recruit unemployed or former LTC workers, as well as providing financial help to LTC facilities to recruit LTC students.

Last updated: January 26th, 2022

Denmark

Already before the pandemic, the LTC sector in Denmark was, similar to other countries, in need for the recruitment and retention of more staff.  During the pandemic the shortage of staff in the LTC sector became even more prominent. According to The Federation of European Social Employers (February 2022 report), Denmark has reported an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

The general shortage of staff has put pressure on those continuing to work in the sector.  There have been reports of more than half of staff in nursing homes being either ill themselves or being in isolation (source: https://www.fagbladetfoa.dk/Artikler/2020/06/25/Syv-dage-med-faellestillidsrepraesentant-paa-coronasmittede-Vendelbocenter-i-Hjoerring).

Service providers have struggled to keep service provision, e.g. in Dec 2021 some municipalities were forced to ask their employees to continue working even though there were supposed to be in isolation (source: https://www.fagbladetfoa.dk/Artikler/2021/12/07/Kommune-opfordrer-ansatte-i-aeldreplejen-til-at-arbejde-trods-anbefaling-om-isolation).

It was common for staff working in other areas to be deployed for social care provision. Some municipalities activated emergency plans and amongst other paid out extra salary to employees who would take an extra shift (source: https://www.fagbladetfoa.dk/Artikler/2022/01/25/Knap-hver-7-ansatte-i-aeldreplejen-er-blevet-smittet-i-aarAlle-er-slidte).

Last updated: May 25th, 2023   Contributors: Daisy Pharoah  |  Tine Rostgaard  |  

Finland

According to a recent report (February 2022) by The Federation of European Social Employers, Finland has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

France

France recorded high levels of staff sickness, together with poor working conditions for staff entering the profession during the pandemic, and limited support during, led to chronic workforce shortages in LTC sector. Most staff were paid ‘Covid bonus’ of up to €1,500. However, staff shortages, in turn led to care staff taking on difficult tasks (e.g. end of life care) and also contributed to limited access to care.

According to a recent report (February 2022) by The Federation of European Social Employers, France has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Germany

Similar to other countries, Germany experienced workforce shortages during the pandemic. To address these, Germany supported the recruitment of LTC students through financial help to LTC facilities and increased/ lifted the maximum number of working hours (sources: Germany LTCcovid presentation; COVID-19 in long-term care: impact, policy responses and challenges).

According to a recent report (February 2022) by The Federation of European Social Employers, Germany has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Hungary

OECD report indicated that Hungary faced similar staff shortages during pandemic to other countries, there were efforts to recruit volunteers from the health sector to address the challenges (e.g. students, professionals in private sector).

Last updated: January 26th, 2022

Ireland

According to a recent report (February 2022) by The Federation of European Social Employers, Ireland has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Italy

During the first wave of the pandemic, a large share of nurses and doctors left long-term care (LTC) settings to enter the national health service, which was recruiting professionals to cope with the outbreaks in hospitals. Since then, the shortage of LTC personnel keeps growing, and as of December 2021 there were no plans to increase the LTC workforce (source: LTC system and the pandemic December 2021; Amnesty International Report 2021).  Conversely, an OECD paper indicated that in several Italian regions (e.g. Apulia, Lombardy, Piedmont, Veneto), an important hiring effort was implemented during the first wave of pandemic attracting many professional care workers thanks to public sector contractual conditions (generally better contracts applied in private nursing homes).

According to a recent report (February 2022) by The Federation of European Social Employers, Italy has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Netherlands

An OECD paper and other sources indicated that the Netherlands has experienced staff shortages during the various waves of pandemic. To address these, the country provided financial help to LTC facilities to recruit unemployed or former LTC workers, and provide financial help to LTC facilities to recruit students. LTC facilities also received financial support that they could use independently; including for stafff recruitment. Moreover, a pool of volunteers for emergencies was activated to boost staff at the start of the pandemic.

However, according to a recent report (February 2022) by The Federation of European Social Employers, The Netherlands has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Norway

Norway experienced staff shortages during the various waves of the pandemic. This was mostly due to increased staff sicknesses and inability to recruit new staff. In fact, a report (February 2022) by The Federation of European Social Employers, states that Norway has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

To address workforce shortages in LTC sector, Norway has taken several measures. For example, the maximum number of working hours allowed has been increased or lifted, visas for foreign workers in LTC facilities have been temporarily extended, and the country has provided financial help to LTC facilities to recruit unemployed or former LTC workers and to recruit LTC students (source: LTCcovid Norway presentation; COVID-19 in long-term care: impact, policy responses and challenges).

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Poland

During the pandemic, pre-existing workforce shortages were exacerbated (source Poland presentation; Long-term care in Poland Nov 2021). According to a recent report (February 2022) by The Federation of European Social Employers, Poland has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Joanna Marczak  |  Daisy Pharoah  |  

Portugal

An OECD paper  notes that Portugal’s LTC facilities experiences staff shortages during the pandemic, exacerbated by high levels of sickness among staff, e.g. workers in LTC facilities accounted for about a third of COVID-19 related sick leave.

Last updated: February 1st, 2022

Romania

According to a recent report (February 2022) by The Federation of European Social Employers, Romania has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: February 5th, 2022   Contributors: Daisy Pharoah  |  

Spain

In December 2020, It was agreed by the Territorial Council of Social Services (TCSS) and the System for Autonomy and Care for Dependency (SAAD), that weekly IMERSO reports would be published for the duration of the pandemic. These reports contain information about how residential centres are coping during the pandemic.

The reports show that during the peak of each wave of the pandemic, the number of staff infected with Covid-19 was lower than the number of infected residents of the centres. This was not the case in the last weeks of December 2021 and first week of 2022, where the number of infected care home staff exceeded that of residents.

To guarantee services for people who rely on care from others during the pandemic, the TCSS and SAAD decided in March and October 2020 (and again in December 2021) that care home staff could be exempted from holding a professional qualification for the duration of the pandemic.

Survey data suggests that the number of long-term care (LTC) workers in Spain increased by 7% during the first wave of the pandemic. The increase was driven by the private sector recruiting female temporary staff; mostly part-time. Conversely, in Navarre, Spain, over 24% of workers in LTC facilities took at least one medical leave, and three-quarters of LTC facilities had at least one employee who took leave during the first wave.  Leave in context of staff shortages limited the capacity to respond effectively to the pandemic (Source: OECD paper). More recently, concerns have been voiced around staff shortages linked to the spread of the Omicron variant (Source: Territorial Council for Social Services, 2021).

According to a recent report (February 2022) by The Federation of European Social Employers, Spain has experienced an increase of between 1 – 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: June 29th, 2022   Contributors: Daisy Pharoah  |  Sara Ulla Díez  |  

England (UK)

One of the key messages from the recent State of Care report (by the CQC) is that although staffing pressures have been felt across both the health and care service delivery sectors, the impact of the pandemic has been seen most acutely in all areas of adult social care (including care home and home-care services).

The care workforce has been under increasing pressure due to people leaving the social care sector, which happened at a steadily increasing rate throughout 2021. Various factors explain the decline in care staff over this period, for example the appeal of more attractive salaries in the retail and hospitality industries, staff from adult social care (especially nurses) taking vacant posts in hospitals, and the requirement for all care home workers to be fully vaccinated against COVID-19 (as of 11 November 2021) (Source: CQC).

Workforce shortages: impact on mental health

Workforce shortages were reported as a key source of stress and anxiety in healthcare staff in a study by Nyashanu et al. (2020). Authors of this study collected data through interviews with forty healthcare workers from nursing homes (n = 20) and domiciliary care agencies (n = 20) in the English Midlands in the early phase of the pandemic (before May 2020) to explore triggers of mental health problems. Sickness rates increased and some had to use leave entitlements – this caused staff shortages and for the remaining staff to become increasingly mentally and physically drained. Participants reported feeling stressed and anxious in particular when shifts were being covered by agency staff who could have been exposed to the virus from working elsewhere.

Omicron wave

The rapid spread of the Omicron variant has had a drastic impact on the ability of social care providers to continue to offer services due to very high rates of staff sickness (ADASS).  In January 2022, more than 90 care operators declared a ‘red’  alert i.e. they don’t have the staff to meet demand (see section 2.04 of this report for more details on the impact on pandemic on access to care); these operators also reported an 18% vacancy rate and 14% absences as a result of Omicron, the vacancy rate was up from 9.4% in December 2021 (Skills for Care, 2021). Some providers reported having to close (some of their) care homes due to acute staff shortages, others report that care workers are under considerable pressures due to staff shortages  (see also section 3.06 of this report for more details on measures to ensure workforce availability).

References:

Nyashanu, M., Pfende, F., & Ekpenyong, M. S. (2020). Triggers of mental health problems among frontline healthcare workers during the COVID-19 pandemic in private care homes and domiciliary care agencies: Lived experiences of care workers in the Midlands region, UK. Health & Social Care in the Community. https://doi.org/10.1111/HSC.13204

Last updated: March 8th, 2022

United Kingdom

According to a recent report by The Federation of European Social Employers, The United Kingdom has experienced a strong increase of over 10% in staff shortages since 2021. The sub-sector most critically affected by staff shortages across the countries surveyed for this report were services for older persons. The job position most affected was nursing, but care assistants and homecare / social care workers also face real shortages. The most common reasons given for staff leaving the social care sector for another include low wages, and mental and physical exhaustion relating to the pandemic.

Last updated: March 8th, 2022   Contributors: Daisy Pharoah  |