LTCcovid Country Profiles

Responses to 4.05. Reforms to address Long-Term Care workforce recruitment, training, pay and conditions

Bulgaria

An EU report (2021) noted that a new social services law in Bulgaria established the right to training for LTC workers and the right to supervision.

Last updated: September 13th, 2021

Ontario (Canada)

To improve staffing levels, in November 2020, the Ontario government announced funding to increase the average daily direct care from a nurse or personal support worker  per long-term care resident to four hours a day by 2025. The Act proposes to enshrine this commitment in legislation, and to increase care provided by allied health care professionals to an average of 36 minutes per resident per day by March 31, 2023. The proposed Act provides that higher (but not lower) targets of average care may be established by regulation (source: Fixing Long-Term Care Act, 2021;New Legislation To Reform Ontario’s Long-Term Care Sector).

Last updated: December 10th, 2021

Croatia

An EU report noted that Croatian government launched a programme in 2017 to encourage the employment of disadvantaged women (especially 50 years old+) to provide support and care for older people, the programme was serving around 30,000 people, and employed 6,000 women in 2020.

Last updated: September 13th, 2021

Czech Republic

An EU report (2021) noted that the Czech government has continually and significantly increased the wages of employees in LTC sector since 2014 which is likely to have made the profession more attractive.

Last updated: September 13th, 2021

Denmark

There have been attempts to attract and retain workers to the formal care sector following the action plan ‘More hands in the older person and health sector’ of the Association of Municipalities from 2018. These have not least attempted to get more young people to start training as home and health care assistants or helpers. The measures span information campaigns, higher wages, and better collaboration between relevant partners to attract, educate and retain more workers. These efforts have so far not proven successful, perhaps partly due to the poor image of the sector with the general public, including the young people who are intended to take up education and look for work in the sector (source: Publications catalogue – Employment, Social Affairs & Inclusion – European Commission (europa.eu).

References:

Lauritzen, H.H.; Jensen, M.C.F. and Kjer, M.G. (2022) Analyse af social- og sundhedsfagenes image og imageudfordringer Rekruttering til og fastholdelse i social- og sundhedsfagene https://www.vive.dk/da/udgivelser/analyse-af-social-og-sundhedsfagenes-image-og-imageudfordringer-18142/

Last updated: May 25th, 2023

France

Following the Segur de la Sante a number of measures were taken to increase the attractiveness of careers in health and care. 

To increase the attractiveness of the residential and nursing home sector as a route of employment, care worker pay was reviewed in 2020 and increased by 183€ per month in public and not-for-profit residential and nursing homes for older people, and by 160€ per month in for-profit care homes (source) 

Criticisms around the disparity in the distribution of salary increases – focused initially only on the public sector for older people – led to an inquiry into increasing attractiveness and salary rates across the entirety of job roles from public to private and for disabled care services also (Mission Laforcade). This has led to a wider approach to salary increases to ensure increases regardless of the financing of employment (whether post is financed through regional health authority or local authority), ownership, and job (e.g. expanded tot include educational support, psychological support etc.) Timeline of salary increases for staff working in long-term care professions, (see here, here, here and here): 

• September 2020. Salary increases for staff working in residential nursing care for older people:  

• Publicly-owned and not-for-profit: 183€ per month 

• For-profit: 163€ per month  

• June 2021. Extension of salary increases to: 

• Staff working in non-nursing residential settings for older people 

• October 2021. Extension of salary increases to: 

• Staff working in autonomous public non-nursing residential settings for disabled people 

• Staff working in public domiciliary care for older or disabled people (13-15% increase based on experience) 

• Staff working in extra care settings 

• November 2021. Extension of salary increases to: 

• Staff working in local authority-funded non-nursing care services (all age) 

• Some staff working private not-for-profit care 

• April 2022. Final extensions to: 

• Staff working in publicly-funded care services previously excluded from other rounds of increases 

• Staff working in specific private not-for-profit care services 

• Other public employment roles, including social workers 

An 2,330 additional training places?for nurses were also created. 

Since the implementation of these measures, some challenges have been observed around their implementation. For instance, not all staff have benefitted from increases to salary depending on how their employer is financed (e.g. by the local authority) (source). Non-care staff (e.g. administrators, technicians…) are also not affected by the salary increases, which is leading staff to exit these roles to other better paid sectors and creating difficulties around recruitment (source).  

Last updated: October 23rd, 2024   Contributors: Adelina Comas-Herrera  |  Camille Oung  |  

Malta

An EU report (2021) noted that jobs in the LTC sector are being made more attractive through new training opportunities at tertiary level, with the launch of certified training programmes for potential carers.

Last updated: September 13th, 2021

Netherlands

An EU report (2021) noted that the Netherlands implemented numerous measures in 2017, including: improved working conditions; better protected contracts (e.g. open-ended contracts, flexible working time, leave); better matching of supply and demand. The government programmes also focus on improving the attractiveness of the sector via image campaigns as well as other measures improving working conditions and training.

Last updated: December 2nd, 2021

Sweden

In 2020 (partly due to pandemic) a reform was introduced in Sweden whereby LTC employees are offered paid training to become, for example, assistant nurses. Local authorities and the relevant trade union agreed to offer a permanent full-time job for those who participate in this training (source: Employment, Social Affairs & Inclusion – European Commission).

Last updated: November 30th, 2021

England (UK)

A Health and Social Care Levy was announced by the government on September 9, 2021. As part of this £36 billion investment to reform the NHS and social care, at least £500 million will be allocated for funding the care workforce across three years. It is reported that it represents a five-fold increase in public spending on the skills and training of care workers and registered managers. The government have committed to providing additional support for the continuous professional development of the workforce, including training places and certifications for care workers. The funding will also be directed to mental health wellbeing resources and to provide access to occupational health funding (DHSC, 2021a).

The government announced that this would be accompanied on November 3, 2021, with a new recruitment campaign to encourage people to apply for roles in the adult social care sector. ‘Made with Care’ will launch across broadcast and social media for five months and will highlight vacancies in the sector as well as showcasing the work care workers do. However, many organisations and sector leaders have raised concerns that the existing funding and measures in place are not sufficient to mitigate a deepening workforce crisis ahead of a difficult winter.

The government published its White Paper on social care reform on 1st December 2021 (DHSC, 2021b). In it were a suite of initiatives for strengthening the skills and training of the social care workforce. These include the establishment of a Knowledge and Skills Framework, portable care certificates, and support for mental health and wellbeing. However, it stopped short of enhancing pay and no new money beyond the previously announced (£500m over three years from the health and social care levy) and the £162.5m for the winter of 2021/22 was allocated to workforce initiatives (Source: Workforce Recruitment and Retention Fund for adult social care).

Visa Relaxation for Migrant Care Workers

In December 2021 , addressing unprecedented challenges prompted by the pandemic, the government announced a temporary relaxation of immigration rules for overseas care workers in an attempt to recruit and retain care staff. Care assistants and home and social care workers are to be added to the Shortage Occupation List (SOL) in early 2022 and will be eligible for a 12-month health and care visa; allowing migrants to fill gaps in workforces. It is proposed that these measures will be in place for at least 12 months (Sources: BBC News and gov.uk).

References:

DHSC (2021a). Health and Social Care Levy. Department of Health and Social Care Policy Paper. Retrieved from: Health and Social Care Levy. Accessed on 28/03/2022

DHSC (2021b). People at the Heart of Care: adult social care reform white paper. Department of Health and Social Care Policy Paper. Retrieved from: ASC Reform White Paper.  Accessed on 28/03/2022

Last updated: March 28th, 2022   Contributors: William Byrd  |  Nina Hemmings  |  Natasha Curry  |  Daisy Pharoah  |  

Northern Ireland (UK)

The ‘Social Care – Making a Difference’ campaign has been developed by the Northern Ireland Social Care Council (NISCC) on behalf of the Department of Health as part of its ongoing work to reform Adult Social Care. The campaign highlights that social care staff are an integral and valued part of the health and social workforce and their work is critical to the sustainable provision of social care services now and in the future. This campaign went live on May 10, 2021 and is centred on local social care workers, whose stories are told through video and photography while highlighting the diversity, impact and importance of social care and the positive difference it makes in people’s lives (Source: Adult social care recruitment campaign launched).

Last updated: March 28th, 2022

Scotland (UK)

In April 2020, the Scottish Government announced an immediate 3.3% pay increase for all social care staff in recognition of the vital work they carried out during the pandemic.

Last updated: March 28th, 2022   Contributors: Jenni Burton  |  David Henderson  |  David Bell  |  Elizabeth Lemmon  |